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Keep waking up several times at night, central apneas
#1
Keep waking up several times at night, central apneas
Hello all,

I'm a 33 year old guy who was diagnosed last year with an AHI of 17, mainly hypopneas and obstructive events. No significant oxygen desats were noted, and I confirmed this several times at home by sleeping with an oximeter. My oxygen keeps above 95 at all times. I do have to say I only slept for like an hour in that sleep study, so they probably pieced everything together to make my diagnosis. My prescribed pressure was 7 cm H20 fixed, but I opted to get an APAP just to have the option of changing it to an automatic pressure.

So I started with the APAP last week. My mask is the Resmed P10 and I have it set to a pressure of 7-14 cm H20 with EPR on 3 and humidity on 4. Haven't really felt a massive difference in my sleep quality like most people who write about it online. Maybe a slight difference. The only thing that did change is that I no longer wake up with a pounding heart and headache (although this morning was a little different, I think I had a veeeery slight headache). I also seem to dream a lot more. Before, I never dreamt during the first part of my sleep (first 3-4 hours). Now I do seem to do that.

My pattern of sleep has been the following for the past 3 years orso: wake up after 3-4 hours of sleep, then try to get back to sleep and wake up every hour/40 minutes. It's exhausting. I THINK that this is because the first part of sleep (first 4 hours) is deep sleep with little REM sleep. The last 4 hours is more REM sleep, and this is where most apneas occur to my knowledge. But Unfortunately CPAP hasn't helped this for the most part. Which is unlogical because according to Oscar my apneas are all but resolved wearing the mask. Except for one night last week were I seemed to have slept 6 hours on end, which is unusual for me. But since starting 2 weeks ago I've stuck to my old pattern unfortunately. And I my sleep remains unrefreshing for the most part.

So I've looked at oscar and mainly the AHI is below 1 (except for last night, where it was 1.19), and I don't have many obstructive events, mostly centrals. How can I get rid of those centrals (if possible?). Is there something that I could change or try to attempt to combat my early morning wake ups and REM sleep fragmentation?

The forum won't allow me to post pictures as I don't have 4 posts, but here is a link to a picture album with my Oscar screenshots: https://imgur.com/a/V2ycBja
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#2
RE: Keep waking up several times at night, central apneas
Welcome to the board. I am in the same boat as you, Sleeping 3-4 hours, waking up every 45 minutes exhausted during the day. I hope some expert in board could answer your question.
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#3
RE: Keep waking up several times at night, central apneas
Quote:who was diagnosed last year with an AHI of 17

Quote:I started with the APAP last week.
So you have been on some kind of therapy a year or a week in total?
or 
You put off therapy until a week a go?


Quote:Haven't really felt a massive difference in my sleep quality like most people who write about it online. Maybe a slight difference.
If the above answer is a week.  You don't get better that fast.  It more slowly getting better.  I could take 6 weeks to a few months.   You have been sick for a while I am sure.  It might be a bit before you are fully feeling it.

I am sure other will comment to.   Welcome
Thank you,
Brent aka Factor

Just a Regular guy.
My untreated AHI was 87.  You can do it hang in there.
"You can if you will"   Jerry Kramer

Got OSCAR?
Organize Charts
Optimizing Therapy

My Story
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#4
RE: Keep waking up several times at night, central apneas
(07-13-2021, 08:59 AM)factor Wrote: So you have been on some kind of therapy a year or a week in total?
or 
You put off therapy until a week a go?


If the above answer is a week.  You don't get better that fast.  It more slowly getting better.  I could take 6 weeks to a few months.   You have been sick for a while I am sure.  It might be a bit before you are fully feeling it.

I am sure other will comment to.   Welcome

I was diagnosed a year ago but didn't really bother on treating it because at first I couldn't stand the masks I was given. But last week I decided to give it another go with the Resmed P10 en that worked fabulously, and I haven't missed a night since then. 

I know about tempering my expectations but I do want to know if I'm on the right track and what I can do to make things better. And possibly getting a grasp on what I could do to finally get rid of my early wake ups and fragmented REM sleep.
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#5
RE: Keep waking up several times at night, central apneas
I see 1 obvious break at 5:15, another at 7 when you are waking up. when are your other breaks?
Your AHI is excellent and as such adjustments should be based on comfort and not numbers. I suspect your CA numbers are "up" a bit because they are consistently inconsistent. Any effort to reduce your Centrals will most likely result in an increase in your obstructive events.
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#6
RE: Keep waking up several times at night, central apneas
(07-13-2021, 09:25 AM)Gideon Wrote: I see 1 obvious break at 5:15, another at 7 when you are waking up.  when are your other breaks?
Your AHI is excellent and as such adjustments should be based on comfort and not numbers.  I suspect your CA numbers are "up" a bit because they are consistently inconsistent.  Any effort to reduce your Centrals will most likely result in an increase in your obstructive events.

For last night that was it. I got up at 5:15 to urinate (I seem to be waking up with a half-full bladder after 3-4 hours since I've started doing CPAP consistently, that wasn't the case before, or maybe it's because I drank water before bed, I don't know...) and then at 7 I got out of bed. No other breaks. Why do you think there are other breaks?
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#7
RE: Keep waking up several times at night, central apneas
Only your mention of several and not seeing them. This is really about as good as it gets, especially number wise. As I said this is where tweaking is more about comfort now than anything else, and you are the judge of that.
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#8
RE: Keep waking up several times at night, central apneas
I've been waking up after the first 4 hours with a full bladder with the need to pee since I've started last week. I didn't have that before. What would be the cause of this? My sleeps have also been getting progressively worse, woke up with a headache again this morning. The last 3 hours of my sleep are very fragmented. I wake up after every 40 minutes orso and the headache gets worse after every wake up.
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#9
RE: Keep waking up several times at night, central apneas
Tips http://www.apneaboard.com/wiki/index.php/Sleep_tips

Tell us more of your routine.  

Also tell more about yourself.  Other medical conditions, BMI, allergies, caffeine intake and other stuff that could be helpful.

You mentioned you might be drinking water before bed?  

Post more OSCAR data when you can.
Thank you,
Brent aka Factor

Just a Regular guy.
My untreated AHI was 87.  You can do it hang in there.
"You can if you will"   Jerry Kramer

Got OSCAR?
Organize Charts
Optimizing Therapy

My Story
Post Reply Post Reply
#10
RE: Keep waking up several times at night, central apneas
(07-14-2021, 08:09 AM)factor Wrote: Tips http://www.apneaboard.com/wiki/index.php/Sleep_tips

Tell us more of your routine.  

Also tell more about yourself.  Other medical conditions, BMI, allergies, caffeine intake and other stuff that could be helpful.

You mentioned you might be drinking water before bed?  

Post more OSCAR data when you can.

My routine is quite bad I guess, I stay on my laptop or phone until the moment I go to bed. I go to bed around 12am and get out around 8.
I mostly drink coffee or matcha tea in the morning, and that'll be it for the day. I have hay fever allergy but that's it. 
Sometimes I drink water before bed, sometimes I don't. Last night I didn't and still woke up to have to go take a p***. It's not a completely full urgent bladder feeling, just something that is noticeable to me and something that I could do or not do. More like "it's there" and if I don't take care of it it might interfere with my sleep.
I've had it before when I slept without the CPAP, but not every night. It depends on how "deep" I slept that night if I had to get up to urinate. But never more than once.
I've been tested for diabetes so it's not that. I don't drink alcohol. My BMI is fine, I'm 6ft 154 lbs.

I've practiced sleep restriction (CBT-i) in the past, and found it helped to keep me asleep for longer times. The problem is that it's very hard, and I run the risk of catching a cold or becoming sick (happened several times so then I had to stop doing it) because my immune system is so sh**ty on so little sleep. I should do it again though.

Could it have something to do with my mask (resmed P10)? I noticed the first night I used it, I had a great sleep of 6 hours. But after that it was downhill. I hadn't cleaned it since the first time I used it, so I gave it a thorough cleansing today. Although I do think the venting still worked fine before I cleaned it.

I've decided to do a trial run with EPR set to 2, see if that might improve something. Even though I obviously find 3 the most comfortable.

I obviously have no problems getting to sleep (mostly), but once REM sleep kicks in I wake up. I need to figure out how to stay asleep in REM sleep.

This was last night:
[Image: yD3oI5r.png]

As you can see I woke up at around 4.45 and then went to take a p***. Then I fell asleep several more times but woke up each time, groggy and with a headache that was intensifying each time I woke up. The headache was pretty bad this morning.
Those outliers you see on the chart is me taking deep breathings or sighing. I also have some sort of chronic hyperventilation syndrome during the day (self diagnosed) where I have to take deep satisfying breaths all the time. It's quite annoying and contributes to my overall stress level.
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