AHI higher upon first falling asleep

[rdavis]

Has anyone had experience with AHI events (obstructive, central, hypopnea, etc.) being higher as you are first getting to sleep?

I've suspected this is happening for some time (doctor never paid much attention to my claims) but now that I've downloaded sleepyhead, I'm seeing the proof. I will have clusters of events (most hypopnea, a few clear airway, several "respiratory effort causing arousal") early in the night, then go for long stretches of sleep with nothing. Sometimes if I wake in the night, a cluster will happen again as I'm going back to sleep. Over the course of the entire night, my average AHI is low enough that it wouldn't raise any red flags; but if you just look at the early stretches of time where I"m trying to fall asleep (and being woken frequently by the events) my AHI is definitely above five during those stretches.

I can post a screen shot of my sleepyhead results for a particularly rough night; however, I'm not exactly sure how to do that. When I try to insert an image, it asks for a URL. Is there a way to directly upload an image into a post?

Thanks,

RDavis

[Shastzi]

I suppose your starting pressure (5) is too low. and if you are using ramp you
might want to try turning it off and see if you turn in better numbers.
my low is 15, no ramp but I am used to it now.

Strategy:
#1.
check the sleepyhead pressure being delivered on your graphs.
See what cm pressure the OA's stop occurring.

#2. start bumping up your pressure on the low side 1 cm. Let that ride for a week or 10 days.
slowly work up to the point where your low end is at or just below where OA's dissappear.

Keep an eye on your leaks all the while. and fix those as they come up.

That should get you going on your way.

Good luck and hang in there!

[rdavis]

Thank you!

Ah, bummer, I forgot to update my profile when my pressure changed. My starting pressure is actually 8, and I stay right around 9 to 9.5 about 90% of the time at night while I"m asleep. I don't use the ramp feature.

So the weird thing is, almost none of my events are actual OAs. The vast majority are either hypopnea or clear airway events.

[justMongo]

Not unusual to see a cluster while in stage 1 sleep.
Also not uncommon before waking.

Your cerebral cortex has some control over breathing while conscious. During deep sleep, the pons has total control.

[quiescence at last]

non-event arousals (ones not scored as apneas) are often associated with first several minutes of sleep. Tidal volume at this time is higher than in "sleep" and can be the cause for resistance while getting ready to breathe in more monotonous rhythm. You are also more easily aroused when you are in light sleep, which is your first stage. I have issues for a few minutes when I am getting used to lying down, but that would only be for my going to bed, not during the night upon waking [unless I sit up for a bit].

You can lie down with mask on and hose disconnected for a few minutes before you actually hook up. But, beware you are apt to fall asleep in that mode. So, better to just put up with those sleep-onset events.

QAL

[rdavis]

Thanks very much for the responses so far! Okay, so here's my other question:

It's great to know that clusters when falling asleep are not necessarily atypical...but what do I do when they keep me from falling asleep? I'm having 7 or more waking events within 30-60 minutes, and the next day I still feel rather wrung out, like I did before starting the therapy.

Any time that I am not in a 100% EXACTLY comfortable environment (like if I'm in an unfamiliar hotel bed or at someone's house), my sleep apnea still has the power to torment me for the first hour or two of sleeping, and make me groggy the next day. This is obviously very frustrating, because, as a 31-year-old healthy woman, I don't want to go ahead and resign myself to never traveling or never being rested on trips again.

[OpalRose]

rdavis,
I too have occasional clusters of events early in the evening and also early morning. I try not to get excited over these. The ones I would like to eliminate are RERA's and snoring as these events aren't recorded in the AHI but tend to make me feel groggy even with a low AHI.
There is a lot that we don't understand about how these machines flag events and how the pressure will rise with no events showing on graph.
OpalRose

[justMongo]

...I don't want to go ahead and resign myself to never traveling or never being rested on trips again.

Pack up the machine and travel... Life's too short to let apnea limit your life.

[PaulaO2]

You may want to look into sleep hygeine. Some of the habits it teaches may help you. They work no matter where you are.

Or perhaps a noise machine, or white noise played by a smart phone app. Your brain gets used to hearing that noise (or music) each night so when it hears it, and you are laying down, zzzzz. I use that trick a lot when traveling. I have a playlist I use just for this.

[justMongo]

You may want to look into sleep hygeine. Some of the habits it teaches may help you. They work no matter where you are.

Or perhaps a noise machine, or white noise played by a smart phone app. Your brain gets used to hearing that noise (or music) each night so when it hears it, and you are laying down, zzzzz. I use that trick a lot when traveling. I have a playlist I use just for this.

Fastest way to put me to sleep is to listen to is German language lesson!