Does my sleep data look good to you?

[Namso]

Hi there,
Could one of you experienced folks take a look at my sleep data and check if there are any irregularities?
It’s been almost a month since I started using the CPAP device, but I don’t really feel any better. I wake up multiple times every night and feel like a useless zombie the next day.
The AHI looks good, so I’m hoping I’ll start feeling better with more time.

Also got some info about my sleep study:
TST (= Total Sleep Time):

• NREM1: 9.2%
  
• NREM2: 40.8%
  
• NREM3: 27.6%
  
• REM sleep: 22.4%
  

Arousals:

• All Arousals (index): 28.1 per hour
  
• Number of WASO (Wake After Sleep Onset) periods: 7
  
• Respiratory Arousals (index): 2.4 per hour
  

Apnea/Hypopnea Index:

• AI (Apnea Index): 1.5 per hour
  • Obstructive Index (OI): 0.0 per hour
    
  • Central Index (CI): 1.5 per hour
    
  • Mixed Index (MI): 0.0 per hour
    
• HI (Hypopnea Index): 8.7 per hour
  
• AHI (Apnea-Hypopnea Index): 10.3 per hour
  

Sleeping Position:

• AHI on back: 11.2 per hour (time on back during TST = 64.9%)
  
• AHI on left side: 16 per hour
  
• AHI on right side: 7 per hour
  
• REM AHI: 25.3 per hour
  
• NREM AHI: 6.1 per hour
  
• Non-supine AHI: 8.2 per hour (non-supine time during TST = 35.1%)
  

SpO2 (Oxygen Saturation):

• Baseline O2: 96%
  
• Average O2: 96%
  
• Minimum O2: 89%
  
• Time with O2 below 90%: 00:00:03 hours
  

O2 Desaturation Index:

• ≥3% drop: 11.0 per hour
  
• ≥4% drop: 5.3 per hour
  

Heart Rate:

• Average: 56 bpm
  

(P)LMs (Periodic Limb Movements):

• PLM Index: 40.1 per hour
  
• PLMs with arousal index: 11.8 per hour
  

[jdougc]

Welcome to the forum,
Are you on any medications that affect your breathing or sleep?
Do you have any health issues that  affect your breathing or sleep?
The CAs near the end of you sleep are just from sleep wake junk breathing, common as you transition from sleep to wake
The other few CAs might be treatment emergent.

Try lowering EPR to 1 for a few nights or turn it off and see how you feel.
Your flow limitations my go up.

[Namso]

Hi JD,
I’ve turned off the EPR for tonight, and here are some additional screenshots. I don’t have any other health issues and I’m not taking any medication. I’m just trying to understand why I keep waking up during the night. Do I still need more time to adjust to CPAP therapy? I also noticed that I had a very high PLM index in my sleep study.
By the way, should I keep the pressure at 8 cm?

[jdougc]

You do need time to make up for all of the time your apnea was not treated as well as adjusting to cpap.

Leave your pressure at 8 cm, it will seem stronger without EPR

Your very high PLM index might contribute to your large breathes through the night and your fragmented sleep.
That is something to speak to your doctor about.

REM sleep will have erratic breathing , so don't worry that is normal.
REM can show up as peaks in your tidal volume chart

[Namso]

Data from last night, 7cm with epr off.

---

some of them look like real ca's?

[Namso]

another screenshot of a ca

[jdougc]

Most of the CAs shown are preceded by a large breath where you are flushing out a bit of CO2. Your brain compensates by adding breath pauses until the CO2 drops enough to trigger a breath. This equals a CA on the OSCAR chart. These are clear airway events  not necessarily  central apneas.
Some of the other CAs are occuring in the transition period between sleeping and waking up, like in the last zoomed in image from SleepHQ.
You can share the whole night from SleepHQ for us to zoom in.

You flow limitations ar higher that what is scored, EPR is the tool used to deal with them.
Try raising EPR to 2 for a few nights and see how you feel, The CAs, clear airway events may increase for awhile as you make the change and you body acclimates to this change.

[Namso]

Hmm so back to the original settings.

https://sleephq.com/public/42b0f783-43a7...7bada4e1b2 (7cm epr off)
https://sleephq.com/public/ca7decca-a4a9...1f28cc3713 (8cm epr 2)

Been using the cpap for a month now, and never experienced a well rested day.
How much time would it take do you reckon for the ca's to drop?

Also need 10-12 hours of sleep to be able to get out of bed. If i get out with 9 hours of sleep, i'd have to take a nap for a few hours in the afternoon.

[jdougc]

It can take several week to several months to become rested while using cpap.

Do you have restless leg syndrome (RLS) and periodic limb movement disorder (PLMD)? 
You have some on your sleep study, is it being treated?
This might be causing the sleep fragmentations and large breaths you have during the night

You may want to increase EPR to 2 or 3 for a few nights and see how you feel.
You did better with EPR set to 2 on the sleepHQ link
Flow limitations can lead to daytime drowsiness..

https://pubmed.ncbi.nlm.nih.gov/38530665/

[Namso]

i have 40/plms per hour, but this has not been mentioned in my appointments.

see here my sleep study: https://drive.google.com/file/d/1X22B7zV...sp=sharing