Sleep-Wake-Junk or Actual OSA?
Hi All,
New member here - this forum has already been a lifesaver so huge thanks to the mods and contributors!
F34 - been on my Resmed Airsense 11 for about 3 weeks and collecting data in Oscar for 2 weeks, added SPO2 about a week ago. For years I've had disordered sleep with challenges falling asleep, staying asleep, and feeling rested generally. My work schedule can be quite variable which doesn't help. My journey to a sleep apnea diagnosis started this year (well, my husband argues that the first time he pointed out that he thinks sometime I stop breathing at night was ~6 years ago. I brushed him off because I don't snore and hated the idea of a CPAP). I've always been prone to recurring sinus infections, and this finally converted to chronic sinusitis at the beginning of this year. Concurrently with that, I started having noticeable heart palpitations (PVCs) that eventually led to a full cardiology workup that came back just fine leading to a recommendation of a sleep study.
In-person sleep study came back with an AHI of 16.3. I felt surprised that they were even able to get enough data to make a diagnosis; I move around alot in my sleep normally and being stuck on my back with all the sensors had me feeling wide awake. At most I can imagine I started drifting off a few times but then would be jolted back awake. The technician mentioned at the end that they barely had enough time / data to complete both the diagnostic and therapeutic portions of the study together in one night, and I didn't get any REM sleep. I could not tolerate the nasal mask which I had told them we probably shouldn't even bother with my sinus issues and being a mouth breather (but they still had me put it on for an hour).
Since getting my APAP I've tried the F20 and F30i masks and I'm still going through trial and error to figure out which one will work for me or if I need to find another mask. The F20 makes my nose super itchy and prevents me from turning on my side or stomach comfortably (plus the tube gets in the way). The F30i gives me better flexibility to move and I like the lower profile that only goes under the nose but I have more leaks especially if I don't get it perfectly positioned. I've mostly been able to meet my "compliance" hours with the mask on each night, but would say I'm only able to get 1-2 hours of sleep at most with it on most night and it feels like some sort of sleep deprivation torture where I lay there wide awake and uncomfortable until I eventually start to drift off and then jolt awake again. I'm barely getting through my days on a combination of the mask on half-sleep, a couple hours of mask off sleep, and an AM nap if I can squeeze it in (which I only allow myself to take when I'm wearing the mask).
Over the last couple weeks, I'm noticing that the majority of my "events" are happening at times when myself and my fitbit would agree that I'm actually awake, so after reading some about sleep-wake-junk on the forum here I thought I should disregard the AHI info I'm seeing right now and keep trying / hoping that I would acclimate and get more data when I'm conclusively asleep to confirm that this is really the right path for me as I have been starting to feel like the data collected in the sleep study could all also be SWJ!
I started tracking SPO2 with a viatom checkme 02 sensor last week because I was starting to feel like I was breathing more sporadically / apneic-ally with the mask on than I would be with no mask and I wanted to confirm if I was actually desatting when sleeping normally. Monitoring confirmed that I am desatting to low 90s / high 80s both with and without the mask.
I wanted to get some feedback from the experts here on data from the last couple days in the context of all this. On Oct 15th, I had this ~40 second OA(!) clustered up with a bunch of shorter CAs and OAs around 10am. I know I was asleep and dreaming but popped out of it gasping, but no snorting/ snoring like I have experienced when congested and sleeping on my back - I must have dropped straight into REM sleep right away when my head hit the pillow I was so tired- would you still consider this SWJ? Is there a point where SWJ itself is also confirmatory of OSA? See attached from Oct. 15th.
On October 16th I got ~1.5h of actual masked sleep right after a period of SWJ / SA / desat - fitbit says I hit some time in both deep and REM sleep (~2:45-3:50) where the flow rate and SPO2 looks good, and the next chunk of REM sleep unmasked (~5:30-6) shows desats - confirmation that I am having events or just normal SPO2 drop during REM....? I'll attach the Oct. 16th charts and the sleep study results in replies due to attachment limit.
Appreciate your opinions and feedback on all this! I've yo-yo'd over the past month from being devastated that the sleep study showed OSA (big feelings of failure / shame combined with hating the idea of having a machine strapped to my face every night forever), then feeling excited that maybe this would be the magic to get me sleeping soundly all night, bring back my energy, resolve the palpitations etc., and now I'm back to hating the mask, questioning if the diagnosis is even "real" and feeling super disheartened that my sleep and energy levels right now are the worst I can ever recall.
Misc notes worth calling out -
1. I started my therapy with no EPR for the first week based on the prescription, and the feeling of suffocation I was having was what brought me to this group - I was still having the clustered CA / OA phenotype even without EPR and turning it on has much decreased anxiety from where I was before.
2. I've also been looking at all the positional apnea info here, but I've now had this same cluster pattern happening on my back and on my sides across varying positions.
3. I plan to get my sinusitis issues corrected surgically; ENT and allergist have both indicated that I'm at a point where medication can't overcome my anatomy there, and I'm hopeful that one day I can transition to a nose only mask and will find that more comfortable to fall asleep with (well, I really wish that it would just resolve my sleep issues completely but I've read enough to know that's not likely).
Oct 16 charts
Hypnogram
New member here - this forum has already been a lifesaver so huge thanks to the mods and contributors!
F34 - been on my Resmed Airsense 11 for about 3 weeks and collecting data in Oscar for 2 weeks, added SPO2 about a week ago. For years I've had disordered sleep with challenges falling asleep, staying asleep, and feeling rested generally. My work schedule can be quite variable which doesn't help. My journey to a sleep apnea diagnosis started this year (well, my husband argues that the first time he pointed out that he thinks sometime I stop breathing at night was ~6 years ago. I brushed him off because I don't snore and hated the idea of a CPAP). I've always been prone to recurring sinus infections, and this finally converted to chronic sinusitis at the beginning of this year. Concurrently with that, I started having noticeable heart palpitations (PVCs) that eventually led to a full cardiology workup that came back just fine leading to a recommendation of a sleep study.
In-person sleep study came back with an AHI of 16.3. I felt surprised that they were even able to get enough data to make a diagnosis; I move around alot in my sleep normally and being stuck on my back with all the sensors had me feeling wide awake. At most I can imagine I started drifting off a few times but then would be jolted back awake. The technician mentioned at the end that they barely had enough time / data to complete both the diagnostic and therapeutic portions of the study together in one night, and I didn't get any REM sleep. I could not tolerate the nasal mask which I had told them we probably shouldn't even bother with my sinus issues and being a mouth breather (but they still had me put it on for an hour).
Since getting my APAP I've tried the F20 and F30i masks and I'm still going through trial and error to figure out which one will work for me or if I need to find another mask. The F20 makes my nose super itchy and prevents me from turning on my side or stomach comfortably (plus the tube gets in the way). The F30i gives me better flexibility to move and I like the lower profile that only goes under the nose but I have more leaks especially if I don't get it perfectly positioned. I've mostly been able to meet my "compliance" hours with the mask on each night, but would say I'm only able to get 1-2 hours of sleep at most with it on most night and it feels like some sort of sleep deprivation torture where I lay there wide awake and uncomfortable until I eventually start to drift off and then jolt awake again. I'm barely getting through my days on a combination of the mask on half-sleep, a couple hours of mask off sleep, and an AM nap if I can squeeze it in (which I only allow myself to take when I'm wearing the mask).
Over the last couple weeks, I'm noticing that the majority of my "events" are happening at times when myself and my fitbit would agree that I'm actually awake, so after reading some about sleep-wake-junk on the forum here I thought I should disregard the AHI info I'm seeing right now and keep trying / hoping that I would acclimate and get more data when I'm conclusively asleep to confirm that this is really the right path for me as I have been starting to feel like the data collected in the sleep study could all also be SWJ!
I started tracking SPO2 with a viatom checkme 02 sensor last week because I was starting to feel like I was breathing more sporadically / apneic-ally with the mask on than I would be with no mask and I wanted to confirm if I was actually desatting when sleeping normally. Monitoring confirmed that I am desatting to low 90s / high 80s both with and without the mask.
I wanted to get some feedback from the experts here on data from the last couple days in the context of all this. On Oct 15th, I had this ~40 second OA(!) clustered up with a bunch of shorter CAs and OAs around 10am. I know I was asleep and dreaming but popped out of it gasping, but no snorting/ snoring like I have experienced when congested and sleeping on my back - I must have dropped straight into REM sleep right away when my head hit the pillow I was so tired- would you still consider this SWJ? Is there a point where SWJ itself is also confirmatory of OSA? See attached from Oct. 15th.
On October 16th I got ~1.5h of actual masked sleep right after a period of SWJ / SA / desat - fitbit says I hit some time in both deep and REM sleep (~2:45-3:50) where the flow rate and SPO2 looks good, and the next chunk of REM sleep unmasked (~5:30-6) shows desats - confirmation that I am having events or just normal SPO2 drop during REM....? I'll attach the Oct. 16th charts and the sleep study results in replies due to attachment limit.
Appreciate your opinions and feedback on all this! I've yo-yo'd over the past month from being devastated that the sleep study showed OSA (big feelings of failure / shame combined with hating the idea of having a machine strapped to my face every night forever), then feeling excited that maybe this would be the magic to get me sleeping soundly all night, bring back my energy, resolve the palpitations etc., and now I'm back to hating the mask, questioning if the diagnosis is even "real" and feeling super disheartened that my sleep and energy levels right now are the worst I can ever recall.
Misc notes worth calling out -
1. I started my therapy with no EPR for the first week based on the prescription, and the feeling of suffocation I was having was what brought me to this group - I was still having the clustered CA / OA phenotype even without EPR and turning it on has much decreased anxiety from where I was before.
2. I've also been looking at all the positional apnea info here, but I've now had this same cluster pattern happening on my back and on my sides across varying positions.
3. I plan to get my sinusitis issues corrected surgically; ENT and allergist have both indicated that I'm at a point where medication can't overcome my anatomy there, and I'm hopeful that one day I can transition to a nose only mask and will find that more comfortable to fall asleep with (well, I really wish that it would just resolve my sleep issues completely but I've read enough to know that's not likely).
Oct 16 charts
Hypnogram
