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[Treatment] Treating frequent awakenings
#1
Treating frequent awakenings
Hello! I'll give a short rundown of my sleeping issues: I have a lot of common symptoms of sleep apnea like snoring, peeing at night, waking up a lot, feeling very tired and so on. I recently did one of those basic at home sleep studies and I only slept for 3 hours, and my AHI was 5 (10 on my back and 1 on my side). I had a sh**ty CPAP from before and wanted a Resmed 10 and I was gonna get one from the healthcare system (Sweden) but I also wanted to speak to a sleep doctor and they made me choose between CPAP and speaking with a doctor so I bought a Resmed 10 myself while I'm in the queue to see the doctor which sucked... Anyway rant over.

My CPAP often shows very low AHI but I still feel as bad as usual. I usually have physical awakenings throughout the night, first one about 1-2 hrs after falling asleep and thereafter about 5-10 every night, is what i would approximate. I have not had a night of sleep without several physical awakenings in years.

I have not used my CPAP a lot and as I mentioned I recently bought the Resmed 10 which is so far way better, quieter and better everything, which is making using my CPAP more comfortable which is nice. I'll attach a picture of last night from OSCAR which shows how i woke up after about an hour of sleep like usual, is there anything odd with my flow rate? I'll also attach SleepHQ links from that night and the one before where I used my CPAP the whole night.

I'm a man, early 20's. Also wondering if there is anything you people think I should bring up with my sleep doctor when I see him (in a few month unfortunately) seeing as my low AHI with CPAP and how I still feel horrible. I am convinced my frequent awakenings is wrecking my well-being, I just don't know why I'm waking up so much.

Appreciate it, let me know if I'm missing something.  

Slept and woke up after about an hour with CPAP (night of attached OSCAR data)
sleephq .com/public/8db66662-9f30-4f16-8db4-c94019fd1402

Another day where i had the CPAP the whole night
sleephq .com/public/e937191b-5048-426e-b3c6-7735189847cc

(There is a space in the links I don't have enough posts to post full links)


Attached Files Thumbnail(s)
       
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#2
RE: Treating frequent awakenings
You left off the left column so I can't see many things I would want to see.  Use the F12 key for a screenshot in OSCAR, it will format it correctly.  

Looking at your other attachment it shows a large amount of flow limits.  Flow limits are apnea just like oa and H events.  FL can cause you to wake up or not get into deep sleep. We try to control flow limits by using EPR.

I would try the following

EPR on FULL time
EPR 3

And see how your sleep is.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Treating frequent awakenings
Hello, here's the formatted picture, also for the full night one i posted from SleepHQ


Attached Files Thumbnail(s)
       
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#4
RE: Treating frequent awakenings
You are using your Autoset at 7 to 10 pressure, and we're about to make it a lot more comfortable and effective because your CPAP is actually a BiPAP. The 7-hour night looks pretty good. 95% flow limits are 0.07, and we're going to make them go away by using EPR (exhale pressure relief) which is the bilevel therapy I mentioned. This will give you lower exhale pressure and higher inhale pressure with up to 3 cmH2O difference, corresponding to the setting. Let's go ahead and try the full 3-cm EPR and see what it does for you. Set minimum pressure at 7.0, maximum pressure 12.0, EPR On, Full-Time as Setting 3. Your therapy looks very good for a new user with very low leak rates and few events. The OA event you zoomed to shows an arousal at 22:50:30 followed by an inhale and breath-hold. I suspect you shifted position and this was not actually an obstructive apnea. The zoomed image also shows some oscillations during the exhale phase that your CPAP is misinterpreting as start of inspiration. Those bumps are most likely Carcinogenic oscillations and are normal. Explanation here: https://www.apneaboard.com/wiki/index.ph...cillations

Between the us, I think you made the right choice to go with the machine rather than the doctor.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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#5
RE: Treating frequent awakenings
Hey thanks for the responds. I'll try turning EPR on 3, and I understand the 7 hour night may look good but i had the same amount, probably 5-10 physical awakenings as always where I open my eyes and think "ok just woke up again" and then usually fall asleep quickly again. Which is why I asked if there were any ideas anyone had as to what I should communicate to my sleep doctor in a few months when I get to see him, since he might also just see that my stats are good and I still feel terrible :/ I'll see what the EPR can do for me though
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#6
RE: Treating frequent awakenings
If you want to focus on arousals, look for the flow spikes like the one at 00:12 on your June 12 chart. Also at 23:25, 00:10, 01:25, 01:40, etc. Those suggest arousals. The only question is are they spontaneous, or respiratory related.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#7
RE: Treating frequent awakenings
From experience, it takes a while to get used to CPAP therapy and sleep through the night. It took me 2 months.
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