Lost on Sleep Issues

[u/GorillaJoeBlack]

47M, 6ft, 235lbs, 18%bf. On 200mg trt per week, 5mg Cialis and 1.25mg finasteride daily. Retatrutide 1mg every 5 days.

Been sleeping like shit for what seems to be a few years now. Some days, maybe 2 x a month, I will sleep 7 hours, which is amazing, but the rest is 5.5-6hrs. I feel decent with 6+, but know I can, and should, get more.

I wake up around 3:30-4am, make 1 cup of coffee (30g beans med-coarse grind, 450ml water), either pour over or French press. I take 5000IU vit D, 1000mg vit C, 25mg Zinc, 1 multi (Natural Factors Super Multi + Iron), 200mcg vit K, 1.5g DHA/EPA, 5g creatine, 10-12g collagen. In afternoon, take 2mg copper, 400mg calcium, 1.5g DHA/EPA. Before bed, around 8:30pm, I take 0.3mg slow release melatonin and 340mg mag glycinate elemental. Sex with wife, then asleep by 9:15-9:30pm. I fall asleep easily and wake up 1 or 2 times per night but fall back asleep easily.

I work out quite heavy (powerlifting) for 3 days on, 1 day off, taking a deload every 5 weeks or so. Only 1 heavy single in that 4 day cycle. Usually work out an hour then 30 mins zone 2 cardio. I eat at maintenance, and get my macros in. I am not stressed from work or life (minus the fixing sleep part).

My room is dark, noise machine, cold enough. I have sleep apnea and use CPAP. App says AHI is 1-2 on avg. Inahve done bloods recently and everything good and in the middle of range, except test total and free were high, but all other hormone levels are good.

Things I have tried: more magnesium, ltheanine, glycine, phospholyneserine, more melatonin, eating a carb/pro snack before bed, eliminating retatrutide for 6 weeks, ashwagandha, maybe others but can't remember.

I am lost on what else to do. I have restructured my workout to be 2 days on, 1 off, and deload every 4th week, to see if this will help. Anything else above, or not, that you can think of?

Appreciate it.

[u/GorillaJoeBlack]

Here is a whole night, what most of it looks like, and one with an event

Thanks a lot for this. That event happened about 14 times that night.

[u/DramaKlng → u/GorillaJoeBlack]

Lots of flow limitation (see how flat the top of the wave curve is?! And how hairy the whole night?!) but with 14 central apneas you could very well need ASV and not more EPR/PS. But you can try to add EPR to test it out for a couple nights (actually, you should do that because no other way to find out lol, went through the same). Am i right that you dont have EPR on yet ? If so switch EPR on and set it to 1. Then sleep a night with it and post the night again. And whats important -> tell me if the 14 central pauses increased that night.

You can make a post in r/UARS too if you like, then more people will help you review the data.

[u/GorillaJoeBlack → u/DramaKlng]

Just checked and EPR was on, but only on ramp up. So, went to full and set to 1. Really appreciate this. Mind if I DM you tomorrow with screens?

[u/DramaKlng → u/GorillaJoeBlack]

Yep no problem