HI 0.0 for a week straight.. is this a malfunction?

[bitteroblivion]

Hello all! I am a 31 y/o female that just got diagnosed last month (16.4 AHI); suspected deviated septum / narrow nasal passages. Sleep about 60% on my back and 40% on side.

I have been on an Resmed Airsense 10 machine for the last month; there was some initial struggle with a mask that I felt was suffocating me (the dreamwear nasal) which was causing a lot of anxiety and lack of sleep, however after switching to the N30 mask about 3 weeks ago it's been mainly smooth sailing ever since. My AHI's are now from 0 to 1.3 (highest it's ever been), with a nightly average of about 0.4. That being said, despite feeling mentally and physically adjusted, I continue to wake up a lot throughout the night which is abnormal for me (I don't need to use the bathroom, I just become wide awake multiple times a night and feel very restless). I also have to adjust the mask on my nose sometimes, so perhaps that's a factor?

Wondering if someone would mind analyzing my data to see if there's any reasons why I may be so exhausted, and also I'm just someone who loves to understand things relating to my health / feel educated. If there's anything you see that's odd, feel free to tell me.
I’ve been reading up online and following the Wiki Oscar page, but still find it quite confusing. My sleep therapist has told me since day one everything looks perfect, but of course I get onto Oscar and see all this stuff and am overwhelmed wondering if that's true or not. I also regularly think to myself, do I even need a cpap?! Was it all a sham?! but that's probably just my anxiety and paranoia lol - I have trust issues. It seemed a little too good to be true that I've had close to 0 AHI's since the first night of starting treatment.. I wasn't presented with any alternatives to CPAP and am curious if I would be a candidate / if a cpap is necessary? I spend about 50% of my life travelling aka this has been a tough pill to swallow.. and am currently waiting to see an ENT to discuss options.Here is 3 days worth of data:

Here is 3 days worth of data:

           

[HalfAsleep]

I recently had my septum undeviated, and my experience is that though I can breathe better through my nose, it made no difference to at all to my AHI. It's easier to keep my mouth closed while sleeping, but that's about it!

[bitteroblivion]

Thank you! I'm so sorry to hear it did not help! That is reassuring though, as of course I'm in the early stages of denial / wondering if I could have a surgery to fix all this. 

I'm uniquely pretty much only a nasal breather - my friends and boyfriend always have witnessed me struggling to nose breathe in my sleep and making the oddest, squeakiest sounds, but noticed for the life of me I wouldn't open my mouth to breath. Probably because I'm a huge clencher and am always chomping down, and just normally a nose breather day to day anyway. This is what led me to getting tested haha!

[HalfAsleep]

I didn't have an easy time with the septoplasty (and the other stuff they did), but most folks say recovery is quick. I guess I'm not a good example about whether it's a good thing or a bad thing, but plenty of others on here have had the surgery. My surgeon seemed to think the whole procedure was super routine, EZ PZ: I'm so glad it was, at least for him!

It is nice to be able to breathe through both nostrils.

[BoxcarPete]

I had my nose cleaned up and I can't say what it's done to my AHI until later this month when I take my follow-up sleep study, but I went for the three-in-one surgery because of the adenoids and my CPAP has spent most of the past two months benched. If not for 50-70% of my nasopharynx occupied by adenoid tissue, I would have had a more difficult decision to make (i.e. just deviated septum and turbinates might not have been quite as worth it), so I recommend that you meet with your ENT and see what's going on. You never know what's up there until it's looked at.

[bitteroblivion]

I have a slight concern re: my Airsense 10. Last night marked the 7th night in a row that my arousals have been 0.0. A couple days of this striked me as odd / unusual, but a week seems next to impossible (I think?!). I was recently diagnosed (AHI of 16.7) and I started treatment 2 months ago - I now average about 0.2-0.6 AHI nightly with treatment. Occasionally I'll get a 0.0, but it happens sporadically.

Thinking maybe something was wrong with the machine, I tried on two separate occasions to hold my breath multiple times, talk with the mask on etc - in the past doing this elevated my AHI score (I noticed when I first got the machine and was testing it out). But this time around it’s had no effect and still every night has stayed at 0.0. I took a look at my data in Oscar to see if everything was suddenly blank, but all the data is there surprisingly and changes day by day! Things look OK in there - though I'm a newbie and not an expert at reading the data.. Wondering what people's thoughts are on this?

EDIT: Just got off the phone with my sleep therapist after mentioning my concern. She said everything looks great and while rare it does happen and I seem to be doing great on paper. Not sure what to think!

Here's a few nights worth of data from a couple days ago.

https://sleephq.com/public/4321581f-a401...d03c2dda69

https://sleephq.com/public/36d5fcf1-4445...3308f186c9

https://sleephq.com/public/b66a5c9e-16d1...ef03f24d87

[OpalRose]

Just follow the links in my signature line to Organize a daily page chart and then use the Attachment feature to upload here.

Attaching Images and Files on Apnea Board

[bitteroblivion]

I'm just at work and wouldn't be able to do this until late tonight or tomorrow - i've had some members on this board ask for sleepHQ links so I added a few of those to my post instead. Does that work? Thanks!

[staceyburke]

We are all more accustomed to oscar files so it is harder to identify if you have any problems.  BUT things look very good.  The only thing I noticed is some high flow limits (the chart is bouncing from lower pressure to higher quite a bit) that could stop you from deep sleep.  And all nights you had some snoring.

Your therapy needs to be judged by your quality of sleep not the AHI.  In other words HOW DO YOU FEEL?"  If I were to suggest anything it would be to try raising the min to 8 and see if that helps the flow limits and snoring.  The main question is did it make you feel any better?

[bitteroblivion]

Thank you very much! Well - I feel horrible. It's been an awful two months adjusting to everything - I'm a naturally anxious person who struggles with sleep as is, so it's quite the adjustment. Though I do feel "adjusted" to the machine and routine now, it's still uncomfortable to sleep with (pain/pressure around mouth/teeth/back of head from nasal mask and straps). I wake up more than I'm used to now because of all this. (though I will say in these 3 sleep HQ links I sent, I was just getting back from europe and extremely jetlagged and had the best sleeps I've had since beginning treatment because I was zonked lol).

But yeah, I feel probably worse than before going on CPAP. I actually adjusted my min pressure to 8 a couple weeks ago after the recommendation of someone else on here when I made a post wondering why I'm waking up so often throughout the night. The first night it didn't make a difference.. I managed to sleep with it but still woke up just as frequently, then the second night I struggled with it  - felt harder to breathe and I'm rather sensitive to feelings of claustrophobic and short of breath, so I haven't done it since. 

Just checked my snoring for the month of March and there wasn't much, I agree there is a little more in these three nights of data, maybe from getting better sleeps than normal due to being so exhausted?! For the most part my graphs in March and April have virtually no snoring.

I don't know much about flow limits but I'm looking at my chart for the 3 days you reviewed and I thought it looked pretty decent, graphs look mostly blank except for a small amount of activity. What causes flow limits? I've looked into this before but it's gone over my head and I completely forget / find all of this overwhelming lol.

*edit; just took a look and the pressure changes seem to occur due to leaks, duh. Not sure what I can do about this; we trialed so many masks for me and unfortunately my nostrils are basically child-size plus with the claustrophobia nothing was working until I found the n30. I can manage this one and it's been a huge relief having it, but it's led to a bit more leaks in comparison.