Apnea Events Concentrated in the Morning Hours

I just started CPAP a few days ago and have been looking at my data. Sleep study AHI was 13. Dropped to 4-5 with CPAP on pressure 9 (lots of false positive I suppose, since many of the "central" apnea were clustered around times that I am awake).

Immediately felt more productive and way less sleepy in the day. However, still tired from trying to adapt to sleeping with CPAP.

The same pattern seems to be occurring everyday: I will sleep soundly for 4-4.5 hours (11+ pm to 3-3.30 am) with almost no events, then wake up and have difficulty falling back to sleep again. I might go to the bathroom and then fall asleep again after 15 minutes and sleep soundly for a while.

However, from around 4-4.30 am to when I wake up at 7-8 am, the machine will register a string of obstructive apnea events, with a few centrals mixed in. Most of the events on my detailed graph happens during this period.

Do you guys have any idea what could be happening? I do experience aerophagia from the CPAP but so far it has been just belching and flatulence while sleeping, no pain or any day time effects.

If you are certain that you are indeed asleep during the time frame for the increased in obstructive events then the 2 main suspects for such events are either supine sleeping or REM stage sleep or maybe combination of both.
OSA is often worse when sleeping on our backs or during REM stage sleep and sometimes we just need more pressure to prevent the airway collapse during those times than we might need at other times.

Same here! And I just read the first response, so I will try to sleep on my side more.

Please let me know what changes you make and whether they help. Thanks.

Based on how the sleep cycle looks (http://en.wikipedia.org/wiki/File:Sleep_Hypnogram.svg) and that events tend to be worst during REM sleep, I think I know why all my events are happening in the 4 am - 8.30 am period.

Sleeper Agent wrote:Based on how the sleep cycle looks (http://en.wikipedia.org/wiki/File:Sleep_Hypnogram.svg) and that events tend to be worst during REM sleep, I think I know why all my events are happening in the 4 am - 8.30 am period.

Yes - they don't call that the graveyard shift for nothing.

CoffeePgh wrote:Same here! And I just read the first response, so I will try to sleep on my side more.

Please let me know what changes you make and whether they help. Thanks.

I made a belt out of an old shirt, and taped a bottle to the back to force myself to sleep on my side, and only TWO obstructive event happened!

My AHI went to 1.7! And I believe most of the central apnea events recorded were false positives because they were recorded shortly before/after I woke up and took the mask off due to aerophagia.

Great news. But the aerophagia has worsen significantly (from minor nuisance to a very painful level) when I force myself to sleep on the side.

Can you try lowering your pressure just a notch to see if it gets rid of the aerophagia without affecting your results? It works for some people.

Julie wrote:Can you try lowering your pressure just a notch to see if it gets rid of the aerophagia without affecting your results? It works for some people.

Yes, that is one of the things on my list (and maybe also using the auto mode). Its currently set at a constant 9 on just CPAP.

But I am really afraid of pissing off my doctor. I guess I have to some how make it through the weekend (they're mostly not staffed during the weekends), and call them on Monday to "ask for permission"?

In the meantime, will try raising my sleep posture using two pillows or raising the bed somehow to see if the aerophagia subsides.