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Confused and Overwhelmed
#1
Exclaimation 
Hi Everyone, 

I've just started using a CPAP following a positive home study sleep test (still waiting to get an in hospital study) and it doesn't really seem to helping. 

I'm very symptomatic but don't sleep rather than oversleep and usually have very irregular sleep cycle. Insomnia was never an issue for me until this past year and I think it's playing a big part in how bad I'm feeling - I don't feel physically tired but I'm very tired mentally/brain foggy and extremely lethargic. The quality of my sleep since on the onset of insomnia has been (more often than not) abysmal:

- I wake up frequently during the night
- sleep in 2 hours increments 
- get less then 4 hours sleep some nights and still have no inclination to sleep throughout the day or "catch up" sleep
- still feel awake when i'm asleep (I'm guess i'm in a shallow sleep stage)
- wake up feeling like I haven't slept/feel wired

I've attached some sleepyhead data and my preliminary sleep study. I seem to have somehow lost most the data I uploaded to sleepyhead - I had about 5 days worth the first time I used it but the next time I went to upload it all disappeared and would only show me the last few days. I'm a bit concerned that it looks like I'm having events when I'm still awake e.g. last night I didn't fall asleep until after 4.15am but my events started before then.

Sleepyhead:

https://imgur.com/a/fC68q
https://imgur.com/a/vl1Eb
https://imgur.com/a/CXs0C
https://imgur.com/a/GKVhJ
https://imgur.com/a/RMeEO

Sleep study:

https://imgur.com/a/ufP92
https://imgur.com/a/Vh7TZ
https://imgur.com/a/5KBpn
https://imgur.com/a/7gBtl
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#2
(10-12-2017, 01:31 PM)Miastar Wrote: Hi Everyone, 

I've just started using a CPAP following a positive home study sleep test (still waiting to get an in hospital study) and it doesn't really seem to helping. 

I'm very symptomatic but don't sleep rather than oversleep and usually have very irregular sleep cycle. Insomnia was never an issue for me until this past year and I think it's playing a big part in how bad I'm feeling - I don't feel physically tired but I'm very tired mentally/brain foggy and extremely lethargic. The quality of my sleep since on the onset of insomnia has been (more often than not) abysmal:

- I wake up frequently during the night
- sleep in 2 hours increments 
- get less then 4 hours sleep some nights and still have no inclination to sleep throughout the day or "catch up" sleep
- still feel awake when i'm asleep (I'm guess i'm in a shallow sleep stage)
- wake up feeling like I haven't slept/feel wired

I've attached some sleepyhead data and my preliminary sleep study. I seem to have somehow lost most the data I uploaded to sleepyhead - I had about 5 days worth the first time I used it but the next time I went to upload it all disappeared and would only show me the last few days. I'm a bit concerned that it looks like I'm having events when I'm still awake e.g. last night I didn't fall asleep until after 4.15am but my events started before then.
I'm too new to be helpful with statistics, but I do know this much: lock the SD card before you put it into the card reader and unlock it before you put it back in the CPAP.

Also, it's possible the missing data is on your computer. From my experience, a copy gets stored in SleepyHead data files and can still be accessed at a later time, no SD card needed.

The other thing I know from figuring it out in short order after I got my machine....we're doing "events" at every moment of our lives. I was fascinated just watching in real time how the machine had to adjust the pressure while I was simply reading a book. The troublesome events for the purposes of CPAP treatment, however, are the ones that happen while sleeping.

I feel sure a poster will come on in no time and give you some wise data input.
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#3
I use an old micro SD card i reformatted inside an adaptor which I then remove to put in my laptop (doesn't have a SD slot only micro) - maybe that's the problem...

"we're doing "events" at every moment of our lives. I was fascinated just watching in real time how the machine had to adjust the pressure while I was simply reading a book."

Ohh good to know, I was wondering what was wrong with me :/ 


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#4
Welcome!

A couple of initial thoughts.  CPAP is not like changing channels on the television.  It can take weeks, often months, for the effects of therapy to really be felt.  I only looked at one chart, but it looked reasonably OK for starting out.

The second is that you seem to have sleep maintenance insomnia.  CPAP is probably not going to fix this by itself.  I had a very similar thing and managed to cure it by what is called Sleep Restriction Therapy or Sleep Compression Therapy.  It is brutal, I will say that in advance.  In my case, I was allowed only five hours a night in bed, asleep or not.  After a week or so, my brain decided that it had better start sleeping normally.
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#5
Hi Miastar,
WELCOME! to the forum.!
CPAP can take some getting used to, so just hang in there, it does get better over time.
Good luck on your CPAP journey.
trish6hundred
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#6
At least you have changed 4-10 therapy to 7.5-20. First things first...turn off the monthly calendar by clicking the triangle in the date line, and kill the pie chart in File/Preferences/Appearance and un-check the pie-chart.

With that out of the way, I would keep the same settings, but turn Flex down to 1. These events may eventually reduce as you become more adapted to CPAP therapy, but these are predominately central events, suggesting sleep disturbance and issues that pressure will not address are present. If you set your pressure to 7.5 fixed, it would not hurt your therapy, and might minimize the sleep disturbance that results in these events.
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#7
(10-12-2017, 02:25 PM)chill Wrote: Welcome!
I only looked at one chart, but it looked reasonably OK for starting out.

Hi Smile

It does? Did you get clear airway events initially too?

(10-12-2017, 04:35 PM)trish6hundred Wrote: Hi Miastar,
WELCOME! to the forum.!
CPAP can take some getting used to, so just hang in there, it does get better over time.
Good luck on your CPAP journey.

Hi Smile thank you

(10-12-2017, 05:57 PM)Sleeprider Wrote: At least you have changed 4-10 therapy to 7.5-20. First things first...turn off the monthly calendar by clicking the triangle in the date line, and kill the pie chart in File/Preferences/Appearance and un-check the pie-chart.

With that out of the way, I would keep the same settings, but turn Flex down to 1. These events may eventually reduce as you become more adapted to CPAP therapy, but these are predominately central events, suggesting sleep disturbance and issues that pressure will not address are present. If you set your pressure to 7.5 fixed, it would not hurt your therapy, and might minimize the sleep disturbance that results in these events.

I put it to 7.5 for one night but I woke up with a killer headache and my AHI/sleep hadn't improved so I put it back down.

"but these are predominately central events, suggesting sleep disturbance and issues that pressure will not address are present"

So it seems like I have central sleep apnea?! Is this as bad/dire as I think it is?
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#8
Based on your description of your sleep habits, those CA events are likely at least partially sleep/wake junk and rolling over in bed. And they could be too much flex and getting used to therapy. It does not look to me like you have real Central Sleep Apnea. Only an in-lab study will tell for sure. I think that is what Sleeprider was trying to say as well.
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#9
Miastar, please correct the formatting issues with your charts so that Events, Flow Rate, Pressure, and snores appear in the charts, and a meaninful statistical summary of the events, pressure and settings is in the left column. 7.5 may not be an ideal pressure, but I'm certain Flex is not helping you, and the widely variable pressure is not helping isolate the conditions that make your events better or worse. I'm not sure it would be fair to conclude that a pressure of 7.5 is the cause of headaches based on one night, but it's certainly possible. Perhaps a range of 5-7 with Flex at 0 or 1?
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#10
I think you're right I've since upped the pressure and not any issue with headaches. I put flex down to one but left the max pressure at 20. Seemed to help at first (had a good nights sleep, few events) but now my sleep has gone to sh*t again. It may be related to the fact that the airflow is suddenly feeling weak or tolerable at every pressure and I can't figure out why. Thanks for the the help, will post better charts when I can figure out sleepyhead.
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