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And here's my first zero
#21
Thank you for your input, FormerFed. Much appreciated!
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#22
(02-10-2017, 02:00 AM)ppca Wrote:
(02-09-2017, 09:41 PM)Russatrice Wrote: I don't want to weigh in on whether you actually need CPAP or not, though it sounds strange to me that you feel tired like you do with such low numbers. But I do want to tell you that it takes much longer than three weeks for sleep patterns to readjust. I'm not exaggerating when I say it took six months for me to stop waking up and laying awake half the night. This was a big nuisance because I was used to sleeping 8 hours straight, with apneas of course, which made me exhausted by morning, but I certainly wasn't used to laying awake during the night. Now I usually have one waking period around 3am, and then I sleep again until 6 or 7.

I most likely do need CPAP. My AHI at sleep study 3 years ago was 15.3, which would qualify for moderate case of apnea. How and why it showed only 5.2 at the latest study (not that there's anything wrong with it Grin ), remains to be seen.

When I mentioned that I wake up multiple times during the night, I wasn't specific about the fact that it only takes less than a minute to fall asleep again. It is not like I'm lying there in bed fully awake for long periods of time. It is just that my deep sleep doesn't seem to last long enough, and is frequently interrupted by these short periods of being awake. Even though, now with the mask on, I may be seeing a bit of improvement. Too early to say.

I'm aware that a few weeks of CPAP is not enough to draw any conclusions. That is why I am determined to persist with the therapy.

Once my oximeter arrives, it will be very interesting to see what my oxygen saturation is, and check to see if it improves with CPAP. My guess right now would be - yes.

Thanks, Russatrice.

Cpap use reduces the tissue swelling in the airway. This does reduce AHI on a follow up sleep study (that is why they advise to get off Cpap for a week before a new sleep study to get the real bad number). 

Waking up for a minute is very normal. It typically happens after you complete the R.E.M. Part of the sleep cycle. Try timing them. You will find that they happen at a periodic frequency (most likely every 90 minutes).
Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
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#23
(02-10-2017, 02:00 AM)You ppca Wrote:
(02-09-2017, 09:41 PM)Russatrice Wrote: I don't want to weigh in on whether you actually need CPAP or not, though it sounds strange to me that you feel tired like you do with such low numbers. But I do want to tell you that it takes much longer than three weeks for sleep patterns to readjust. I'm not exaggerating when I say it took six months for me to stop waking up and laying awake half the night. This was a big nuisance because I was used to sleeping 8 hours straight, with apneas of course, which made me exhausted by morning, but I certainly wasn't used to laying awake during the night. Now I usually have one waking period around 3am, and then I sleep again until 6 or 7.

I most likely do need CPAP. My AHI at sleep study 3 years ago was 15.3, which would qualify for moderate case of apnea. How and why it showed only 5.2 at the latest study (not that there's anything wrong with it Grin ), remains to be seen.

When I mentioned that I wake up multiple times during the night, I wasn't specific about the fact that it only takes less than a minute to fall asleep again. It is not like I'm lying there in bed fully awake for long periods of time. It is just that my deep sleep doesn't seem to last long enough, and is frequently interrupted by these short periods of being awake. Even though, now with the mask on, I may be seeing a bit of improvement. Too early to say.

I'm aware that a few weeks of CPAP is not enough to draw any conclusions. That is why I am determined to persist with the therapy.

Once my oximeter arrives, it will be very interesting to see what my oxygen saturation is, and check to see if it improves with CPAP. My guess right now would be - yes.

Thanks, Russatrice.

Cpap use reduces the tissue swelling in the airway. This does reduce AHI on a follow up sleep study (that is why they advise to get off Cpap for a week before a new sleep study to get the real bad number). 

Waking up for a minute is very normal. It typically happens after you complete the R.E.M. Part of the sleep cycle. Try timing them. You will find that they happen at a periodic frequency (most likely every 90 minutes).
Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
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#24
(02-10-2017, 08:52 PM)AshSF Wrote: Cpap use reduces the tissue swelling in the airway. This does reduce AHI on a follow up sleep study (that is why they advise to get off Cpap for a week before a new sleep study to get the real bad number). 

Waking up for a minute is very normal. It typically happens after you complete the R.E.M. Part of the sleep cycle. Try timing them. You will find that they happen at a periodic frequency (most likely every 90 minutes).

I was actually off CPAP for much longer than a week before that follow up study I mentioned. That low AHI is not easy to explain, but I'm not going to worry about it anymore.

Speaking about waking up during the night, now with CPAP on, I do not think it is nearly as frequent as it used to be before, without CPAP, which should be a good sign.

Earlier I would wake up every 10 minutes, or so. This wouldn't be going on every night, but it was quite often. I would be awake for a few seconds, not longer than that, I would then fall asleep again, even have dreams, for about a few minutes, until I wake up again. A few seconds later, back to sleep. These cycles would typically be happening closer to morning hours, no so often in the middle of the night. I always thought it was really strange that I would be able to dream for such short periods of time, and lots of times those dreams would continue, after that very short period of being awake. Weird...but again, what do we really know about dreams, and how human brain works.

Out of curiosity, what should be an average time spent in REM, percentage wise? My sleep study, without CPAP, showed only about 4%, and I am pretty sure that is low.
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#25
REM should be between 20-25%.

However, it can be a bit lower in an overnight sleep study. 

But 4% is very low,  and might explain the AHI number you got in the second study.

What was your REM time  in the first study when your AHI was 15? 

A lot of people have much, much higher AHI in REM sleep versus non-REM.

Also, what is your daytime Oxygen level? It seems pretty odd to have such low nocturnal oxygen levels with relatively low AHI ... unless the events are extremely long?

Being in Canada too, I know that our healthcare system can move somewhat slowly, and also that sleep doctors have a high patient load, but it does seem that with your average oxygen level being 88.8%, and spending a whopping 96.7% of the night below 90% ... this would qualify as quite serious.

I really wonder if the report is accurate? My sleep study report had some weird mistakes ....
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#26
(02-11-2017, 08:46 AM)Timur Wrote: I really wonder if the report is accurate?

That's what I would like to know.

REM time during the first (no CPAP) study was also 4%, resulting in that 15.3 AHI. I had a titration study a couple of weeks later, and it showed 7.6% REM. Recommended pressure from that study was 9 cm H2O, with AHI at zero. That titration study also reported O2 above 94%.

I am still waiting for an oximeter to arrive from China, so right now I cannot control oxygen levels on a daily basis, but anytime in the past when I did it, in doctor's office, numbers were good.

About doctors, I don't know what to say. As I said, after this latest sleep study, I had a titration study as well, which failed miserably. I did not sleep at all, no idea why. The doctor did not call me back, but instead, based on the no-CPAP study only, his office called, and they asked me where would I like to go to buy my CPAP, and they would send the prescription to that place. What kind of prescription, I don't know, since titration study was useless. That prescription, without titration, can only be doctor's guess of what might work. They also completely forgot the fact that I already have a machine, and all the equipment, and therefore I definitely do not need a new one.

So what I'm doing now is I am using slightly modified original prescription settings from the study 3 years ago. Prescribed pressure then was 9, and I am running at 7.4 right now. My AHI numbers are always below 1 (averaging 0.6). Just a few events every night, typically 3 or 4.

When I get my oximeter, I'll start monitoring O2 on a daily basis. If those numbers are not good, I plan to go see my family doctor, and go from there.
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#27
(02-08-2017, 12:15 PM)ppca Wrote: Yes! Following OpalRose's advice, I managed to force myself to keep the mask on all night. I was always cautious not to rip something out when turning in bed, but last night I decided to stop worrying about it.

That's awesome. All you have to do is make the conscious decision to keep the mask on all night, and you will.

(02-08-2017, 01:59 AM)ppca Wrote: Since my sleep quality is very poor, especially recently (I'm waking up numerous times throughout the night, and feeling tired all the time),

Keep in mind that this is the way you feel when you don't use the machine.

You reported that you wake up more often when you're wearing the mask than when you aren't. This means nothing. We can wake up multiple times and have no memory of it. All that means is that we're getting a crappy night's sleep and we don't know it until we try to function during the day.

If you make the commitment to wearing the mask every time you sleep, all the time you are sleeping, then you will adapt and stop waking up as often. On the other hand, if you spend time sleeping without the mask you will never adapt and you will always have problems staying asleep.

After three months of complete and total use, you can re-evaluate the situation. If you feel better you know the reason. If you don't you can try going without the machine for a few nights and see if that makes you feel worse.

Meanwhile, however, if you spend any time at all sleeping without the machine it could have the psychological effect of convincing you that you don't need it. The so-called slippery slope!
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#28
Yeah, it makes perfect sense. That is why I am forcing myself to keep the mask on all the time. It would be so great if I could get my old sleep habits back. I used to sleep like a baby, until a few years ago, when the problems started.

Just yesterday, I cranked up the pressure from 7 to 7.4 (baby steps, lol), and this morning SleepyHead reported 0.29 AHI. Even at 7 cm H2O I was averaging 0.6 AHI, but this seems to be even better, if only for one night at this new pressure.

Like some of you fine people said here in another thread - me and my hose are becoming one. Grin

Thanks everyone for this amazing forum!
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#29
Regarding your comment re doctors, I'm based in Ontario and have found that when it comes to the field of sleep, and getting to see a sleep specialist, it is incredibly frustrating to try to get anything done, and communication with these specialists, other than at an actual appointment,  is very difficult because they are so in demand. 

My theory is that when the AASM rules for scoring hypopneas  changed in the past few years, the OSA case load sky rocketed, and there just aren't enough sleep specialists to keep up.  

Also several Canadian provinces do not permit at home sleep studies(Ontario being one) and so wait times for in lab studies are frustratingly long. A friend of mine has an appointment scheduled for June 2017, and she requested one in September last year. She almost certainly has OSA, has all the symptoms, and yet that is the earliest "non-urgent" appointment her doctor could get for her. (ie she hasn't landed up in ER with AFib yet!)

Thankfully we can take care of our own therapy due to info sharing on forums like this and don't have to rely 100% on doctors.  Kudos to you for taking charge of this yourself.
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#30
Yes Timur, it is very frustrating. I am in Ontario as well, and while it was always relatively easy for me to book an overnight sleep study, seeing a doctor to discuss the results is a different story. Very, very long waiting times.

The problem is not limited to sleep specialists only, but let's not even go there. Smile 

Normally I prefer to consult doctors about any medical issue (that's what they are there for, anyway Grin ), but in this particular case, it is fairly easy to take care of it yourself. After the original titration study, and the purchase of the machine, it is just a matter of monitoring things in SleepyHead. Of course, this great forum is such a valuable source of information.
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