If I don't sleep through my events increase

[mwarshofsk]

If I sleep through the night for 7 - 8 hours I regularly average 2 - 3 events an hour.

If my sleep is disturbed either from a trip to the bathroom or any other awakening event my average events increase to 5 - 10 an hour by morning. If I am woken up it is generally after 4 - 5 1/2 hours of sleep at around 2 events an hour.

My CPAP Rx is currently 9 cmH2O ...

Any ideas why the events increase so dramatically after my sleep is interrupted and is there anything I can do to eliminate or decrease the additional events I am experiencing after sleep interruption.

Thanks, Marc

[DariaVader]

Perhaps it is the other way around, and if your RDI/AHI is climbing you tend to rouse. Makes sense to me

[mwarshofsk]

I have the ResScan software and have downloaded my data. The hour or two leading up to my awakening is consistently at 0 - 1 AHI. After I go back to sleep it spikes to 8 - 12 AHI on average but as high as 30 - 40 AHI on a couple of occasions during the last hour of sleep.

So I don't think I am being woken up to pee because of increased AHI.

Hope the extra information helps - Can I provide anything else?

[DariaVader]

I have the ResScan software and have downloaded my data. The hour or two leading up to my awakening is consistently at 0 - 1 AHI. After I go back to sleep it spikes to 8 - 12 AHI on average but as high as 30 - 40 AHI on a couple of occasions during the last hour of sleep.

So I don't think I am being woken up to pee because of increased AHI.

Hope the extra information helps - Can I provide anything else?

yeah, that is why I included RDI in the equation. RERA don't register on any of the Resmed machines except the Airsense10 Auto *for her* RERA + AHI = RDI.

getting up to pee, in particular, is a symptom of apnea events due to atrial natriuretic peptides being released in response to hypoxia. An oximeter might help to prove or disprove that theory. An AHI of 30 to 40 while under treatment is high. Are you having untreated Central Apnea?

[Crimson Nape]

These events could be false positives. If you are tossing and turning or takes you awhile to get back to sleep, and on the other end, you are waking up but just lying there. Usually they will be reported as CA's because our breathing while awake is sporadic as opposed to our patterns while asleep.

[trish6hundred]

Hi mwarshofsk,
WELCOME! to the forum.!
Hang in there for more answers to your questions and much success to you with your CPAP therapy.

[DariaVader]

Also, you are on a fixed pressure. perhaps the same thing that is causing you to rouse (whatever that is) is also causing you to require higher pressure. Maybe being more congested than usual, for instance. I am on autopap and those early morning hours between 3 and 6:30 when I normally wake are when my pressures rise above the median. If I have any extra congestion, the amount the pressures rise can differ from normal nights by quite a bit. normally I stay in the 11 range at that time, but congestion can max me out to 15.

[Sleeprider]

It looks like you're on fixed CPAP, but I didn't think that machine gave detailed AHI data. With the limited information you have, your AHI is still relatively high, even before disturbance. This is not medical advise, but I think you are in a position where you should try some higher pressure and observe the results. Increasing pressure by 1.0 cm should reduce AH events. You may need that additional pressure support for different sleep positions or sleep stage. Give it a try, and if the results point in a positive direction, you can consider additional small increases, or if your AHI settles in at generally under 3.0 AHI, that might be good enough. If pressure increase causes higher AHI, you need to back down to current prescription. Note it usually takes several nights to observe a trend.

[mwarshofsk]

Daria, I was not familiar with the RDI - thanks for the education! A brief read tells me that is a possibility for me as well as different levels of congestion.

Sgear, I wondered if while I was trying to get back to sleep if I was having false CA's. Honestly, I am still not clear on exactly what a CA is. Also, its interesting that the nights I wake up to pee, but fall right back to sleep I maintain an AHI between 2 - 3. It only escalates when I am having trouble getting back to sleep.

Back to Daria, I think I may be experiencing both false CAs and untreated CAs. I have had only one night that I woke up literally feeling suffocated. I had never felt like that for the 5+ years I had untreated apnea or any other night in the last 2 months. Didn't like it I blamed it on the hotel room I happened to be in that evening along with extra congestion.

80+ percent of the nights I have had the CPAP (only 2+ months now) my sleep has been great and my AHI < 5. I am an IT guy, so I was psyched to find this forum and get the ResScan software. I love data as I am a database programmer There literally has been less than 10 nights where my AHI > 5. I haven't slept through the night in 6+ years and I am doing that half the time now. I love feeling rested and excited about life! So being armed with data I can see that my sleep pattern (number of AHIs throughout different hours of the night) is pretty consistent night to night. The outliers bother me as I covet my sleep and CPAP machine now ... LOL ... so just wanting to tweak things a little if it makes sense.

How do you treat untreated CAs?

Are my expectations too high to want an AHI < 5 ALL the time?

As its been only two months, might I need a bit more time to adjust to the therapy?

Lastly, am I better off going to an APAP at some point?

Thanks so much for your thoughtful responses!

[mwarshofsk]

Sleeprider, I like the way you think. My sleep Doc started me at 8.0 cm. I tweaked it to 8.2 and then 8.4 cm and saw some benefit. The Doc wasn't happy with me at our 1 month consult for changing the setting. After a chat about being a "grown ass man" who is his own best health advocate we came to an agreement ... LOL ... They bumped it to 9.0 based on my first month's data. I am waiting for the 2 month follow-up and to actually "own" the machine and then I will experiment with incremental changes as you suggested.