My experience over the last 2 years, mild OSA

[tedgreen]

2 years ago, I realised that my sleep was getting worse and worse, and was not restorative, despite "sleeping" for 8 hours each night. I was also snoring a bit more.

• Home sleep study showed a fairly mild sleep apnea (AHI less than 5), so was put on CPAP as a trial (upgraded to APAP soon after)
  
• After getting used to the machine and using for several month, didn't see a major improvement despite being fairly compliant
  
• Then had a proper clinic sleep study done (first half without APAP, second half with APAP): showed that the OSA was a bit worse than expected (AHI of 10), but that CPAP was dealing with it fully. Nothing else found, including restless syndrome etc. Sleep cycles were heavily disrupted (brain waking up) but not because of breathing issues
  
• After a few months, I was put on Modafinil, to increase alertness during the day. It did work but had lots of side effects/weird behaviour/"carrie mathison" kinda talking, including making actual sleeping much worse/shorter, so I stopped
  
• I had a battery of blood tests to see if any other underlying issues were creating poor sleep (including vitamin deficiencies), and slightly elevated blood sugar was found (may create hypoglycemia during the night)
  
• I was advised to go on a low carb diet to try reverse it without medication, and that worked
  
• I lost about 10kg of weight (was only slightly overweight to start with), meaning occasional snoring has also stopped
  
• Sleeping with CPAP is still better than without (despite for some reason only now tolerating it for 3/4 hours a night), and getting usually a score of less than 1 on AHI and often 0
  
• My Fitbit smartwatch is showing no drop of oxygen in the blood with or without CPAP during the night
  
• I use a weighted blanket (in winter), which I think helps a bit too to stop moving too much
  
• I occasionally take Melatonin, despite not having issues falling asleep. Seems to help a bit having a better restorative sleep
  

Conclusion:

• Losing weight and better diet has helped
  
• CPAP can be useful even for mild cases of OSA, even if not used through the night
  
• There can be many contributing factors, and sleep is still not well understood by doctors. My sleep doctor doesn't have any more ideas now...
  

That's my story so far! Hopefully, will be useful to some people. 

CPAP/APAP equipment:
I have a Resmed Autoset 10 for her at home (sleepyhead software), and a Resmed Airmini when travelling etc. Airmini usually reports also a perfect score (AHI of 0 or close). Both are in autoset mode (not Her), with a range of 6.5 to 11. Usually, machines don't go above 8 or 9 in pressure.

[Sleepster]

You should make a commitment to use your machine every time you sleep, for the entire time that you are sleeping. With practice, this becomes easier and more natural and will definitely help resolve some of the problems you're still having.

Congratulations on losing the 10 kg and keeping it off. That will also go a long way towards helping you feel better.

[tedgreen]

You should make a commitment to use your machine every time you sleep, for the entire time that you are sleeping. With practice, this becomes easier and more natural and will definitely help resolve some of the problems you're still having.

Congratulations on losing the 10 kg and keeping it off. That will also go a long way towards helping you feel better.

Thanks. When I started on CPAP (before losing weight), I could do easily 5+ hours each night.

Since I have lost weight, I have been struggling to do more than 3/4 hours per night, no idea why. I am still feeling a bit better than not using CPAP at all. My Fitbit device doesn't show much difference in term of SPO2 with or without CPAP (no issues either way)...

[Dormeo]

Thanks for posting this account; I bet it will be helpful to other people. Do you sometimes look at your daily chart on Sleepyhead? Could you post a screenshot of a typical night? This could be a dead-end, but it is possible the experts could spot something that might help you get some more restorative sleep.

About the mask: I wonder whether the weight loss (congrats!) has changed the contours of your face a little so that your mask fit is less optimal than it used to be. Is it about the same level of comfort? Are your leaks at about the same level as before the weight loss?

[Sleepster]

Since I have lost weight, I have been struggling to do more than 3/4 hours per night, no idea why.

Well, you are either consciously or unconsciously taking the mask off. If you're doing it unconsciously then there are strategies such as bobby pins or extra straps that make it more difficult to remove the mask.

If you're doing it consciously you just have to commit to stopping. If you have the mindfulness to lose weight, you have the mindfulness to make this commitment. It will be difficult at first as you may have to get out of bed and read with low light when you feel exhausted. But in just a few short minutes you can go back to bed and put the mask back on.

Just think about what's happening to your body when you sleep without the mask. You are never falling into the deeper levels of sleep needed for your health, and you are increasing the risk of cardiovascular disease and stroke or early death.

Mentally, you are making it harder on yourself to keep the mask on! Let me explain. Your mind is used to waking you up to breathe. It will continue to do this (for many of us) even when we're wearing the mask and getting the CPAP therapy. It's so used to doing this out of necessity that it keeps doing it even when the CPAP therapy makes it not necessary. The only way to train your mind that it's safe to let you keep on sleeping is by training it to do so. Every time you sleep without the mask on your mind says "I knew it was unsafe to let you stay asleep". You short-circuit the training process and make it impossible for you to adapt.

I am now so used to sleeping with the mask on that I don't even notice it anymore.