When data isn't enough?

[PaulaO2]

I am not sleeping well. It is taking me longer to fall asleep, even with Ambien. I wake up many times a night. One day last week, I was so exhausted during the day, I actually napped. Took a while to fall asleep but when I did, it was hard to wake me later.

My data says everything is good. Only a few nights of AHI higher than 2. But dang, I'm tired!

The only thing I'm noticing is more CA events. Either about the same as OA or even more than, but still, overall AHI less than 2 most nights. Little to no hypopnea. Nearly all of the events are 17 seconds or less. Most are around 14-15sec. Leaks are basically non-existent. I have woken up with lip leaks but it is never bad enough to show up on SleepyHead. Pressure is set to 15-20. 95% is probably 18 although it has been getting lower. SH says my 30 day 90% is 17.44 with average being 15.96.

I'm going to sleep with an oximeter tonight to see what happens.

Could be the heat. My fan in the bedroom died a few weeks ago. It was also the one I used in the office so could be I'm just hot and uncomfortable in my sleep. When I put the mask on, I feel like I am not getting enough air. It is taking longer for me to adjust to it. I'm using the Nuance. Normally my asthma doesn't bother me in the summer but this summer has been awful in terms of humidity here.

Could by thyroid? I take med for it.

Could be aliens? It has been a while since they last visited.

I need to get some blood work done anyway. I'll drink a lot of fluids and get it done Monday. I am what they call a "hard stick" so I have to be fully hydrated for them to even find a vein.

Anything else?

(Here it is 1:10am and I'm still awake. I'll go to bed, exhausted, but can't fall asleep. Then I'll wake up a minimum of 5 times. I'll also get up twice to go pee (highly unusual for me). Then I'll wake up groggy as heck and feel like crap.)

[srlevine1]

PaulaO2,

First, let me thank you for all you do and the nifty things I have learned from your posts.

Second, the oximeter is a great idea -- and you may wish to check your bloodwork for high hgb and hct which may indicate too many red blood cells which can be your body's reaction to desats by making more oxygen-carrying red cells. The condition is polycythemia.

Third, a endo workup is another must as our thyroids can screw with us in so many ways -- fatigue and sleep issues among them.

Fourth, have you verified the pressure at the mask with a gauge? In my old S8, what was being reported by the sensor was not always the accurate number. The sensor was replaced and all was well.

Fifth, have you considered acid reflux or positional issues.

Best of luck on getting a better tomorrow.

[Walla Walla]

This is not meant to be funny but could it be hot flashes? My wife goes through them from time to time and it really screws up her sleep.

[duhmom]

HI Paula, sure sounds like you may have sleep stuff still going on - the waking to pee, not staying asleep. I agree with @srlevine1 about getting the machine checked to make sure it is pushing the pressures it says it is. How long has it been since you had a sleep study?

I also suggest along with your CBC - an Iron panel. CBC could be normal, but iron low and this will cause extreme fatigue.
Good luck

[PaulaO2]

No to the hot flashes. Thank gawd I've managed to avoid those so far. When I do have them, I get quite ill. But thanks for thinking of it!

So I used the oximeter last night. Had to do it twice. The first time was for just over an hour. I would fall asleep and snap awake, rinse, repeat. The oximeter was too tight. I was too hot. Blah blah blah. Finally ripped the thing off and got up. I got the box fan from the office, put it on the pup's crate, and aimed at it the bed. Took a while to fall asleep again but I was cooler and not as grumpy. I got up again at 6ish and tried the oximeter again.

Both times the O2 remained in the 90s. Pulse rate was ridiculously low. I need to check older overnight recordings to see if it was that low previously. AHI 1.5 so good there.

I dunno. Maybe I'm going a little nuts. Or, rather, nuts-er.

First oximeter go:


Second:


SH:

[duhmom]

Oh, that pulse rate is a clue.  Do you by chance have a BP cuff?  your BP may be running low too.  will make you feel like crap.

[PaulaO2]

I do. I take medication for it. One of the side effects of the med is it slows the heart rate down. But it isn't usually THAT low. I meant to keep an eye on it today, doing spot checks, but was distracted.

I'll take my BP a few times a day, too.

[Rcgop]

Paula02
First I would like to thank you for all your good advice and far be it for me to give you advice.  Some of my own observations might trigger some thought.

Do you take statins? For me Statins kept me awake to the point I had to stop taking them. I would skip at least one night a week so as to allow me to get a good night sleep. I proved it to myself too many times to believe that statins were the cause for my not sleeping. It was over 2 years off the statins and sleeping like a baby before my sleep apnea kicked in. 

Also, CPAP treats apneas not external arousals. We have a cat that sleeps all day and at 3 in the morning wants to be fed. He will not let you sleep until you feed him. And not just once but every hour until you get up for the last time. We also have a dog. She is crate trained and likes to chase squirrels in her sleep. She becomes quite vocal. 

You mentioned about the heat. We live in Florida and keep the A/C at 78.  That is usually comfortable but the other night I woke up drenched with sweat. I had to get up to change my T-shirt. I still do not know why I was so hot but I think that is what woke me

Finally, my dreams have become very "vivid" and some times troubling. It seams I am in a situation that cannot be solved without waking up. 

Some times its not about the data and more about the environment. 

I also have a comment to YOUR comments on my "Pasty mouth" thread. 

Again thanks for you help

[PaulaO2]

I do wake up often with my hand asleep. My elbow is not completely healed yet and doesn't like to be bent for too long. I go to sleep with it propped up and all that but you know what happens in our sleep - we move!

I went to sleep last night without the fan. Took me about an hour. I woke up about 2hrs later, soaking wet, in the same position. Body pillow was wet, I was wet, sheet under me was wet. I rolled onto my back and wondered what I was going to do and fell back asleep. I woke up in the same position 2hrs later to feed dogs.   Took me forever to claw out of the mud in my brain. Again my back was wet and my leg that was under the body pillow was wet. Gonna have to change the sheets and fluff that pillow!

I have chronic insomnia so I'm used to having problems getting to sleep. I just am not used to waking up so many times each night. And this exhaustion has got to go.

[Crimson Nape]

As far as your hand going to sleep; In time that should slowly diminish. I managed to detach my bicep muscle from the bone and had to have it reattached. For a year after the surgery if I bent my arm at the elbow, my hand would go to sleep. This finally went away but was a pain (literally) when sleeping.

The sweating; By chance are you sleeping on a memory foam mattress? You are taking Niacin supplements or acetaminophen? Don't try Googling it (which you probably have done). . . That alone will give you nightmares.