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Sleep Fragmentation
#21
PLEASE HELP ME
            Hi Guys

As mentioned in one of my older threads, I have been suffering from sleep fragmentation for the last 7 months although my AHI numbers have always been below 2.0. Although my numbers are good, I am usually feeling tired and sleepy in the morning due to lack of refreshed sleep and MUST have an afternoon nap. 

Is there any way that you guys could help me out to determine if there is anything wrong in my pressure settings or have I missed something important ?

I have recently switched from using APAP (6.4-20) to CPAP (13) but I still tend to wake up at the end of each sleep cycle every night. My one hour afternoon naps are fine and AHI's are always 0. 

I am posting charts of the last three days. Hoping for some good advice . Many thanks in advance.

P/S - Sleepster, sleeprider, bonjour etc please help
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#22
RE: PLEASE HELP ME
Why are you starting another new thread??
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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#23
RE: Sleep Fragmentation
I have merged three threads. The questions on sleep fragmentation was the root cause, and you worked with bonjour on using fixed pressure. Your most recent post #21 in this new thread builds on those two previous discussions. By keeping the discussions together, we can form a more cohesive idea of what has been done, what has worked, and not have to look all over the forum to find it.

The three most recent charts posted show auto pressure of 6.4 to 20 on January 26, and the results of fixed pressure on the 27th and 28th. Therapy results with fixed pressure are clearly better, but it is obvious that therapy is stopped four or 5 times. Why do you stop therapy instead of just leaving the mask on and waiting to fall to sleep? I do think the fixed pressure is less disruptive to you and will eventually help you to sleep better. The main problem with auto-pressure was the wide range of pressure from 6.4 to 20, and I'm certain auto pressure in the range of 9.0 to 14.0 would have been much better.
Sleeprider
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#24
RE: Sleep Fragmentation
You might be able to sleep more soundly if you stopped napping. I say that knowing how hard it is not to take a nap when you long for one! But try taking a walk instead or doing something else that gets you out of the house and on your feet.

Also, if you are getting up to urinate, try avoiding liquids for a longer period before bedtime.
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#25
RE: Sleep Fragmentation
(01-29-2020, 09:31 AM)Sleeprider Wrote: I have merged three threads. The questions on sleep fragmentation was the root cause, and you worked with bonjour on using fixed pressure. Your most recent post #21 in this new thread builds on those two previous discussions.  By keeping the discussions together, we can form a more cohesive idea of what has been done, what has worked, and not have to look all over the forum to find it.  

The three most recent charts posted show auto pressure of 6.4 to 20 on January 26, and the results of fixed pressure on the 27th and 28th. Therapy results with fixed pressure are clearly better, but it is obvious that therapy is stopped four or 5 times.  Why do you stop therapy instead of just leaving the mask on and waiting to fall to sleep?  I do think the fixed pressure is less disruptive to you and will eventually help you to sleep better. The main problem with auto-pressure was the wide range of pressure from 6.4 to 20, and I'm certain auto pressure in the range of 9.0 to 14.0 would have been much better.

Thanks a lot SR for merging the three threads. Am actually a dinasour when it comes to using these kind of stuff.
On your Q on why I stop therapy......reason being is that I would like to track my wake up times. As such, I reset and let the machine ramp up from start. No issues on going back to sleep.

By the way, do you think that I should stick to fixed 13 or try auto 9-14 ?
Honestly I know you are not God, but frankly how long more do you think it will take in order for me to sleep better ?
Dont want to sound like a baby but I actually lost my job due to my sleep fragmentation issues as it caused me to doze off at work on many occasions. As such, I am extremely desperate to find a solution. I am also a single father. As such am really praying for this therapy to eventually work  to allow me to have better sleep !!!

Thanks once again for everyone's support and guidance. Am really glad to be in this forum. God bless
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#26
RE: Sleep Fragmentation
(01-29-2020, 09:58 AM)Dormeo Wrote: You might be able to sleep more soundly if you stopped napping.  I say that knowing how hard it is not to take a nap when you long for one!  But try taking a walk instead or doing something else that gets you out of the house and on your feet.  

Also, if you are getting up to urinate, try avoiding liquids for a longer period before bedtime.

This. You likely need to be really rigorous about sleep hygiene in general.

Read up on "sleep restriction therapy."
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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#27
RE: Sleep Fragmentation
Nobody has mentioned RERA’s yet AND it appears they are turned off. I have been on APAP for 4 years now and have noticed slow CONTINUOUS progress over the full 4 years. I have gotten my AHI to less than .5 every day. HOWEVER, I still do wake up 4 or times a night. Never do I have to get up but I still wake up. 

It seems the more RERA’s, the more I wake. Still can’t prove a timing relation but I can prove a pressure relationship. They all (almost all) happen at max pressure. 

Because my RDI is so low, I can’t say for sure RERA’s are the answer, but I would turn on RERA and explore that possibility.
CPAP is a journey like “The Wizard of Oz”. It’s a long slow journey. You will face many problems and pick up many friends along the way. Just because you reach the poppies, it doesn’t mean you are in Kansas. 
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#28
RE: Sleep Fragmentation
Your chart looks way better at 13 than it did at 6.4-20.

You might find that you can stay asleep longer if you turn ramp off and let yourself get used to the fixed pressure before you fall asleep. Fewer changes to deal with. The feeling of pain in your lungs is something that will go away with time.

If the pressure is too uncomfortable to breathe out against and you simply can't sleep, you could certainly try 9-14. Or you may be in the same boat as me and need bilevel. It's a delicate balancing act between comfort and getting the right level of therapy air.
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#29
RE: Sleep Fragmentation
I'm still quite new, to everything, but I got pushed toward better sleep hygiene and fighting the nap by my sleep doctor just yesterday.  He saw all my erratic sleep episodes (first compliance visit @ 3 months), and gently suggested I begin resisting urges to nap, begin reacting differently to waking up every 3-4 hours, stop jumping up and having coffee and food like it's morning.  I'm slightly under-employed at the moment, and honestly, I was taking some naps out of sheer boredom.  They're becoming less needed, and way shorter and unsatisfying right now, so I'm definitely striving to clean up my whole behavioral approach to this long and interesting (and life-changing) process.  I sure appreciate the collective experience behind this site; I'm impressed by its scope and its traffic...
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#30
RE: Sleep Fragmentation
PS It wasn't all scolding: I got high praises for 90 days averaging 1 event per hour, no matter how I was getting the sleep!
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