One week on CPAP, would appreciate some input regarding my stats

[jclarke131000]

6 nights on CPAP and it's going okay. Definitely more energetic throughout the day, no naps and less sleep needed to feel good. However today I woke up with alot of my older symptoms, feeling hungover w/ a headache, a tight feeling in my head, bit of a fever and incredibly tired. It slowly diminished over the first 2-3 hours of the day but I was wondering how my stats are looking as I feel like the breathing and resp rate is very inconsistent as well as quite a few unflagged events.

https://sleephq.com/public/1ffc1288-520 ... 1a78b4e7de

Would greatly appreciate some input! Using the F20 mask with an AirSense 10 autoset.

[Pugsy]

Do you remember waking several times during the night?

Are you having any nasal congestion at night?

Do you take any medications of any kind? If so, what?

[jclarke131000]

Absolutely no waking during the night.

I've had a lot of sinus issues over the last 2 years, sometimes it's almost impossible for me to breath through my nose unless I'm using nasal sprays regularly ( currently xylometalozone ) which usually lasts a full nights sleep. I get a ton of mucus in the back of my nose and throat although It's not really bad right now in comparison to times in the last 12 months.

Not other medication outside of the xylo

[Pugsy]

Well you may not remember waking during the night but your flow rate (breathing) says you had a lot of arousals during the night. The bulk of your flagged events (especially the centrals/CAs) have evidence of big gulps of air preceding the flagged event which means you weren't sound asleep. We don't take big gulps of air while we are asleep and they are easily seen when we zoom in on your flow rate.

I looked up the side effects for your nasal spray and trouble sleeping is one of several listed side effects.
So it may or may not be a factor in what appears to be multiple arousals. You might want to read up on the side effects.

Your flow limitation graph is a big active but we don't know if that activity is related to airway obstructions or nasal mucosa congestion.

You might try turning EPR on and setting it to 3 and see if the FL activity reduces any.....it should if the FLs are airway related but it won't if nasal mucosa congestion related.

[jclarke131000]

I use a snore recording app too, and all of the sound spikes are me moving around, bed creaking etc so I can definitely agree there was alot of arousal in the night.

I'll give tonight a go without the nasal spray. Hopefully my nose isn't too congested. I have been taping my mouth since the 3rd night as the first two had absolutely horrendous aerophagia.

Flow limitation graph has looked very similar every night so far. At most I have 10 minutes of 0 before it increases. Is flow limit resistance opposing the pressurisation from the machine? Indicating a restriction somewhere in the air way?

I'll give EPR a go tonight and see if it makes anything better.

[Pugsy]

The machine (when in auto adjusting pressure mode) will try to kill the FLs with more pressure because FLs are one of the things it responds to in an effort to prevent collapses of the airway. The machine will also increase the pressure in response to snores as well as OAs and hyponeas. Fls and snores are early warning signs that the airway is trying to collapse.

The machine can't tell the difference between nasal congestion FLs and airway FLs though. More pressure won't help FLs that are originating in the nose though from congestion....but it will still try to kill them with more pressure.

Your FLs aren't horribly horrible though but FLs (originating in the airway and not the nose) can potentially cause sleep disruptions even if they don't grow up to become OAs or hyponeas.

[jclarke131000]

Okay so I had a night with EPR set to 3 and the Flow limits did not change. 95 of 0.17, 99.5 of 0.35. Resp rate was considerably lower though throughout the night.

Had 15 apneas, 1.8 AHI and there again seems to be quite alot unflagged.

[vandownbytheriver]

Okay so I had a night with EPR set to 3 and the Flow limits did not change. 95 of 0.17, 99.5 of 0.35. Resp rate was considerably lower though throughout the night.

Had 15 apneas, 1.8 AHI and there again seems to be quite alot unflagged.

Can we see an SHQ?

[jclarke131000]

Apologies I'll send it shortly!

[jclarke131000]

Okay here was last night

https://sleephq.com/public/7e85fabd-7cb ... 05b5cd24d6

I set EPR to 3, as per recommendations here and elsewhere. I also set ramp to just 5 minutes too.

[Pugsy]

So.....how did you sleep last night and how do you feel today?
How was the congestion?

About half those flagged events appear to be more SWJ (sleep/wake/junk) arousal/awake related.

[jclarke131000]

Felt a little better while waking up but I just feel very lethargic a few hours later. Body feels like I've been hit by a train.

Congestion isnt good. Woke up a handful of times in the night and felt like I couldn't breath at all even with the mask on.

[Pugsy]

Deal with the congestion the best you can. If we can't breathe comfortably we don't sleep so great.
Frequent wake ups can really screw up the sleep stage progression that we need for the restorative powers of sleep to work their magic.

[jclarke131000]

Is it probably due to congestion that I'm waking up? Most nights I'm aware there's alot of arousals however I don't remember them.

Is there anything I can do to help with congestion besides using my usual nasal spray?

[Pugsy]

Unfortunately you have asked some questions that there really isn't any way to know exactly what the answers are.

Could those arousals be from nasal congestion discomfort??? Sure they could but they could also be simply spontaneous arousals from some other cause. Lots of people have trouble with arousals and subsequent crappy sleep that aren't having nasal congestion issues. I am one of those people myself. Lots of arousals (other health issues) but my nose is rarely congested. So I feel your pain but even when we know the cause of arousals it doesn't always mean that there is an easy fix. I know the cause of my crappy sleep but fixing it isn't so easy.

You do need to get off the Afrin (or whatever it is you use) but that isn't easy either. Rebound is a bitch....been there and done that myself. Some people have had some luck by doing the one nostril at a time thing.
If the congestion you are experiencing is plain old rebound it might work but if you have physical abnormalities then that's another wrinkle and you will likely need a doctor's help.

Does a hot steamy shower help relieve the congestion?....or make it worse?

Do you happen to use something like Simply Saline nasal rinse/spray to help keep the nasal mucosa hydrated? If not, you might add that during the day along with one of those steroid nasal sprays like Flonase.