[Long Post] Am I getting enough sleep?

Before I ask my question, I want to say how thankful/grateful I am to this community for the insights/support/help provided to newer CPAP users like me.

Prior to going on CPAP therapy, I had been tracking my sleep/fitness through Oura and Fitbit and the apps really create/reinforce a physiological reward (via sleep scores) for sleeping around 8 hours. My body also felt really good when I got 8 hours of sleep (I was averaging 7.5). For context, my need for therapy was borne out of RERA reduction (~12) vs a very high AHI (~4/5).

Since going on CPAP, my sleep has been a bit all over the place. When I first started on therapy, I noticed I could get about a half hour less sleep and feel about the same. Looking to get the most out of my therapy, I set up time with Jason from AXG to review my data. He pointed out that my pressure was way too low (5 - 7 range) and that the shape of my breathing wasn’t very good.

I’ve since gradually increased my pressure (currently at 12 - 13) and began mouth taping and I’m now getting less sleep around 6.5 hours, though the shape of breathing is better and I do feel the quality is improving. I now tend to sleep an initial 5.5 - 6 hours chunk of pretty deep sleep and sometimes that’s it, I’m ready to wake up and other times I get a couple more hours of much lighter sleep. I wouldn’t say I feel the same as I would getting 8 hours of non-CPAP sleep. While I wake up rested, my body doesn’t feel fully awake at 3:30 - 4:30am.


Here’s an example:

Last night, I went to bed at 9:15pm and initially woke up around 2:45am (Oura and Fitbit scored this a 70). As I was waking up, I thought - “good night’s sleep - I feel rested - it must be around 5am”. I was surprised to see it was around 3am (9pm - 3am is typically when I get my deepest sleep). Typically if I fall back to sleep after 3am, it’s much lighter.

I guess I worry that going off of purely how I feel right when I wake up isn’t the right approach toward knowing if I’m getting enough sleep, though I guess my body should adjust from night to night and eventually I should fall into a new equilibrium.

Here’s what it looks like from Oscar:

https://imgur.com/a/DDxOIv5

I think the leak was from the mask position from me sleeping on my stomach. I checked my tape in the morning and didn’t have any leak going. Airsense scored 4.08 CAs per hour but I can’t tell from the graph if this is actually the case and/or if this is what woke me up.


The night prior, I slept 7 hours (80 scores from Oura and Fitbit) but woke up feeling tired. Oscar data:

https://imgur.com/a/Jibiqxo

I had tried no humidity in hopes of getting to zero leak and got dry so I took off my mask for a few hours (no doubt that’s why I was tired when I woke up). I think my body is getting used to higher sleep quality so when I go to no CPAP sleep, the hours of sleep just aren’t the same.

I would love thoughts/feedback and any optimization tips from my sleep graphs.

I think your best bet is to keep a written record for a couple of weeks that notes your answers to something like this list of questions:

How long did I sleep last night?
Did I wake up early and feel like getting up?
If yes, did I go back to sleep for some additional "lighter" sleep?
How did I feel the next day -- refreshed and alert, OK for a while then sleepy, or ...?

I think this will tell you far more than your Oscar charts (or Oura or Fitbit) will about what will work best for you. If I were a betting woman, I'd bet you'll find you do better when you get some of the "lighter" sleep after your first chunk of sleep.

You might also want to review the recommendations below for good sleep. This first one is especially relevant for you.

• Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
• Set a bedtime that is early enough for you to get at least 7 hours of sleep.
• Don’t go to bed unless you are sleepy.
• If you don’t fall asleep after 20 minutes, get out of bed.
• Establish a relaxing bedtime routine.
• Use your bed only for sleep and sex.
• Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
• Limit exposure to bright light in the evenings.
• Turn off electronic devices at least 30 minutes before bedtime.
• Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
• Exercise regularly and maintain a healthy diet.
• Avoid consuming caffeine in the late afternoon or evening.
• Avoid consuming alcohol before bedtime.
• Reduce your fluid intake before bedtime.

Oh, and if you post additional Oscar charts, could you close the calendar and provide all and only these graphs:

Events
Flow rate
Pressure
Leaks
Flow limitations
Snores.

Don't judge your sleep quality in the morning. Judge it near bedtime. Was I energetic today? Did I have excess sleepiness today? Near bedtime, am I fatigued but not stressed?

This is so helpful! Thank you, both.

I will start logging the questions you posed, Miss Emerita. I'll also make sure to share the relevant Oscar information you outlined.

Judging sleep quality at night makes a ton of sense. Thank you, Chicago Granny!

In regard to sleep schedule. I find it very difficult to stay up past 9:30pm. I'm typically asleep between 9:15pm - 9:30am. My goal is to always sleep till 5:30pm (8 hours in bed to get 7 hours of sleep), but some days (like today) I'm just up at 3am and have no desire/need for additional sleep. To your point, this may be an edge case and as I dial in my therapy things will normalize.

slowmo2000 wrote: ↑

Tue Apr 02, 2024 2:00 pm

but some days (like today) I'm just up at 3am and have no desire/need for additional sleep

Here is what often happens to me. I go to bed at 11 pm and later wake feeling like I had a good night's sleep and ready to take on the day. But I look at my watch and it is 3 am. Of course, 4 hours is not enough sleep.

Here is how I learned to deal with this. I will often get up and take a tinkle whether I feel the need or not. Then, I go back to bed and tell myself to have faith in falling asleep again. It might take a half hour, but I usually go back to sleep. Keep the faith baby!

BTW, I don't remove the mask when I get up. There is a quick disconnect between the mask and hose. The more a person fiddles around to put the mask back on, the more awake he gets.

Yep, makes total sense. I'm trying to do the same unless I absolutely feel I'm ready to get up.