Sleep Wake Junk and insomnia

[0rangebear]

B4 I started therapy I was experiencing insomnia a few times a week. I woke up during the night and could not go back to sleep for several hours.

In the first few weeks of therapy the insomnia got worse and when I first stated looking at my data it showed events > 80 in the hours I knew I was awake. I learned from the folks here in the forum that this was sleep wake junk.

As I continued to adjust to therapy the insomnia disappeared in the fourth month of therapy and I began sleep through he night from 5-7.5 hours with an AHI < 1.2

However in the last week some insomnia has come back, I around 3.5 hours and lay awake for about an hour before falling back asleep.

The strange thing is; the machine does not show any sleep wake junk as CA OA or H, but I am scoring RERA's of around 2.5 during that hour.

Typically my RERA is <.2

I am wondering why "wake time" is scoring differently than it did when I first started therapy?

Does the machine learn and adapt to the users breathing patterns, or has therapy change the way I my breath during wake time?

[PoolQ]

My guess is that the therapy is not bothering you so much while awake. Sleep/wake junk does not have to happen, it's just that it can happen.

For me what I found. pretty sure at least, is that when I first would go to sleep I was tired enough to ignore some little things that I did not like about my machine settings. I would wake up after being somewhat rested and have trouble going back to sleep. With continued adjustments and after quite a while playing with the settings, I finally got things tuned in and literally as I made the final changes I slept better each night until with the last one I am now sleeping through the night.

It seems that some people can sleep through anything, or at least many default settings are just fine for them, and others like me are very sensitive regarding how the machine reacts with me while I sleep. I was told by many that I just needed to get used to it, I truly think that I would never have gotten used to it.

I also did not get sleep/wake junk-I would just wake up and need to take the mask off and stand up for a few minutes (maybe 3-10 minutes) and then I would hook back up and lay there for quite a while before drifting off to sleep again. With my change to BiLevel I got access to more settings:

EPR at 3 was not enough and now set to the same as EPR of 4 made a difference
My breathing (inhale) was being cutoff, I seem to have a very slow inhale and I could watch the pressure bar drop before I finished my inhale0changed Ti Max to 4 seconds just to get it out of the way-this had a good impact but still not enough
Change the Trigger setting to very high and this seemed to do the trick- the machine was not detecting my start of inhale quite soon enough and I was feeling that difference.
I can now tolerate, even enjoy humidity that I have never been able to stand
Finally it turns out that my starting therapy pressure was slightly too low, by a whopping 1.4cm and this was the final change that gave me sleep. As someone explained to me I was not going into full apnea, but my flow rate was going down to zero and I was taking a recovery breathe and then repeating over and over for hours at a time. The slight increase in pressure stopped this disturbing pattern from happening and I was finally able to sleep through the night. It turns out that this pattern was stopping me from sleeping through the night, I could get to sleep but not stay asleep.

I have no idea if everyone will be able to adjust or tune the machine to what they need, but until you have made adjustments to every single setting I suggest that you do not give up and just "live with it" as there may indeed be something more you can do.

[Crimson Nape]

Orangebear,

Here is a trick I use to eliminate "stuff" while trying to fall asleep. I set my Resmed's Ramp feature to "ON" and then set the timer to a length of time that it will take me to fall asleep. During this phase the Resmed won't record any events. Be sure to set the starting ramp pressure to the highest allowed. This will be the lowest pressure of your range if in Auto mode or the set pressure if in straight CPAP mode. This way you're starting at a theoretical treatment pressure.

I hope this may help.

[PoolQ]

Orangebear,

Here is a trick I use to eliminate "stuff" while trying to fall asleep. I set my Resmed's Ramp feature to "ON" and then set the timer to a length of time that it will take me to fall asleep. During this phase the Resmed won't record any events. Be sure to set the starting ramp pressure to the highest allowed. This will be the lowest pressure of your range if in Auto mode or the set pressure if in straight CPAP mode. This way you're starting at a theoretical treatment pressure.

I hope this may help.

That's cool to know, thanks for enlightening me today!

[nadprok]

I have now seen several posts on the forum where people say that events are not recorded for the period that ramp is on.
I have been using ResMed AirCurve 10 Vauto for a year now and I have ramp set at 20 minutes. I have events recorded almost daily in the 20 minutes that ramp is on. Most of them are central apneas but hypopneas are also recorded at times.
Is that only happening with the AirCurve 10 or is anyone experiencing that with other models ?

[Crimson Nape]

I know it works on the S9 Autoset. I see that you are using a higher level machine than I employ so maybe there's a difference. . . Sorry if I provided incorrect information on the AS10's.