Still waking up soaked in sweat

[flanksinatra]

Hello everyone, I have been using CPAP for about 4 months now. My AHI has gone from 8 to around 1-5 with the machine. However, I still feel extremely exhausted and my sleep is still super fragmented. 

A typical night for me looks like: 
  - Going to bed at 10:30PM. I start the night sleeping almost upright. 
  - Waking up at 2:30AM and I usually remove a few pillows so I sleep at around a 35 degree angle.
  - Waking up at 5:30 soaked in sweat, usually a pretty sudden awakening. (It's important to note that this is not caused by nightmares. This awakening always happens when I am dreaming and my dream is always pretty tame. Nothing that would cause me to wake up soaked in sweat)
  - At this point I usually remove all the pillows except for one so I can sleep on my side.
  - The rest of my sleep is very fragmented. The best way I can describe it is that I dream for a bit then wake up for a few seconds. I usually remember changing sleeping positions or adjusting my mask. I can't give an exact number on how many times this happens but if I had to guess, I'd say I remember briefly waking up 5-7 times.
  - I wake up at around 7:30 - 8:30 feeling very unrested but try to get through the day.

I really don't know why CPAP isn't helping. Based on the numbers it should be working but my sleep fragmentation and fatigue have really not been affected. I have posted on this forum and others asking for any advice. I have tried everything that has been recommended to me, but nothing seems to work. I will include my OSCAR report from last night. I will zoom in on some sections of what seems like very irregular breathing which I get every night. Any advice will be greatly appreciated.

Edit: The times on my OSCAR are not accurate. I went to bed at around 11:00PM last night.

[Sleeprider]

Why are you sleeping inclined or upright? This position is usually pretty hard to manage without a soft cervical collar, however you seem to have only sporadic flow limitations. Your event rate is relatively low. Read our positional apnea article to understand the concern with sleeping inclined https://www.apneaboard.com/wiki/index.ph...onal_Apnea

[flanksinatra]

Thanks for the reply. I was told that sleeping upright would lower my AHI which I will say it does actually seem to do. If I don't sleep upright at the start of the night I end up getting a worse quality of sleep. I prefer to sleep on my side but I have found that sleeping on my side causes my AHI to increase and results in me waking up a lot more throughout the night.

[Sleeprider]

I think it might be useful to just sleep in the most comfortable position possible, then we can work out any positional apnea if it occurs. I have not seen anything to convince me that inclined or upright sleeping improves apnea with CPAP therapy.

[Soleil211]

I agree with Sleeprider that you should sleep in a position that's comfortable for you. I tried sleeping on an incline and I found it very uncomfortable. Some apnea side sleepers have success with the Pillow Cube. I know it may look uncomfortable, but don't knock it until you've tried it. I've turned a lot of skeptics on to the Pillow Cube. if you don't want to spend 70 bucks for the name brand, there are a bunch of knock-offs on Amazon.

[HalfAsleep]

IMO sleep in a position that's most comfortable for you all night long and work from there. This is your sleep, and not someone else's. Most folks on xPAP have to make some adjustments, but you seem to be making waaay to many compromises in your sleep habits to be comfortable. Personally, I can't imagine doing all that work regarding pillows and angles and getting a good night's sleep.

There are conditions when it's medically necessary to sleep at a high angle (e.g. after nose surgery), but generally, all those pillows you're using would cause a kink in the neck and make for some very problematic sleep.

A night sweat could have a thousand causes, in my experience, but could be something as simple as using a pillow that runs hot or, yep, getting in the wrong position.

Try doing a few nights with your favored sleep position, all hooked up, then post the Oscars and see what folks think.

[Deborah K.]

Maybe you need to sleep under something very light, perhaps just a sheet to avoid sweating. Sometimes anxiety and a warm room can cause sweating.

[robbob2112]

My night sweats got pretty bad before I had the apnea machine. Literally soaked the sheets every night and the pillow too. I used to use gell pillow inserts under my back straight out of the fridge to get to sleep.

It took a few weeks to a month before that stopped totally.

For me, my best positions are on my back and on my front, I try to side sleep left side down (less acid reflux) if I can, but 2 shoulder surgeries make that difficult. And right side down is my 3rd rotator cuff repair... yes, I am bionic when combined with the hip and wrists....

So, take the advice and sleep any way that is comfortable all night and the folks here will help dial in the rest.

[flanksinatra]

Thanks for all of the replies. I already have some data from nights where I slept on my side the entire night. I will include my report from one of those nights below. I don't know why but when I sleep on my side I sleep so much worse. My AHI is higher, my sleep is more fragmented, and I feel so much worse the next day. I do wish that I could side sleep all the time as it is by far the most comfortable position.

I really feel that my sweating is related to sleep apnea as I keep my room cold and I only sleep with a single thin blanket. Also, whenever I wake up soaked in sweat I am always awoken quickly and my heart is beating quite fast. I have been evaluated for anxiety twice (my old doctor thought my high blood pressure was cause by anxiety, which my new doctors all say makes no sense given how high my blood pressure was) and both times I was told that I do not have anxiety.

[robbob2112]

One thing you may want to consider is an O2Ring - viatome - it constantly measures your pulse and pulseox as you sleep, just fits over a finger so it isn't annoying for the most part.

It will tell you if your O2 drops in the night and if your heart is racing to try to bring it back up.

I need suplemental oxygen when I sleep because it drops and my heart races to keep up. This is because when you sleep only your diaphram is moving to breath and the rest that are normally used are not.