[CPAP] Wake up every half hour

[skoggy]

Hello,

I've been suffering from sleep problems for a long time and often can't sleep for 2.5 hours at a time and always feel like sh*t. Since last Tuesday (today Sunday) I now have a CPAP mask, namely the N30i + chin strap + Resmed Airsense 10 Autoset. I haven't been able to fall asleep with the mask yet, but after waking up for the first time, I wore it for 7 hours tonight. Before the CPAP mask I used to wake up every ~2 hours. With the mask on tonight I woke up every 30 minutes. My sleep tracker also tells me that I had exactly 0 minutes of deep sleep tonight and that's exactly how I feel. I had sooo hoped that this stupid waking up with the mask would finally come to an end.

The AHI value tonight was 0.8, in the sleep lab it was 26, so a great improvement. However, it doesn't do me any good if I wake up every half hour. I have switched off the ramp because otherwise I have the feeling that I can't breathe at all if the pressure is still insufficient. The default pressure is apparently 7 and the set range is 7-15. I have switched on the advanced menu:
- Average usage 5.1 hours
- Hours of use 25.4
- Pressure 8.5
- Leak. 4L/min
- AHI 2.5
- AHI total 1.7
- AHI central 1.3
- Smart Start off
- Ramp off
- EPR on
- EPR type full time
- EPR level 2
- Humidification level 4

Please tell me that this will settle down and that my body just has to get used to it, that would make me feel better. 
I'm a bit impatient, yes, because my sleep has deteriorated considerably due to waking up every half hour.

OSCAR from the last two nights.
Note:
Nap 8.6: Didn't fall asleep
Sleep 8.6: I took the mask off and fell asleep without it, then woke up with it on.
Sleep 9.6: Was able to fall asleep with the mask, but woke up so often that it was enough for me.

Oscar-Screenshots:
   
   
   

Can you get any information from the data to help me? I was constantly awake again last night.

[PeaceLoveAndPizza]

You are new to CPAP after having slept horribly for years, so give yourself time to adjust. Adapting to a new way of sleeping is understandably an anxiety-filled time we all go through. Once you adapt to it things will smooth out.


Your numbers and charts look good, so nothing I would necessarily tweak at the moment. If you do want to try something, consider this.

Mode APAP
Min pressure 8
Max pressure 12
EPR 3 full-time
no ramp

A bit more EPR for comfort and managing the few remaining flow limitations, and a lower max pressure in case things go off the rails. Give that a go for a few days and report back with some new OSCAR charts.

[skoggy]

You are new to CPAP after having slept horribly for years, so give yourself time to adjust. Adapting to a new way of sleeping is understandably an anxiety-filled time we all go through. Once you adapt to it things will smooth out.


Your numbers and charts look good, so nothing I would necessarily tweak at the moment. If you do want to try something, consider this.

Mode APAP
Min pressure 8
Max pressure 12
EPR 3 full-time
no ramp

A bit more EPR for comfort and managing the few remaining flow limitations, and a lower max pressure in case things go off the rails. Give that a go for a few days and report back with some new OSCAR charts.

Thank you very much for your answer. I will change the settings as proposed and will come back with the results :-)

[HalfAsleep]

To accelerate the process, I recommend using your set up while watching TV or reading (i.e. awake), so your body gets a chance to get into a rhythm with it and feel more comfortable. To me, it's kind of like learning to ride a bicycle: you learn how your legs work, your favorite gears, how to make turns, the most comfortable place on the saddle, and how to get off. On a a bike, "time in the saddle" is how you get a smoother, experienced ride. On a PAP, it's "time in the mask".

And, yes, it takes a while. I was stuporous for the first 6 weeks, even though my Oscars were more or less OK.

[PeaceLoveAndPizza]

Great advice from HalfAsleep. I like the metaphor.

One thing with CPAP is you need to learn to relax whilst trying to fall asleep. The more you fight the machine, the worse things get and the more mental we become. It manifests as aerophagia, insomnia, brain fog, and other effects of sleeplessness. Getting frustrated happens to all of us at times.

Sleep hygiene is critical as you get used to things. Taking time to prepare for bed is important. Get away from electronics, dim the lights, listen to soothing music, do some yoga, avoid the telly, read, do some deep breathing, whatever works for you.

When you do go to bed, relax your body and breathe with the machine. Don’t focus on it, just breathe naturally. Let your mind wander. Easier said than done at first, but you will learn it over time.

[HalfAsleep]

I agree with PeaceLoveandPizza. I've learned to really enjoy the feel of the air when I put the mask on. I take deep breaths. It's like breathing in fresh air on a cool night. I now fall asleep very quickly, within a few breaths.

While I'm thinking of it, check to be sure you like the temperature of the unit humidity. I prefer coolish air, because warmer air makes me feel stuffy. I also don't enjoy the feel of warm air! It took a loooong time to figure this out. I like Alps, not Texas. The trick is to arrive at a humidity temperature and quantity setting that won't make water bead in your mask (this is called "rainout") and shower your face. The humidity settings are in the patient options panel.

[skoggy]

Hello,

I've gotten more used to the device by now. However, I still have the problem that I wake up very often, actually just as often as before the CPAP device. However, I still notice that it's good for me, as I haven't had a migraine for a long time, for example.

Can anything be learned from my OSCAR stats from last night?

   
   

Thank you.

[SarcasticDave94]

Any possibility you're dealing with other sleep robbing medical conditions? The chart and settings look acceptable.

It's not necessarily going to be found here, but I'm wondering if you're not getting into deep REM sleep.

[quiescence at last]

so often we think of deep sleep or REM sleep as the great satisfier, and many that seem never to reach a satisfying sleep have had issues with getting appropriate doses of deep or REM sleep.

Let's clarify something - Deep Sleep and REM sleep are two different sleep stages. Deep sleep is also known as Slow Wave Sleep (SWS) (delta brain waves) and is linked with clearing of wastes in the brain and is restorative and regenerative. REM sleep is a sleep that seems critical in imaginative health. It usually involves rapid eye movement, and brain waves during REM are very similar to awake and aware brain. During REM sleep, much of your body is paralyzed, and the regulation of respiration controls can also be reduced (enough to sometimes ignore regulation of oxygen, rate and depth of breath.) Most dreaming also happens during REM sleep, and very rarely in deep sleep. Some dreaming occurs in lighter sleep.

Having each at appropriate amounts affect your body and mind positively.

Wishing you the best,

QAL