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Waking up every hour - newtothis1 - 12-29-2023
Hi. I attached a chart from OSCAR. I am waking up every 1-2 hours and I also have high AHI with many Clear Airways. Can anyone see on my chart the reason why I am waking up so often? Also how do I reduce my AHI? And why am I getting such a large amount of clear airways?
RE: Waking up every hour - Dormeo - 12-29-2023
Welcome! This looks like lousy sleep, so it's good you're seeking some help.
Could you re-post your chart after making some changes?
* Close the calendar
* Show the whole left panel
* Include all and only these graphs:
Events
Flow rate
Pressure
Leaks
Snores
Flow limitations.
You can fit the graphs into one screenshot by grabbing the gray bars that separate them and pushing them up. You can re-order the graphs by clicking and dragging them.
I'm curious why there are such long intervals between your times using the machine. Do you get up? Also, how did you arrive at your current pressure settings?
Even without seeing a reformatted graph, I strongly suggest that you turn off EPR. Let's see how you do with that and then consider what additional adjustments to your settings might be appropriate.
RE: Waking up every hour - newtothis1 - 12-29-2023
Hi. Thank you for responding. I usually go to washroom when I wake up and that's probably the main reason there are intervals. I just purchased a new mask - Air Fit f20 yesterday so I might have taken some time adjusting it to make sure it is not leaking. I also suspect that I get many clear airways when I am awake so considering that I wake up often - my real AHI might be slightly better than it shows? But still not good.
I attached 2 Oscar images that you requested. I also attached a zoomed in flow rate so you might be able to have more insight.
RE: Waking up every hour - Dormeo - 12-29-2023
Yes, you're right that at least some of the CAs may be happening when you're awake or right after an arousal from sleep. That's pretty common, and the problem in those cases isn't the CAs themselves so much as the wakefulness or arousal.
Several of the gaps were over half an hour, which is why I asked about them. With luck, once your apnea is under better control, you'll need to get up to go to the bathroom less often during the night. (Apnea can cause nocturia.)
I see that you've turned off EPR, so tomorrow let's take a look at tonight's chart. Please also tell us what the experience of no EPR was like and how you'd subjectively rate your sleep.
RE: Waking up every hour - newtothis1 - 12-29-2023
Ok. I will sleep with no EPR tonight even though its less comfortable. Will post results tomorrow. I did sleep study with a small size simplus mask and my sleep doctor said that my results were perfect and I have a great response to CPAP therapy. He prescribed pressure from 7-8 with Simplus Mask.
I purchased Vitera mask and only recently switched to Large size Air Fit F20 mask. Due to no success with AHI and inability to sleep without waking up every hour I played around slightly with the pressure so I keep switching from 7-10. Sometime giving a machine a certain range...
I assume that a larger mask requires more pressure? Also Is it true that too much pressure can cause Clear Airway events?
Lastly I decided today to take melatonin every night before sleep until I resolve my issues just for the sake of nerves...
RE: Waking up every hour - SarcasticDave94 - 12-29-2023
I myself have used both Fisher and Paykel masks, along with the ResMed F20. My experience was either F&P was more comfortable due to the Rollfit seal allowing a looser adjustment yet still controlling leaks. If you go too tight with any of those, leaks get worse.
CA or clear airway events may go up with increased pressure, but it should be for most a minimal influence, given a small adjustment period.
An importance on controlling obstructive apnea including hypopnea and flow limits over CA for most users is better. Unless you are predisposed to having CA on the diagnostic test, CA should be a lesser evil than the other events. I make the distinction because to treat CA will often make the rest of the events worse, due to the opposing methods to treat.
RE: Waking up every hour - newtothis1 - 12-29-2023
Do CAs make one feel as tired in the morning as Apneas and Hypopneas? Also I do not know what flow limitations are. Are they calculated in the AHI?
My biggest concern at the moment is that I am waking up about every hour or 2. I also have no idea if I am waking up at night because I need to urinate or I urinate because I wake up. Not sure what is the cause...
I am on medication for overactive bladder and frequent urination that mostly seem to work fine during the day...
Also for me the Resmed Mask that I just got yesterday seems to work better than Vitera. I think because I have a narrow nose I have leaks with Vitera unless I go very tight.
I also got nasal pillows for one month to test and so far was only able to sleep 20 minutes with them and then woke up (daytime experiment)
I must say that the pillows are way more comfortable. Its almost as if there is no treatment in terms of freedom. But worried about mouth breathing. Wouldnt even think about trying them before the septoplasty that I did recently so will see...
RE: Waking up every hour - SarcasticDave94 - 12-29-2023
Flow limitations are the beginning stage of reduced air flow, next in reduction is Hypopnea, finally an Apnea.
It appears to me that some of your CA are in clusters, and again quite a few happen at the beginning or end of a session.
Clusters can indicate these may be false centrals and may be caused by chin tuck/positional apnea. If correct, the remedy is typically a soft cervical collar to physically prevent the airway from kinking like a garden hose.
If the clusters are related to sleep wake junk, these are disruptions in sleep breath control due to the awkward handoff of breathing in cycling between wake and sleep.
RE: Waking up every hour - Dormeo - 12-29-2023
Flow limitations aren’t calculated in the AHI.
CAs could be correlated with feeling unrested in several ways. If you had a ton of CAs and thus had a lot of O2 desaturations, that’d be one. But what is more likely is that the CAs are the side-effects of arousals and wake-ups.
I’m not so sure that a collar would help with CAs. But at any rate let’s just see what tonight looks like.
RE: Waking up every hour - Gideon - 12-29-2023
I see considerable positional apnea. We need to get your neck straight so we can see what is going on. Try 1 instead of two pillows, a flatter, less firm pillow. If that fails a soft cervical collar will be needed, see the wiki article.
I also suspect that many of your centrals are actually you holding your breath when tossing. Post 3-minute views so we can verify that.