CPAP newbie / OSCAR / study feedback

[Brad124]

Hi all.  I’m a CPAP newbie looking for some guidance.

I’ve suffered with poor sleep quality for many years.  Over the past three years I've started to eat healthy, exercise, and I’ve become pretty fit.  Unfortunately my sleep problems have persisted despite those changes.
 
My most common symptom is that I’ll rocket awake at 3AM like I’ve just received a shot of adrenaline and then have a very difficult time falling back asleep.  If I do fall back asleep, it’s poor quality.  Sometimes it'll take me a couple of hours to settle back down, at which point I’ll realize I need to be up in another hour anyways to get the kids off to school and so won’t even bother.

I finally pushed for an in-lab sleep study which has led to a diagnosis of mild obstructive sleep apnea.  I had a CPAP prescribed (AirSense 11) which I picked up last week.

My follow-up appointment isn’t for another eight weeks.  I’d prefer to use guidance from these forums to iterate more quickly.

My initially prescribed settings on the CPAP were pressure 5-10cm, start 4cm, EPR 1, ramp Auto.  I noticed during my first week via the events GUI on the device that the large majority of my events were CA events.  My in-lab sleep study from 2/19/24 had showed a perfect 50/50 split of 21 central apneas and 21 obstructive hypopneas.  For reference I’ve also attached the screenshots from the in-lab study.

I tinkered with settings last night for the first time simply to begin experimenting and reduced pressure to 4-6cm, EPR 3, ramp 30 mins.  I was curious to see if my hypopnea or CA events would increase or decrease at the lowest pressures.  I also acquired an SD card yesterday and captured the data to run through OSCAR for the first time this morning.  Results attached.  I wasn’t too surprised to see my largest combo of adverse events occurred during my problematic 2-3AM timeframe.  I had a flurry of CA events during this same window in the in-lab study as well.

For some reason I consistently don’t breath properly during that window and my body responds by waking me up like I’ve been shot out of a cannon because it thinks I’m about to die, at which point adrenaline is coursing through my veins and it becomes difficult to get back to sleep.

I’d love to have some guidance from the forum gurus regarding what they’d do based on what they’re seeing.  I know my numbers may look a bit mild compared to some others but I feel tired/foggy/irritated most days due to these symptoms and I’d like to do whatever I can to get this sorted.

Thanks in advance for taking a look at my data!

Brad

[Brad124]

Update with data from last night.  mix/max 6, EPR 2, ramp disabled.  I had more CA event clusters last night along with increased flow limit.  Suggestions on what changes I should make?

[Brad124]

Removed EPR and ran at a constant pressure last night to determine if my centrals were being caused by the use of EPR.

Result: even more centrals and AHI 10.12

I noticed that my nasal passages were pretty dry and congested when I woke up in the middle of the night.  I adjusted the humidity settings from Auto to 6 and then tried to go back to sleep.  It felt more comfortable at the higher humidity, and I was less congested after the change, but the CA's continued.

I'm frustrated and not too sure on where to go next from here but trying to look at the bright side that at least I'm learning a couple of things along the way with this trial and error.

[John Reston]

I don't have a good analysis of the data you've posted because I too am fairly new at this, but I will say your sleep study, your experiments with pressure and humidity, and some of the results are nearly identical to mine. I too wake at 3 and staying in bed is like wearing a straight jacket. It's not that I'm full of energy when I get up, but I'm definitely ready to get up and go. After three months on the CPAP, I haven't made progress in lowering the 8.5 AHI recorded in my sleep study. I've talked to the doctor once already, and I talk to him again next week to see what else I can do. I'm not convinced apnea is the reason I'm getting less than 5 hours' sleep a night. I'm hoping the CPAP will improve the sleep I get, but I'll need to do something else if I want to sleep longer.  The good news for you is that you're working on this at a younger age than I am, so you have a good chance of preventing some of the long-term health problems associated with chronic lack of quality sleep.

[Brad124]

Last night I set my machine back to the default settings that were initially prescribed (apap 5-10cm, epr 1) and had over 20 CA's within the first hour.  I'm now capturing o2 data from an o2ring and could see that my oxygen levels were dipping down into the 80's (low 87) during that hour.  Just look at how chaotic my o2 levels were swinging around with the CPAP on (first hour) compared to without (next eight)!

I am going to discontinue treatment until I can figure out what I'm supposed to be doing.  It can't be healthy to be intentionally causing this amount of respiratory distress every night.  I feel like I've been prescribed the wrong type of machine, or wrong settings, or maybe shouldn't be on CPAP at all and am better off just living with my natural background level of hypopneas and CAs.