Waking up around midnight, 2AM and 3AM

[midnighttwoam]

Hi

I've been using a Resmed 10 with Min 9 to Max 13 and EPR 2 or 3 for almost a year now.
I don't have lots of events however I consistently wake up around midnight, and then at 2AM (usually take off mask) and then again 4AM.

I sleap on my left side. Don't remember ever dreaming so I assume my waking up starts when REM phase starts?

I did try for more than a month wtih increased min and max pressure and lower the EPR but it did not have any effect. Still same waking up at midnight and 2AM.

At the sleep study they noted I have more apnea sleeping on my back ( which I have not done in a year now ) and more during REM phase.

I would appreciate it if someone could look a the charts ( happy to upload more in detail ) and tell me if there is anything I can do or any other idea on how I can stop waking up at these regular times.

[Phaleronic]

Welcome to the forum midnighttwoam

I sleep worse on apap mode too. Can you please set min/max pressure to 11.6cm (this is cpap mode with flow limits being recorded)-try it for 30 minutes before bed tonight to see what you think (turn EPR off too please).

This should help your arousals and microarousals.

[midnighttwoam]

Thanks, I'll give this a try.

[midnighttwoam]

Hi

I gave it a try for more than two weeks. Had to reduce the pressure to 10.8 or I get a lot of leaks but disabled EPR and set it to CPAP mode.

While the machine does register fewer "events" I still have the same exact problem. I wake up pretty much after 3h of sleep on the dot which I assume is when a REM phase starts.

Has anyone had this sort of thing? Anything I can try to somehow get through REM without waking up? 

Any help appreciated!

[G. Szabo]

I have been having  the same issue for over a decade. I speculated that It could be associated with bathroom brake. 
Before waking up, I also detected increasing flow limitations due to nasal congestion. 
After 5-10 minutes I can resume my sleep.    

[midnighttwoam]

No apparent reason for me since I don't need to get up at all. I fully wake up though. I do feel my heartrate going faster but nothing else.

There is no apparent reason for why apart from low PulseOx I can see on my watch. So clearly it is my breathing but it is always 3 hours in and after that every 1.5 hours or so. 

I wish I could figure out how to make the machine push me through that particular time but so far no luck.

[G. Szabo]

If you look carefully at the Aug 12 chart, you can see that your FL goes sharply up just before the break. This might trigger the oxygen saturation drop and the HR increase, which wakes you up. I suspect respiratory arousal.

Would you mind uploading 3-minute windows of your flow rate curves, including the very first seconds of the breaks? It would be best to provide multiple samples.

[Phaleronic]

That last chart looks very good midnighttwoam, do you think there's something external to the cpap machine that is possibly causing the arousal?

[quiescence at last]

I gotta ask, cuz I'm a REM is good and dreaming is even better: When you do awaken, do you recall dreaming. Is it usually recalling that you dreamed, or recalling what you dreamed, if only for a minute or two? Thanks. REM sleep is generally after several other phases of sleep, but usually before 90 minutes transpires after falling asleep.

QAL

[midnighttwoam]

I dream almost nothing or very little. This is why I suspect REM triggers my apnea beyond what the machine can control.

There is nothing external to the arousal. Everything completely quite, not too hot or cold, no sounds, no phones. But very consistently after 3 hours of sleeping I will most likely wake up.

I also added zoomed in screenshots of just before I woke up this time at midnight and at 1:30AM