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AHI higher upon first falling asleep
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rdavis Offline

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Post: #1
AHI higher upon first falling asleep
Has anyone had experience with AHI events (obstructive, central, hypopnea, etc.) being higher as you are first getting to sleep?

I've suspected this is happening for some time (doctor never paid much attention to my claims) but now that I've downloaded sleepyhead, I'm seeing the proof. I will have clusters of events (most hypopnea, a few clear airway, several "respiratory effort causing arousal") early in the night, then go for long stretches of sleep with nothing. Sometimes if I wake in the night, a cluster will happen again as I'm going back to sleep. Over the course of the entire night, my average AHI is low enough that it wouldn't raise any red flags; but if you just look at the early stretches of time where I"m trying to fall asleep (and being woken frequently by the events) my AHI is definitely above five during those stretches.

I can post a screen shot of my sleepyhead results for a particularly rough night; however, I'm not exactly sure how to do that. When I try to insert an image, it asks for a URL. Is there a way to directly upload an image into a post?

Thanks,

RDavis
(This post was last modified: 03-09-2015 09:47 AM by rdavis.)
03-09-2015 09:46 AM
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Shastzi Offline

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Post: #2
RE: AHI higher upon first falling asleep
I suppose your starting pressure (5) is too low. and if you are using ramp you
might want to try turning it off and see if you turn in better numbers.
my low is 15, no ramp but I am used to it now.

Strategy:
#1.
check the sleepyhead pressure being delivered on your graphs.
See what cm pressure the OA's stop occurring.

#2. start bumping up your pressure on the low side 1 cm. Let that ride for a week or 10 days.
slowly work up to the point where your low end is at or just below where OA's dissappear.

Keep an eye on your leaks all the while. and fix those as they come up.

That should get you going on your way.

Good luck and hang in there!

Sleep-well

"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
03-09-2015 10:25 AM
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rdavis Offline

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Machine: Phillips Respironics REMstar Auto
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CPAP Pressure: 8-15
CPAP Software: SleepyHead Other Software

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Post: #3
RE: AHI higher upon first falling asleep
Thank you!

Ah, bummer, I forgot to update my profile when my pressure changed. My starting pressure is actually 8, and I stay right around 9 to 9.5 about 90% of the time at night while I"m asleep. I don't use the ramp feature.

So the weird thing is, almost none of my events are actual OAs. The vast majority are either hypopnea or clear airway events.
03-09-2015 10:55 AM
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justMongo Offline

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Post: #4
RE: AHI higher upon first falling asleep
Not unusual to see a cluster while in stage 1 sleep.
Also not uncommon before waking.

Your cerebral cortex has some control over breathing while conscious. During deep sleep, the pons has total control.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
03-09-2015 11:15 AM
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quiescence at last Offline

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Post: #5
RE: AHI higher upon first falling asleep
non-event arousals (ones not scored as apneas) are often associated with first several minutes of sleep. Tidal volume at this time is higher than in "sleep" and can be the cause for resistance while getting ready to breathe in more monotonous rhythm. You are also more easily aroused when you are in light sleep, which is your first stage. I have issues for a few minutes when I am getting used to lying down, but that would only be for my going to bed, not during the night upon waking [unless I sit up for a bit].

You can lie down with mask on and hose disconnected for a few minutes before you actually hook up. But, beware you are apt to fall asleep in that mode. So, better to just put up with those sleep-onset events.

QAL

Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
(This post was last modified: 03-09-2015 11:19 AM by quiescence at last.)
03-09-2015 11:17 AM
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rdavis Offline

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Post: #6
RE: AHI higher upon first falling asleep
Thanks very much for the responses so far! Okay, so here's my other question:

It's great to know that clusters when falling asleep are not necessarily atypical...but what do I do when they keep me from falling asleep? I'm having 7 or more waking events within 30-60 minutes, and the next day I still feel rather wrung out, like I did before starting the therapy.

Any time that I am not in a 100% EXACTLY comfortable environment (like if I'm in an unfamiliar hotel bed or at someone's house), my sleep apnea still has the power to torment me for the first hour or two of sleeping, and make me groggy the next day. This is obviously very frustrating, because, as a 31-year-old healthy woman, I don't want to go ahead and resign myself to never traveling or never being rested on trips again. Sad
03-09-2015 11:36 AM
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OpalRose Offline

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Post: #7
RE: AHI higher upon first falling asleep
rdavis,
I too have occasional clusters of events early in the evening and also early morning. I try not to get excited over these. The ones I would like to eliminate are RERA's and snoring as these events aren't recorded in the AHI but tend to make me feel groggy even with a low AHI.
There is a lot that we don't understand about how these machines flag events and how the pressure will rise with no events showing on graph.
OpalRose
Bed

OpalRose
03-09-2015 11:36 AM
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justMongo Offline

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Post: #8
RE: AHI higher upon first falling asleep
(03-09-2015 11:36 AM)rdavis Wrote:  ...I don't want to go ahead and resign myself to never traveling or never being rested on trips again. Sad

Pack up the machine and travel... Life's too short to let apnea limit your life.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
03-09-2015 12:16 PM
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PaulaO2 Offline
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Post: #9
RE: AHI higher upon first falling asleep
You may want to look into sleep hygeine. Some of the habits it teaches may help you. They work no matter where you are.

Or perhaps a noise machine, or white noise played by a smart phone app. Your brain gets used to hearing that noise (or music) each night so when it hears it, and you are laying down, zzzzz. I use that trick a lot when traveling. I have a playlist I use just for this.

PaulaO2
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Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
03-09-2015 03:12 PM
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justMongo Offline

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Post: #10
RE: AHI higher upon first falling asleep
(03-09-2015 03:12 PM)PaulaO2 Wrote:  You may want to look into sleep hygeine. Some of the habits it teaches may help you. They work no matter where you are.

Or perhaps a noise machine, or white noise played by a smart phone app. Your brain gets used to hearing that noise (or music) each night so when it hears it, and you are laying down, zzzzz. I use that trick a lot when traveling. I have a playlist I use just for this.

Fastest way to put me to sleep is to listen to is German language lesson!
Bed

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
03-09-2015 04:26 PM
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