Effort to improve treatment of OSA and IH

[QuietSign]

Just a quick question/update: I've been struggling with waking up after a few hours lately and being unable to go back to sleep. Consequently, I have to take a very long nap in the middle of the day. Has anyone experienced this before? I'm not sure why I am waking up in the middle and it's pretty frustrating. Here's my sleep from the last day ( spills over into the current day).

   

   

[Sleeprider]

There is nothing in those results that explains night-time awakening, but you're not alone. I have sometimes also awakened and laid for hours hoping sleep would come. Those nights are not my favorite. You have the choice to get up until you feel you can sleep or just lay quietly, which is your best chance that you will eventually fall asleep. The problem gets worse if you start getting anxious about waking up and getting back to sleep, so the best attitude is to assume this will pass and it has nothing to do with CPAP. If it continues then talk to your doctor about what can be done. Having a solution at hand in the event you need it, removes the anxiety and may solve the problem.

[Shadowpup]

Just a quick question/update: I've been struggling with waking up after a few hours lately and being unable to go back to sleep. Consequently, I have to take a very long nap in the middle of the day. Has anyone experienced this before? I'm not sure why I am waking up in the middle and it's pretty frustrating. Here's my sleep from the last day ( spills over into the current day).

I have been referred to a Therapist for a ten week CBT (Cognitive Behavior Therapy) treatment for insomnia.  Supposedly has a good record of addressing awakening at night(My manifestation of insomnia).  We will see and I’ll report back.  Hopefully I won’t be reporting at 3am.

If you are a veteran, the VA has a good program on line.  I had started that, but the sleep doc wants better, quicker resolution of my insomnia.

[QuietSign]

Thanks for the replies regarding insomnia. I'll try to keep updating as a form of accountability - really trying to get the sleep structure right to get the most out of CPAP therapy.

On another note, I've been finding generally more success with some mouth tape + a simple loop elastic strap. I've found the Knightsbridge doesn't seem to offer a comparative advantage over the elastic strap, if the mouth tape is also being used in conjunction. Consequently I opt to go with the elastic strap since it's more minimalistic and comfortable.

However, I still haven't quite found the perfect tape yet. The 3M micropore paper tape is cheap but a little too strong. Even if I stick it to fabric a few times before my mouth, it is still leaves a lot of residue.

The Somnifix tape is very expensive. The adhesive strength is pretty reasonable (doesn't leave a residue), but it's a little small and the shape is weird and tends to result in the tape loosening as the night goes on.

I wish I could find a big, simple roll of tape that has the (weak) adhesive strength of the Somnifix without the clumsy shape. Any suggestions? Has anyone tried Vaseline or chapstick on their lips to make the 3M micropore tape removal easier?

[SarcasticDave94]

Sorry I can't answer the tape questions. I did notice this thread after it was already into today's activity. The AutoSet is doing great for you. If you get a 90 second CA let me know. These bits of CA here and there are very likely you and the PAP together have increased your breathing efficiency. CO2 is being washed out a bit quicker than your body is used to. It is recalibrating to your new "normal" as you use it. This is the likely cause for any of your CA. Although a few clusters in the middle of the OSCAR charts may be a change of sleep position. They're just a blip on your screen right now, and should fade out mostly in a few weeks. If you get little CA clusters at the start or end of a sleep session, it'll very likely be SWJ or sleep/wake junk. It's safe to mentally disregard SWJ typically.

[QuietSign]

Sorry I can't answer the tape questions. I did notice this thread after it was already into today's activity. The AutoSet is doing great for you. If you get a 90 second CA let me know. These bits of CA here and there are very likely you and the PAP together have increased your breathing efficiency. CO2 is being washed out a bit quicker than your body is used to. It is recalibrating to your new "normal" as you use it. This is the likely cause for any of your CA. Although a few clusters in the middle of the OSCAR charts may be a change of sleep position. They're just a blip on your screen right now, and should fade out mostly in a few weeks. If you get little CA clusters at the start or end of a sleep session, it'll very likely be SWJ or sleep/wake junk. It's safe to mentally disregard SWJ typically.

Regarding CO2 levels, are you saying that it's low CO2 levels that result in CA's?

I was considering looking into O2 levels with an oximeter. Is this something people here have experience with? I'm familiar with oximeters that give readings on the spot, but are there also ones that track levels over the course of the night? I'm curious about O2 levels because I still feel I haven't found the perfect mask - the Swift FX nose pads don't fit quite right but has strong ventilation, whereas the Airfit P10 has nice nose pads/straps but very weak vents. There was actually a thread on another sleep apnea forum where a doctor showed via flow data and microscope imaging that the P10 vents were susceptible to clogging, which leads to unreasonably high CO2 levels. They took the issue to Resmed, and found that Resmed had done very little in terms of ensuring quality control for their vents, and got the design passed via some automated process that required very little testing. It seemed like results varied from user to user, but some of the people more susceptible to CO2 found their P10's to be very problematic for their sleep, and it's something I'd like to rule out.

Has anyone here looked into the issue with the P10's before? Some people have tried homemade solutions to poke extra holes in the P10 mask to encourage venting, and others have jury rigged the Swift FX vents onto a P10 mask.

I'd still be curious if anyone has input or recommendations for mouth taping as well - see above posts where I was wondering if there's a weak adhesive option.

[SarcasticDave94]

Low CO2 levels in regards to causing CA, low is relative to normal levels while off PAP.

Oximeter use here is fairly common just to track O2 levels. Some record the data and even upload it to OSCAR. I don't know exactly which models, except it's not the one I have. Mine is a cheap base model CMS 50D just for quick O2 and heart rate checks. I have COPD and PVCs/cardiac condition, so I check these routinely during the day.

P10 works well for most, the vent issues are mainly just to be sure to brush the vent clean every so often. I've never used it, but it still has a big following.

[Sleeprider]

The big problem with P10 vents is always associated with moisture obstructing the very fine mesh. I get a replacement mask through insurance on a routine basis and almost never clean the frame and vents any more. I keep the pillows and headgear maintained. I have never experienced a flow issue on the P10 since I started using it after switching from the Swift FX in 2015.

[QuietSign]

Does it make sense to track O2 over the night to see if there's anything amiss? I'm curious if O2 levels look ok, even when my apneas are well managed.  I'm interested in learning more about oximeters - I'm seeing the Contec CMS50D, CMS50F as recommended devices, but don't quite understand how to weigh the pros/cons. Any advice on this matter?

[Crimson Nape]

Make sure it is the "D+" and not the "D" model.