Is there any way for me to monitor amount of time in N3 sleep?

[mrkdilkington]

In my initial study in May I had 0 mins in stage N3 sleep which was disconcerting but understandable due to having undiagnosed (and misdiagnosed) OSA for probably 15 years. However in a titration study I did in early September, at which point I was compliant using APAP for 2+ months, I also had 0 mins in N3 sleep. I think this explains why I am still fatigued all throughout the day and have yawning fits in which I yawn a dozen times in a half hour at several points during the day. So I'm wondering, is there a way I can monitor my N3 sleep?

Some sleepyhead stats: imgur.com/a/sMTGT

[mrkdilkington]

Not seeing how to edit my message now, but my pressure pre-titration was 6-12cm (determined by Kaiser), and the titration study in September was found to be 7cm. However during the titration study they started me at 5cm and increased it slowly & I slept very poorly (66% sleep efficiency with constant awakenings, 15 mins total in REM). By the time they got me up to 7cm the study was pretty much over. Since using 7-12cm in September, I've slowly increased it up to to 9-12cm now and am sleeping better than before, but as I said earlier nowhere near rested.

[AshSF]

2 months is still early days for PAP therapy. Are your leaks under control? AHI? RERA index?

If your leaks are under control and AHI is under control and RERA is under control then O2 levels are not causing you to miss going into deep sleep.

If you are not Going to Deep sleep (N3/REM), then one potential cause is microarousals caused by pressure variations of the Auto PAP machine. These microarousals knock you out of a deeper sleep state to a shallower one, consequently not letting you get to N3/REM.

You may want to try straight pressure to rule this out. A good straight pressure to set is the 90% pressure reading of your machine for the last 30 days.

[mrkdilkington]

2 months is still early days for PAP therapy. Are your leaks under control? AHI? RERA index?

If your leaks are under control and AHI is under control and RERA is under control then O2 levels are not causing you to miss going into deep sleep.

If you are not Going to Deep sleep (N3/REM), then one potential cause is microarousals caused by pressure variations of the Auto PAP machine. These microarousals knock you out of a deeper sleep state to a shallower one, consequently not letting you get to N3/REM.

You may want to try straight pressure to rule this out. A good straight pressure to set is the 90% pressure reading of your machine for the last 30 days.

My AHI over the past 3 months (started cpap late June): imgur.com/a/sMTGT (can't post links so just copy/paste)

My leak rate seems to be okay: imgur.com/zT1wuxx

Looking over individual nights there's always 10-20+ pressure spikes like in the image above so that could definitely explain any microarousals. I'll give straight CPAP a go.. thanks!

[mrkdilkington]

Question.. is there any difference on a System One between straight CPAP @ 9cm vs. Auto @ 9-9cm? E.g. are there certain advantageous non-pressure-increasing related functions performed in auto mode but not in straight cpap, like pressure pulses?

[DariaVader]

There may be other issues with your sleep, but it may also get better with patience and time. It took me 6 mo to begin to see an increase in REM and probably also deep sleep cycles, since I'd had apnea for so long and had developed sleeping patterns around the arousals of apnea. At just short of 1 yr, I am hoping to see continued improvements.

[mrkdilkington]

There may be other issues with your sleep, but it may also get better with patience and time. It took me 6 mo to begin to see an increase in REM and probably also deep sleep cycles, since I'd had apnea for so long and had developed sleeping patterns around the arousals of apnea. At just short of 1 yr, I am hoping to see continued improvements.

That definitely could be the case with me too; I am 29 now and dozed off all the time in high school & college classes so I'm looking at 15 years of bad sleep to undo..

[DariaVader]

so then, like me - you had apnea during childhood yrs, probably. good on you for finding it before 30. I am in my late 50s

[AshSF]

Question.. is there any difference on a System One between straight CPAP @ 9cm vs. Auto @ 9-9cm? E.g. are there certain advantageous non-pressure-increasing related functions performed in auto mode but not in straight cpap, like pressure pulses?

Your leak rate, AHi is excellent. Looking at your pressure chart you should Stay in auto @9-9. System one flags flow limitations only in APAP mode. So it's useful to stay in APAP mode with min = max, just to collect more useful data.

Pressure pulses are used in all modes, purely to differentiate between a clear airway event and an obstructive event. They are typically less than a second in duration and don't show up on pressure curve. What you are seeing on your pressure chart is the hunt n peck algorithm of the system one which raises the pressure by 1.5cm over a longer duration and then ramps it back down if it doesn't detect any qualitative improvement in its analysis of the breathing waveform.

[SleepyDude]

Definitely give it some time. I'm at 6 months now and have recently started consistently getting good deep rem sleep. Ha-ha I always told people I never remembered dreaming -- turns out I just never was dreaming at all. I dream now.