4 weeks - Zero AHIs, still waking up a lot

I'm now 4 weeks in with my Resmed S9.

AHIs and other events are pretty much zero and have been for the past 2 weeks. (Never more than 0.3 AHI).

My sleep has def improved, but not to where I'd like it to be. I'm basically still consistently waking up 4-8x per night once I start hitting REM sleep, and when I wake up, I still feel short of breath and sometimes my heart is pounding, just like when I have apnea. I'm a light sleeper so I suspect it's from my apnea starting up when I move to certain positions, but offset by the CPAP device. Most of these awakening events don't even register on the machine (I think I wake up before my breathing gets too disoredered.)

On the bright side, I no longer have to get up from sleep since I can actually go back to sleep, but I'm probablky 'wasting' an hour of sleep per night with all the wakeup time.

It's still overall much better than pre-CPAP where I had AHI=29 in REM sleep, but it's still far from normal, and I still do wake up tired, like I'm short an hour of sleep. (Thankfully not REALLy tired like pre-cpap).

I'm thinking of increasing my S9 CPAP pressure slowly to see if it helps. Any suggestions?

If you are going to stick around the forum why don't you register so we can see at a glance what equipment you are using?
See how I have done my equipment profile.

Which model machine are you using?
What pressure are you using?
Using EPR?, If so, at what setting.

Did you know about software to see the detailed graphs? See my signature link.

Don't go changing the pressure without an understanding of what is going on first. Like...maybe leaks..it wouldn't be impossible for leaks to be a factor in waking you up. Might not be the whole story but it's possible there are multiple things affecting sleep quality.

hhnngg1 wrote:
I'm thinking of increasing my S9 CPAP pressure slowly to see if it helps. Any suggestions?

Rig for data!!! If you are going to do self adjustment you really need to be able to see your nightly data.

If your machine is not data capable then if you are REALLY in a pinch you could use carefully recorded nighttime audio (you can hear events and often figure out what they are). On good nighttime audio you should be able to "see" each breath using an audio waveform editor such as Audacity.

But you need data to see what the results of the adjustmens are, to see the kinds of events that result or go away with adjustment. Simply you need feedback to adjust.

Then if you adjust consider seven to ten days at the new level to have enough data to make a decision about where to go next or if to make a further change.

hhnngg1 wrote:I'm now 4 weeks in with my Resmed S9.

AHIs and other events are pretty much zero and have been for the past 2 weeks. (Never more than 0.3 AHI).

My sleep has def improved, but not to where I'd like it to be. I'm basically still consistently waking up 4-8x per night once I start hitting REM sleep, and when I wake up, I still feel short of breath and sometimes my heart is pounding, just like when I have apnea. I'm a light sleeper so I suspect it's from my apnea starting up when I move to certain positions, but offset by the CPAP device. Most of these awakening events don't even register on the machine (I think I wake up before my breathing gets too disoredered.)

On the bright side, I no longer have to get up from sleep since I can actually go back to sleep, but I'm probablky 'wasting' an hour of sleep per night with all the wakeup time.

It's still overall much better than pre-CPAP where I had AHI=29 in REM sleep, but it's still far from normal, and I still do wake up tired, like I'm short an hour of sleep. (Thankfully not REALLy tired like pre-cpap).


I'm thinking of increasing my S9 CPAP pressure slowly to see if it helps. Any suggestions?

With all your 4-8 nightly awakenings and position changes, I am very surprised with your reported zero AHI. I would have expected to see several CAs and HIs every night. Are you sure your machine is reporting properly?

On the off chance the S9 has got "stuck" reporting a 0.0 AHI you can try rebooting the machine.
Just unplug it from the electric source and wait a few minutes then plug it back in. This forces the internal software to reboot similar to when we reboot a computer to clear out the cobwebs. Doesn't hurt a thing to try it.

Note that the OP said "pretty much zero", and "Never more than 0.3 AHI", not 0.0.

I can relate, I've been experiencing a handful of arousals nightly since starting CPAP 2+ years ago - but without the other symptoms the OP indicates - even with a pretty low AHI, generally well below 5. For the most part it hadn't been bothersome until recently, I just rolled over and went back to sleep and felt well rested during the day, and my sleep doctor wasn't worried (she did offer me sleeping pills but I turned it down) so I just lived with it.

The past few weeks its become much more of a problem. My AHI is now generally less than 0.5, I've dropped 13 lbs in the past two months, yet my arousals are more than twice what they were before and seem to be causing me more daytime drowsiness. I should add that I've been on Qsymia for the past two months (hence the weight loss) and it is known to cause insomnia issues in some people. Its a little strange though that the effect seems to have become much more pronounced the past couple of weeks even though I've been on Qsymia for several months - I did notice some minor sleep issues the first month - mainly, it would take me a little longer to fall asleep at night - but nothing as severe as what's been happening the past few weeks. My Sleepyhead data "seems" to be normal, though I am far from an expert at interpreting it, beyond looking at AHI.