(05-05-2016 10:07 PM)PoolQ Wrote: Payton,
I have tried to figure out what wakes me up and have failed to narrow it down to anything.
I wake up with the goal of taking the mask off, I sit up, stand up and walk around for less than 5 minutes and then remask up and go right to sleep. No noise or light. Very consistent every night, just different number of times.
Are these wakes roughly 90 minutes apart? If so, they may be normal post REM wakes that once you realize you're awake, you decide you need a brief break from the mask.
It's very normal to briefly wake up after a REM cycle. The thing is, most of the time a person wakes up just enough to realize that everything is ok and they go right back to sleep. The total wake is maybe a minute or two long and the person doesn't remember it in the morning.
But what may be happening now is that when you wake up post-REM, you're still noticing the mask as an alien on your nose instead of "normal". So you wake fully up and decide that you need to get the alien off your nose. But you're also conscious enough of the need to not
go back to sleep without the mask on your nose. So you take the mask off, but sit up and walk around just a bit in order to prevent yourself from falling back asleep without the mask.
Quote:I never did this before CPAP. with the adjustments I made in the first post, I mostly now only get up 2-3 times a night.
Prior to starting CPAP, you most likely reacted to normal post-REM wakes in a normal fashion: You quickly established that nothing was wrong and you fell right back asleep and didn't remember the wakes in the morning.
Quote:I sleep 10-11 hours at a time and my getting up usually stops between 4 & 6 am, giving me 3-4 hours of uninterrupted sleep at the end.
My guess is that if you have any post-REM wakes after 4-6AM, you're body and brain are now reacting in a normal fashion: The brain is no longer concerned about the alien on your face, and so you go right back asleep after the post-REM wake.
Quote:Making those changes made a big difference so I thought that there might me more changes that would help on a different machine. It "seems" that I wake because I am fatigued from using the CPAP and just need to get vertical and take a break.
I disagree. I don't think you are waking because you are some how "fatigued" from using the CPAP.
I think your wakes are most likely normal post-REM wakes that you are reacting to in a fashion that prolongs the wake so that you remember them. And because you remember them, they have become disruptive to your sleep.
As for what to do about them. I think you need to train yourself to react normally to these wakes so that they last 1-2 minutes long and so that you don't have to get out of bed before going back to sleep.
I've had some experience with having to retrain myself to not over react to post-REM wakes during my first year or so of PAPing. So maybe my story may help you figure out how to deal with these wakes in a way that minimizes how disruptive they are to your sleep.
During the first year of PAPing, I had such horrible problems with aerophagia that every time I found myself awake in the middle of the night, I badly wanted to "escape" the pressure. The aerophagia problems not only caused a lot arousals and wakes, it also meant that every time I had a normal post-REM wake, I still would wake up and start worrying about the aerophagia and that made it much harder for me to get back to sleep. (Which in turn increased the aerophagia and would cause additional wakes.)
After being switched to a PR System One Auto BiPAP in with an EPAP range of 4-6 and an IPAP range of 6-8, I decided that rather than take the mask off, I'd just turn the machine off and then back on. That way I knew the pressures were back down at EPAP = 4 and IPAP =6 and I wouldn't get aerophagia while getting back to sleep.
This simple habit of turning the machine OFF and back ON when I find myself awake in the middle of the night and some CBT for insomnia allowed me to conquer the worst of the aerophagia-related wakes. But I still have post-REM wakes most nights. However, turning the machine OFF and back ON every time I find myself awake in the middle of the night usually lets me immediately fall back asleep and the only reason I know the post-REM wakes happened are that the OFF/ON cycles show up in my SleepyHead data. In other words, I am now reacting to these post-REM wakes in a normal fashion: I wake up, realize there's nothing serious causing the wake, turn the machine OFF and back ON so that I don't have to worry about my stomach, go back to sleep, and I don't remember the wake in the morning. And because the wakes are now down to 3-4 a night and I don't remember them, they no longer disrupt my sleep too much.