Can't fall asleep with cpap anymore. Please help.

Hey.

In the last few weeks i have been experiencing a difficulty in falling asleep with my cpap device. I basically spend 15-50 minutes on bed and never get past the initial sleep phase. When i go to my cpap device it always shows apnea ratings such as 9-20 apneas per hour. When i go to my pc to have my sd card read by sleepyhead it always show that all those apneas are Clear Airways (followed by RERAs sometimes) . I already use the lowest pressure setting (4) and don't know what to do anymore. I've never had a very severe apnea, and recently i've been wondering if the Cpap device is a bit "overkill" for my case. The thing is that the nature of my apnea is a bit ellusive and may be related to muscle weakness rather than airway collapse (unconfirmed).

Anyways, can someone show a light on how to stop these Clear Airways apneas from happening? There are days that they are completely absent and i can initiate sleep fine, but the days that the opposite happen i end up sleeping 3-4 AM and can't function properly in the other day. I am afraid of not sleeping with Cpap and end up being worse, but not being able to fall asleep because i feel suffocated because of those Clear airways apneas is also very awful.

Device-Resmed S10 (with that heating tube)

Mask-Airfit P10 Resmed

Pressure: 4 or 5

user20398 wrote: ↑

Thu Oct 18, 2018 10:57 am

In the last few weeks i have been experiencing a difficulty in falling asleep with my cpap device. I basically spend 15-50 minutes on bed and never get past the initial sleep phase.

What medications do you take? How is your sleep hygiene, diet and exercise? When and how much caffeine do you consume? Don't overlook smaller amounts like in chocolate.

ChicagoGranny wrote: ↑

Thu Oct 18, 2018 11:12 am

user20398 wrote: ↑

Thu Oct 18, 2018 10:57 am

In the last few weeks i have been experiencing a difficulty in falling asleep with my cpap device. I basically spend 15-50 minutes on bed and never get past the initial sleep phase.

What medications do you take? How is your sleep hygiene, diet and exercise? When and how much caffeine do you consume? Don't overlook smaller amounts like in chocolate.

Hello.
I take levothyroxine and a few supplements for exercises. My diet is fine, i try to eat as healthy as possible. No caffeine. During late afternoon and night i rarely ever eat anything with sugar or chocolate.

The thing is, i actually feel suffocated when i try to sleep.

Here is last night:

After trying to sleep 3-4 times i gave up and slept without the cpap.

Somebody has been messing Your machine is not providing enough air pressure it is currently in CPAP mode with a fixed pressure of 4
It’s no wonder you feel starved of air/suffocated

What was your prescription I see in an earlier graph the machine was set to a fixed pressure of 5

I suggest setting it to apap mode with a minimum pressure of 6 and a max pressure of 20 and sleep with it for a night and let’s see what happens. Post up a graph when you’ve done that.


You can’t count the CA’s before you go to sleep as those are not true CA’s as our awake breathing is just too irregular

I agree...trying to breathe with a pressure of 4 is ridiculous. Change your setting to Auto with a min pressure of 6 and max pressure of 12 and see what happens. The machine can't stop the CAs from happening, but with a higher pressure you may be able to fall asleep faster which will eliminate most of them.

I am the one that changed the settings lol. I used to have a automatic pressure, but because the device would always put me in the highest pressure i would wake up bloated and with stomach pain so i decided to put a fixed pressure and slowly reduce the pressure until i found the most adequate setting for me.

Turns out that no matter how i changed the settings the ahi would stay the same so i decided to lower to the lowest setting (4). Another reason for changing the pressure to a lower setting is that when i did a sleep exam with a Cpap it would also show a very high number of central apneas that would be possibly linked to the cpap use (60% of them were central apneas).

Also, my apologies if i can't bring any more relevant info, i am struggling to keep myself awake at the moment.

user20398 wrote: ↑

Thu Oct 18, 2018 11:29 pm

I am the one that changed the settings lol. I used to have a automatic pressure, but because the device would always put me in the highest pressure i would wake up bloated and with stomach pain so i decided to put a fixed pressure and slowly reduce the pressure until i found the most adequate setting for me.

Turns out that no matter how i changed the settings the ahi would stay the same so i decided to lower to the lowest setting (4). Another reason for changing the pressure to a lower setting is that when i did a sleep exam with a Cpap it would also show a very high number of central apneas that would be possibly linked to the cpap use (60% of them were central apneas).

Also, my apologies if i can't bring any more relevant info, i am struggling to keep myself awake at the moment.

The lower pressure is why you are currently feeling suffocated. You should raise it to at least 6 and see if you can get to sleep better. The centrals you are having on those sleepless nights are probably sleep/wake/junk as you toss and turn. They are all at the beginning and it is normal if we are not sleeping.

What was your original pressure range? Perhaps starting with a smaller range that doesn't go as high would help you sleep better and see what pressures you actually need. Start at 6 and maybe go up to 9 or 10 and see if you have any issues.

Those clear airway events look like sleep-onset events to me, or just sleep-wake-junk from being roused from sleep by something. I get a couple of minor batches of them per night usually.

Put your machine in Auto mode (APAP) and set the minimum to 6 or 7 and the max to 15 or 20. 4cmH20 is way too low for most people to feel like they're getting enough airflow. That could be what's preventing you from getting to sleep or waking up once you're finally exhausted enough to sleep.

I could be wrong, as I often am - and readily admit it.

I was able to sleep with an automatic pressure of 5-8. First time in a while that i was able to get a decent night of sleep. Still a bit sleepy, though lol.
Also, thanks everyone here for the help. You people are very kind.

user20398 wrote: ↑

Fri Oct 19, 2018 8:34 am

I was able to sleep with an automatic pressure of 5-8. First time in a while that i was able to get a decent night of sleep. Still a bit sleepy, though lol.
Also, thanks everyone here for the help. You people are very kind.

Do you mean 5cmH20 minimum and 8cmH20 maximum? Or between 5-8cmH20 minimum only?

user20398 wrote: ↑

Fri Oct 19, 2018 8:34 am

I was able to sleep with an automatic pressure of 5-8. First time in a while that i was able to get a decent night of sleep. Still a bit sleepy, though lol.
Also, thanks everyone here for the help. You people are very kind.

Post a graph and let’s see how it looks, max pressure of 8 is quite low but if you did not get any aerophagia then great.. hopefully you will feel better with a few nights of sleep

Midwest_non_sleeper wrote: ↑

Fri Oct 19, 2018 8:50 am

user20398 wrote: ↑

Fri Oct 19, 2018 8:34 am

I was able to sleep with an automatic pressure of 5-8. First time in a while that i was able to get a decent night of sleep. Still a bit sleepy, though lol.
Also, thanks everyone here for the help. You people are very kind.

Do you mean 5cmH20 minimum and 8cmH20 maximum? Or between 5-8cmH20 minimum only?

5cmH2O minimum and 8cmH2O maximum.

*7cmH2O maximum to be exact.

Jas_williams wrote: ↑

Fri Oct 19, 2018 10:58 am

user20398 wrote: ↑

Fri Oct 19, 2018 8:34 am

I was able to sleep with an automatic pressure of 5-8. First time in a while that i was able to get a decent night of sleep. Still a bit sleepy, though lol.
Also, thanks everyone here for the help. You people are very kind.

Post a graph and let’s see how it looks, max pressure of 8 is quite low but if you did not get any aerophagia then great.. hopefully you will feel better with a few nights of sleep

Here it is.

It was actually a max pressure of 7 not 8

user20398 wrote: ↑

Fri Oct 19, 2018 9:51 pm

It was actually a max pressure of 7 not 8

And that's why your AHI is higher than it needs to be.

Can you remove the mask pressure graph and add in the flow limitation graph, also I would increase the max pressure another 1cm to 8 to help treat the Hypopnoea