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Any insight on why I keep waking up?
#1
Gross 
Any insight on why I keep waking up?
I'm new to PAP therapy and have been using my BiPAP for a little over a week now. I feel like I've got my leaks under control after switching masks and taping my mouth. My problem now is that I keep waking up about 3-5 times a night. I've posted a screenshot of my OSCAR data from last night. Maybe there's some info there that would help figure this out.

I woke up around 0:39, 2:03, 4:30, 6:04

Also, if anyone knows why I'm having so many centrals that would be great. Thanks!
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#2
RE: Any insight on why I keep waking up?
Welcome to the Apnea Board,

We're data driven here, so let's see OSCAR from the free report tool and post a redacted version of your full, detailed sleep diagnostic test.

If you have a lot of Central Apnea, we need to dig into the info. And we need to see how much you actually have, both on OSCAR and the sleep study.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Any insight on why I keep waking up?
My mistake. I've attached last night's OSCAR data along with my sleep study.

               
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#4
RE: Any insight on why I keep waking up?
OK, I see the info. This OSCAR isn't exactly shouting lots of CA, but it's one night. What's the CA trend you've had thus far?

The sleep study tells us you are biased towards Central Apnea and I believe you would do better on the ResMed AirCurve 10 ASV which is the machine to treat CA. That is, if your comfort and rest is lacking.

Your numbers on the test:
0 Obstructive
0 Mixed
12 Central
28 Hypopnea

Note that Hypopnea can be either Obstructive or Central. They don't typically separate these however.

Now, you had posted 1 OSCAR shot above. How comfortable is your therapy and sleep?

You'll be best served by making a sleep therapy diary about your Apnea and if CA are an issue. If need be, you'll need to talk with your Dr. Dolittle about CA, discomfort, unrest, etc. and inquire about an ASV Titration.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Any insight on why I keep waking up?
I've attached a photo below of my CA trend so far.

My therapy is decently comfortable, that is, if I don't wake up in the middle of the night. 
I feel like my sleep has improved just barely. I've started to have a lot more vivid dreams but still feel tired the next morning and throughout the day.

Is there anything in the OSCAR data that would signify why I keep waking up? Do I need to adjust anything?

   
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#6
RE: Any insight on why I keep waking up?
You said you tape your mouth, but do you still get air shooting inside the mouth? On your leaks graph, the thin spikes looks like mouth leaks.

This happens to me and wakes me up in certain sleeping positions that will drop my tongue due to gravity when my tongue relaxes when falling asleep. Because the tongue is actually blocking the back of mouth so you breath through your nose only.

It's due to high enough pressure and sleeping in a positon that would cause tongue to drop. To prevent air pushing inside my mouth, I sleep on MY left side and reduced my pressure to constant 9, and the lower pressure reduces these mouth leaks.

If I keep it on auto with high enough max, and my tongue relaxes, the greater pressure will push air through to inside my mouth.

Interstingly, sleeping on my left side keeps my tongue blocking the airway as long as pressure is low enough at 9. Supine is the worst due to greater gravity force acting on the tongue. My tongue relaxes, causing pressure of air to press through.
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#7
RE: Any insight on why I keep waking up?
OK, thanks for that, the trend is just what to expect with Centrals. Consistently inconsistent. That CA may be your waking source, just a possible that is.

Others that are better with settings might have better suggestions, but have you tried PS 3 instead of 4? Trying to knock down the CA, it might be your PS is flushing more CO2 than you're currently used to.

I think your CA trend is going to be an important item to keep track of to direct your therapy. Consider trying PS 3 for a night or 2 as mentioned above and see if it reduces your disturbances.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Any insight on why I keep waking up?
Note also that there are many respiratory disturbances in your test. some result in arousals, not to say you definitely knew you were awake, but they can tell by the brain waves you alerted to some level, then drift back to sleep. Meanwhile, you had many PLM (movements) some resulted in arousals, at least a couple times during the test you registered as awake for a little bit. This may be causing you to awaken during your normal night at home, too. It is important to note that most of the limb movements were not associated with respiratory distress, and also didn't wake you.

I was happy to see that the test results did show you had both deep sleep (N3) and REM sleep, which are restorative. In a regular, non-sleep deprived, human, REM sleep usually is entered about 60 to 90 minutes after you fall asleep, and is usually following a period of deep sleep.

Generally, a person awakens somewhat after REM sleep, but most people do not notice themselves being awake. I do awaken fairly often, and when I do, 80% of the time, I remember that I had been dreaming. So, I would suggest that some awakenings are possible and may not have a bad event that causes it.

So, check yourself, the next time you find yourself awake after sleeping, do you know you were dreaming. If so, probably no big deal, and assuming you can forget the dream (if you even remember any subjects of the dream), just hit your start button and drift off again.

QAL

if you remember the dream and it is haphazard, alarming, or horribly out of control, you might be having truly disruptive sleep and might need help solving it.
if you remember the dream and it is non-sensical but just funny or enjoyable (like you can fly so you do fly over and do some things), those are generally the type you'll dream while in REM sleep.
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#9
RE: Any insight on why I keep waking up?
you had a bundle of arousals in your sleep test. at least 1/hr of which due to periodic limb movement. movement can produce ca and rera and you had plenty of the latter as well. plm has to be dealt with separately from pap treatment.
  Shy   I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  
 
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