Anybody had a sleep test while using CPAP?

[StevesSp]

Like significant numbers of others have experienced, I have not found that successful CPAP therapy has helped me in terms of energy, fatigue or daytime sleepiness. In fact, and again as others have experienced, I'm worse.

Over the five years I have been using CPAP, I have frequently found that my fatigue is WORSE when my AHI is low. I don't understand that and nothing in my reports gave a clue. I haven't done any rigorous testing of that however, so this is really just an 'impression' (the low AHI fatigue).

Another weird experience came the time I first used CPAP and then again when I swapped from CPAP to APAP. Each time, my first 2-3 nights of use left me feeling wonderfully energised, but that feeling soon dissipated. Maybe psychosomatic? I so want to feel better that I experienced the 'placebo effect'?

I do suspect though that, while PAP certainly reduces the patient's AHI, it does NOT produce refreshing sleep, though I can't fathom why. I am 100% compliant and very used to using the machines, so it's not as if I'm tossing and turning, fighting the hose or suffering mask leaks. In fact, I'm so used to PAP now that I can't sleep without it.

Perhaps we're not getting quality sleep, with the required sleep cycles of REM etc? Maybe being inflated all night disturbs our digestive system which, as scientists are coming to understand, is linked to our brain/nervous system in unexpected ways and so won't let us sleep properly?

With so many reporting similar experiences, I would be keen to hear if any decent studies of sleep quality while using PAP have been conducted.

[Sleepster]

With so many reporting similar experiences, I would be keen to hear if any decent studies of sleep quality while using PAP have been conducted.

A lot of people complain about not being able to get enough quality sleep. I don't know how they would go about measuring sleep quality, like you say, it's very subjective. The thing is though, for those of us who need the CPAP machine to be able to breathe while sleeping, there really is no choice.

[PaulaO2]

Most sleep tests are done either on 2 nights or with a single "split" night. The first half/night is done w/out xPAP to determine if the condition exists. The 2nd part is to put the person on an xPAP and determine the treatment pressure. During this, all aspects of sleep are observed, not just apnea events.

Have you brought your concerns to your sleep doc (assuming you have one)? Since it has been 5yrs, your insurance may pay for another sleep test with the idea of monitoring you for why you still feel like crap.

Which S9 do you have? What does the software report? What about the length of the events and when they occur? An apnea event is counted when it lasts 10 seconds or longer. So if an event lasts 45 seconds, it still only counts as 1.

[StevesSp]

Hi Paula
I had just one 'sleep test', which was conducted at home, while wired up to some sort of monitor. The sleep lab diagnosed apnea (38AHI) on the basis of that test.

I was then provided with a Resmed Autoset of some sort, which was used to determine the correct titration.

I have to pay for any and all sleep tests myself.

I subsequently bought the Resmed S9 and used it for approx five years. After the usual awful faffing about that goes with CPAP apprenticeship, I eventually managed to sleep through the night and those first 2-3 'good nights' were a revelation in terms of subsequent energy. As I said in the OP however, things rapidly went downhill and I very rarely have what I would truly call a 'good day'. Strangely, I have noticed a loose correlation between low energy and low AHI, not the opposite. I seem to feel 'best' when my AHI is around 10, though still not great.

I used Sleepyhead with the S9 and saw no obvious clues. Sure there were bad nights, but those could usually be explained by sinus infections or too much fermented grape juice ... I saw what I would call a 'normal' range of central, hypos and OSAs. I tried to discern something from the other parameters, but couldn't see anything.

I take your point about the event duration. I recall some were longer than others, but nothing excessive. I do seem to suffer more dramatic centrals lately though (the last year or so), strong enough that they wake me up and I am breathless with a racing heart. Even when they happen, my AHI is in the acceptable range, so your point is taken.

I have lately thought about requesting a second sleep test, where I'm wired up to the home monitor, but this time using the CPAP. I really should do that I think.

[mesenteria]

I had to undergo two sleep lab nights, the first to diagnose, the second after 30 days of treatment to confirm that my treatment was correct.  I think the second night could have been given a pass simply by the record of the machine.  After all, it's what all subsequent sample evaluations rely on, whether for compliance or for correct pressures and configuration.

[ardenum]

You do not need REM sleep for health, you need stage 3/4, REM for some marketing reasons is advertised as such, but in reality it is not. When it comes to brainwaves REM is not deep sleep, it is located slightly above Stage 2, when wavelengths are concerned. Its often misinterpreted as being after Stage 2 because REM sleep can only be enter from stage 2 but it is not a deeper sleep then Stage 2. 

The correct cycle would be Stage 1 - Stage 2 - Stage 3/4 - Stage 2 - REM. Stage 3/4 is where the magic happens, where your brain opens up and all the debris gets cleared out from it using the brains very own lymphatic vessel. If you remove REM but still have Stage 3/4 of about 30-60 mins each night you will be rested. If you have REM but not Stage 3/4, you will experience gradual onset and worsening of insomnia and all the other stuff like brain fog etc.

[elwoodpdowd]

I am truly a novice to this could it be that even though the stats are showing all is good what about the oxygen level? Could this be an issue even if the numbers are within the optimal goals?

[PaulaO2]

Yes, O2 sats are very important. Some people react to apnea events more drastically than others. For myself, a single event results in not much of a drop. But the more I have, closer together, and/or the longer they are, the bigger the drops get each time. But many people experience big drops with each event.

You can get a relatively cheap recording O2 meter and compare it to your sleepyhead report. It is possible to import the oximeter data into SH but I've not had much luck doing it.

If you have an Autoset, have you tried to set it to a range of pressure vs a single? Your Autoset can act like a sleep test of sorts (you just don't get the sleep stages or movement bits). You can read this and figure it out. Read through it, even if it doesn't pertain to your machine. The bit for data capable autoPAP is further down the page.

https://www.apneaboard.com/adjust-cpap-p...re-on-cpap

[Sleep2Snore]

Like significant numbers of others have experienced, I have not found that successful CPAP therapy has helped me in terms of energy, fatigue or daytime sleepiness. In fact, and again as others have experienced, I'm worse.

Over the five years I have been using CPAP, I have frequently found that my fatigue is WORSE when my AHI is low. I don't understand that and nothing in my reports gave a clue. I haven't done any rigorous testing of that however, so this is really just an 'impression' (the low AHI fatigue).

Another weird experience came the time I first used CPAP and then again when I swapped from CPAP to APAP. Each time, my first 2-3 nights of use left me feeling wonderfully energised, but that feeling soon dissipated. Maybe psychosomatic? I so want to feel better that I experienced the 'placebo effect'?

I do suspect though that, while PAP certainly reduces the patient's AHI, it does NOT produce refreshing sleep, though I can't fathom why. I am 100% compliant and very used to using the machines, so it's not as if I'm tossing and turning, fighting the hose or suffering mask leaks. In fact, I'm so used to PAP now that I can't sleep without it.

Perhaps we're not getting quality sleep, with the required sleep cycles of REM etc? Maybe being inflated all night disturbs our digestive system which, as scientists are coming to understand, is linked to our brain/nervous system in unexpected ways and so won't let us sleep properly?

With so many reporting similar experiences, I would be keen to hear if any decent studies of sleep quality while using PAP have been conducted.

Hi, It could be that you have the wrong machine.  There are machines for more complicated Sleep Apnea and you might be one of those that need one.  Without seeing data from a few nights sleep it is impossible to say what you need or if the machine you have needs tweaked.

[StevesSp]

Thanks to all who have replied with advice. Much appreciated.

This time, I shall try not to drop this until I have figured out what's going on. Changing my machine to one that doesn't report in the same detail as the S9 will complicate things, but where there's a will ...