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Help Needed - Continued Insomnia with APAP
#1
Help Needed - Continued Insomnia with APAP
I need some help with sleep maintenance insomnia/middle of the night insomnia.

I'm 7 months into treatment and have 100% compliance with my APAP. I do feel better to an extent, but I'm still struggling to feel functional. (There's a LOT of coffee in my life still.) My AHI is generally under 1.5.

My main issue is that after about 5 hours of sleep I wake up and can't fall back asleep for between 30 minutes to several hours. I absolutely have to go back to sleep as I typically need 8-9 hours to be functional. This has been a nightly problem for me since childhood, so it's not related to age or situation (I'm 46 now). I have implemented pretty strict sleep hygiene, and thus I'm pretty sure it's related to the Apnea. I was hoping strong APAP compliance would fix the problem, but it has not improved at all. I'm wondering if maybe this is a RERA issue or something that is subtle and that I'm not understanding.

I'm wondering if anyone has experience with fixing this type of issue? I'm so tired of being tired. Attached are a few screenshots from Oscar as well as some data from my initial sleep study. I'm happy to provide zoomed-in shots or other data if needed.


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#2
RE: Help Needed - Continued Insomnia with APAP
Look at http://www.apneaboard.com/wiki/index.php/Sleep_hygiene
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Help Needed - Continued Insomnia with APAP
Hi thank you! Yes. I have been very strict with sleep hygiene for several decades now. I worked with a therapist to get that under control (including sleep restriction) for a while, but it has not been effective. That's why I'm asking now about possible RERAs or something more breathing related.
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#4
RE: Help Needed - Continued Insomnia with APAP
Then bring EPR in and let's knock down the flow limitations.

Try EPR=2
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Help Needed - Continued Insomnia with APAP
Okay cool. I can try that.
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#6
RE: Help Needed - Continued Insomnia with APAP
BTW - how many nights of using the EPR do you think it would take to see if that will make a difference?
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#7
RE: Help Needed - Continued Insomnia with APAP
Hard to know.

We'll want to see what happens to your FL graph and numbers with increased EPR, and whether it increases your centrals.
Caveats: I'm just a patient, with no medical training. And my first experience with xPAP was fairly recent. So I'm somewhere along the path of a steep learning curve.
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#8
RE: Help Needed - Continued Insomnia with APAP
Show at one night. When we get where it looks promising we will let it run a while.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
RE: Help Needed - Continued Insomnia with APAP
What physical size are you?
Your minute vent / tidal volume figures are quite low.
Those flow limits could be really impacting on you, bonjour's advice is good.
Your flow limits aren't baaaad, but at tidal volumes that low they may well be causing you issues.
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#10
RE: Help Needed - Continued Insomnia with APAP
I'm 5'4", 125 lbs. (f)
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