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Sleep quality excellent when I'm not in my own bed. High CAs?
#1
Sleep quality excellent when I'm not in my own bed. High CAs?
Hello apnea board. I've been on CPAP for about 5 months now. Over the past 60 days, my AHI sits at 2.52, OA index at 0.31, and CA index at 1.87. Currently using Resmed Airsense 11 with variable pressure from 6 to 11 and a nasal pillows mask.

Since starting therapy, I've noticed when I sleep in a new bed my sleep is absolutely AMAZING. I've spent a few weekends away from home, and everytime I look at data for those nights it consistently shows AHI <1, with very few OA/CA events.. Unfortunately, I've been unable to reach this level of sleep quality at home.

Has anyone noticed this pattern where they sleep much better when they're NOT at home?

Some observations on sleep away from home vs at home
These amazing sleep nights happen when I'm at a cottage or an airbnb with my friends. The beds have varied in firmness, but I suspect a softer bed is better for me. I usually sleep in a single bed or share a queen with a friend. 

At home, I sleep by myself on a queen bed. I've recorded myself sleep and I see that I toss and turn a LOT. Every 10 minutes or so I'd switch from my side to my back, back to my side and so on until my final wake in the morning. Most nights I wake up mulitple times I'my unable to sleep more than a few hours without waking. I usually feel groggy and tired when I wake.

However there are the rare nights at home when I wake up feeling refreshed. These are nights where I don't wake up in the middle of the night, and my OSCAR data shows AHI <1 on these nights. Oddly enough these are usually on nights when I drink. This happens about once every couple weeks.

I remember reading that you may hold your breath in your sleep when you change sleeping position. Could this be related to CAs? Not sure what the correlation and causation is here.

What I've tried:
- Tongue exercises to help keep mouth closed to try and reduce leak rate
- Sleeping on a lower loft pillow to help keep my airway more open
- Reducing EPR from 3 to 1

What I haven't tried:
- Buy a new bed. I will be moving to a new apartment with a softer bed in September, really hoping that will boost my sleep quality.
- Switching masks. I currently use nasal pillows, but I have a nasal mask that I haven't touched since the first week of therapy. 
- Soft cervical collar. I've bought two but I've been unable to fall asleep with either
- Using a constant level of pressure

OSCAR Data from a recent night
Most of my nights look like this. Lots of CAs. Large leaks that start appearing in the hour or 2 before my final wake.
   

Any help or insight is much appreciated!
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#2
RE: Sleep quality excellent when I'm not in my own bed. High CAs?
I noticed this same thing with a new bed. I recently bought a new extra firm bed and It provided more support which abolished all my twisting and turning. When one is turning and repositioning all night searching for comfort I assume you’re holding your breath and or knocking your mask that can create leaks. If you hold your breath as you turn it can look like centrals if you hold your breath long enough.
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#3
RE: Sleep quality excellent when I'm not in my own bed. High CAs?
Follow the exact directions for posting Oscar charts (e.g. no calendar), and ask for help with settings. Incorrect settings tend to be the source of most evils (even mask issues are contingent on settings). After that, address mask issues, since you have significant leaks.

Also, it's not surprising to me that sleep would be different and perhaps better on an "away" bed. When you're away, activities tend to be different, some positive, some negative. These would affect the profile of your sleep. You might just be conking out from exhaustion.

Example: if you want to re-set your biological clock, you can go camping for the weekend. Evidently, that's enough to re-adjust it. You'd be getting sleepy a lot closer to nightfall. And, if you ever spend nights on the Appalachian Trail, you'll find a whole lot of people go to bed at 9, even if they have almost no comfort for a skimpy mattress and no pillow except maybe an empty backpack. And, I can guarantee many have OSA's because there's always someone snoring. Still, they rest. They're physically spent, and it's dark. Sayonara to insomnia.
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