Is apnea really causing me to wake up? Could use help looking at OSCAR data.

[arborgent]

So I've been suffering from middle insomnia for a few years. I wake up around 130/2am and have hard time getting back to or staying asleep after that. Did an at home sleep study, AHI of 10, moderate positional apnea they say. The gave me a cpap machine (Airsense 11) a couple weeks ago., though I haven't been using it every night. I've been using a Philips Dreamwear under the nose mask, pressure range set from 6-15. 

I've been logging on a spreadsheet all the times I wake up and comparing that to my OSCAR data. For one, I'm not seeing much correlation between my waking up and apnea events. In fact numbers have pretty low all in all. Always below 5 AHI, and usually below 1. Yet I'm still sleeping just as poorly as before the cpap. 

Take for example this instance from last night. I recall waking up and looking at the clock at 11:15 PM. On my oscar data it show an obstructive apnea event. Now I don't know if I actually had an apnea event and that caused me to wake up, or if I just woke up and moved around and held my breath a bit as I did, maybe you can tell me. But if the apnea DID cause me to wake up....well aren't these machines supposed to prevent that?? Am I missing something? Forgive me if this is a daft question, but I'm just getting started and have been pretty overwhelmed trying to understand all this stuff.

   

[arborgent]

I suppose a followup question to this is, are people with sleeping issues ever misdiagnosed with sleep apnea? The night of the at home sleep study was also the night that Hurricane Ian made landfall, and my parents were holed up in their condo in Cape Coral right in the eye of the storm, so I recall I slept especially poorly that night anyways being stressed out and all (they ended up being fine fyi). I read somewhere that all people experience some apnea/hypopnea events every night. Could the sleep study have just caught me on a bad day?

[Sleeprider]

Kind of hard to judge your diagnosis without seeing the basis of the diagnosis. We could take a look at a redacted copy of your sleep study. On your first post, we only see a short segment of the night, and that really doesn't give us much perspective on arousal, but there are a lot of respiratory anomalies, including relatively long inspiration time vs expiration time and I suspect flow limitation is under-estimated. I don't see positional apnea here, and your AHI is well resolved. Try taking minimum pressure to 7.0 and use EPR at 3.

[arborgent]

Copy of my sleep study below. I find it odd that there was so much snoring....my wife has never said anything and she is not what you'd call a heavy sleeper. This particular night I slept in the guestroom to avoid being woken up (we have a toddler). I'm just really wondering if I was having an off night.

I'm just frustrated. I was pinning a lot of hope on this machine but I feel like my sleep patterns and quality have not changed at all. My first leg of sleep is pretty solid as it was before. But after 1:30/2am I f I try to sleep with the mask I feel like I keep getting woken by air leaking around the mask, or my mouth opens and air is shooting out. So my sleep has actually gotten worse in those early morning hours. I think I'm just gonna not use it after my first wakeup.

Oh and I should also mention that before I got the cpap I got a dental appliance. Silent Nite brand.  It pulls my lower jaw forward to help prevent obstruction. Didn't help with the sleep so I got the machine. I've been using that dental appliance with the cpap the last few nights hoping it would keep my mouth closed but no such luck.  So yeah, my jaw is being pulled forward and I'm using the cpap and I'm getting nowhere.

A friend of mine suggested I should get an EEG but idno. I suppose my next step should be to call up the sleep doc and maybe get an in-lab study done? Not sure what that would entail.

I will try those settings tonight. Thankyou for the feedback.
edit: just checked the machine. EPR is set to 3 already and full time.

   

[Sleeprider]

FWIW, the sleep test is certainly not definitive and does not include basic EEG to determine arousal or sleep stage. The test is not as definitive as polysomnograpy and tends to over-estimate AHI due to significant inclusion of awake time in the averaging. I'm curious what specialty the physician is that interpreted the test, ENT? We can look at some full-night results of your CPAP data and pretty quickly pick out positional apnea. We know there can be a number of causes for positional apnea, but it's amazing how much of it is just related to chin-tucking or a body position that causes a curvature in the airway that obstructs flow, and that is fully treatable in mild cases with correction of the sleep position, number of pillows or even use of a soft cervical collar. http://www.apneaboard.com/wiki/index.php...onal_Apnea

[arborgent]

Well I am side sleeper. And since I started all this I have noticed that chin does tend to drift down into a tuck at night sometime. I got a new pillow a few days ago that I think is supposed to help with that. It has raised sections that I think are intended to keep your head in place. Too early to tell though if its helping.

I'm so desperate to get this figured out Im trying everything. Daylioght therapy lamps, accupressure mat, cognitive behavioral therapy techniques, journaling, everything. My next step I was thinking of installing a night vision camera over my bed so I can see what I'm doing at the time the cpap machine flags events  

Not sure who looked at the study really. The doctor who signed off at the bottom is not the one I met with in the office: Payam Ag*****, MD, FCCPDiplomate of American Board of Sleep Medicine. That all I got.



   

---

Here's my data last night. Sorry if it looks crap, I wasn't sure at what scale to take screencaps. Let me know if you want me to zoom in on a particular time. From what I can recall, I woke at 2:30 and 4am (approx time, not definite), and after 230 sleep was pretty light. Kept like momentarily waking from air hissing and then conking back out.

   
   
   

[arborgent]

   
   
   

[Sleeprider]

Results look excellent except for short sleep time. Your minimum pressure still needs to be changed to 7.0 or you don't get the full EPR 3. Sleep quality and the ability to remain asleep at night is a challenge for many of us. I often awaken and if I look at the time, I'm sunk and will usually lay awake for a long time. I wish I had a good answer.

[arborgent]

Yeah its a tough nut to crack. Thanks for taking the time to look. Ill try it at 7.