Another study and still having trouble

[Harry]

Well I had another sleep study confirming I have sleep apnea, 3rd time
My oxygen levels averaged 89 and were as low as 86. Does anybody know if that is low?
The study took place on a constant pressure and the report says maximum results were achieved at 7. Of course someone was adjusting the controls all night
I use an Auto machine at home with a range of 6-15.

The problem is I only average about 4.7 hours a night with the machine and general after two hours or so I wake agitated with an elevated pulse and blood pressure.
I calm myself down and give it another go.

I'm not getting quality rest though I do sleep better with the Cpap then without.
I wake agitated with elevated blood and pulse levels most of the time.

I just don't understand why it's not working. I've been using the machine for almost three years now and just not getting the results I think I should. In fact it feels somewhat determental to my health.

Does anybody have any idea what could be causing this situation. My doctor doesn't seem to get it and keeps offering the standard good sleeping habit advice. I've stopped my normal one drink an evening and I'm trying to go to bed earlier and earlier but I don't seem to be making progress.

Some nights are better than others, but mostly it's a disappointing result?

Any theories or suggestions welcomed.
Harry

[BabyDoc]

Welcome, Harry. I am sorry that you aren't feeling better after 3 years of therapy. I am a bit confused by your Autoset's settings of 6 to 15. Did your sleep doctor suggest a change after seeing that your maximum results were obtained with only a pressure of 7.0 in the sleep lab?

Obviously, the sleep lab results may not equate with what you do at home in your own bed. I see that you are using Rescan. What is your AHI? If it is under 5, I am not sure why you are feeling so bad, except that you may not be getting enough quality hours of sleep. Your average oxygen level of 89, presumably during sleep, is a bit low, but probably not low enough to supplement with oxygen unless you have other health issues with your heart or lungs. I see that you are using nasal pillows. Are you possibly awakening when you begin to mouth breath as perhaps the pressure ramps up during REM sleep? Look at Rescan to see what's happening at the moment you are awakening. If the pressure suddenly goes up and you are recording a large leak at that time, it would suggest mouth breathing. If you aren't sure, try using a chin strap, or possibly a full face mask to see if that helps.

[PaulaO2]

Blood oxygen needs to be at least 95%. So, yeah, 86-89% is low. Not OMG low but close.

So after you initially wake up, you are able to go back to sleep or are you then up for the rest of the night?

Since you have an Autoset, it'd be interesting to see what the data says. To see what you are doing that wakes you up.

Did you wake up like that in the sleep study?

Ask the doc what they got the AHI down to with the pressure of 7. Did they get it less than 5? Did you have central events if they went higher? With that setting, what did your blood oxygen get to? Was it still in the 80s even with the pressure of 7?

[JudgeMental]

Harry, I think that I would put my "home" XPAP in the constant pressure "CPAP" mode, set it at a pressure of 7; and leave it there for a couple of weeks and see if that helps you sleep longer and deeper.
You may be sensitive to even the slightest pressure changes in the Auto PAP mode.
Since you have the software, you can use that as a monitor of your therapy.
If you could give us some more info as taken from the software, if you use it,we may be able to offer more posititve suggestions.

[zimlich]

You do need to work on good sleeping habits. If you are not getting a full night of quality restful sleep you are not going to feel better. Waking up agitated as you do tells me you need to use the cpap all night. Both of these things- sleep hygiene and using the machine 100% of sleep time are equally important. They are both a lot of work, but necessary, absolutely necessary for you to feel better. Your doctor knows- it's simple, but not easy. This is one case where a Zeo, or similar machine may be helpful in normalizing your sleep. You can get just about any machine with a 30 day return policy. Of course you don't need the machine, but something to help you chart your progress and give incentive may be helpful. Believe me, I know where you're coming from. Reviewing and working on all aspects of sleep hygiene is hard and somewhat boring. I'm sure you're up to the task at hand- good sleep is worth working hard. I wish you the best of luck in feeling better. Please don't blow this advice off as being old hat- sometimes we have to start again at basics.