Newbie: Still tired and frustrated

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
cousin_brucie
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Newbie: Still tired and frustrated

Post by cousin_brucie » Tue Mar 13, 2018 10:13 am

I've been using my CPAP for close to 2 months now and still don't feel rested when I wake up. As a matter of fact I feel no different than pre-CPAP. I went the first 31 days at a pressure setting of 7 with a ramp starting at 4. My avg AHI during that time was 13.37 with a high of 21.54 and a low of 5.99.
After a visit to my doctor she decided to up my pressure to 9 with a ramp starting at 7. My avg AHI has dropped to 8.73 with a high of 14.24 and a low of 1.35 (immediately followed the next night by a 14.09). My numbers are still obviously all over the place, and I'm totally frustrated that I don't feel any better.
I had no learning curve using my machine and mask. I started night one going 7 hours with no mask issue, and have consistently gone 7+ hours every night since.
Is 52 days not long enough? Am I wrong about being frustrated? And help/suggestions would be greatly appreciated.

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Pugsy
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Re: Newbie: Still tired and frustrated

Post by Pugsy » Tue Mar 13, 2018 10:20 am

Your current pressure settings are still sub optimal.
Works well part of the night and not so great other parts of the night.
Usually when we see this happen it is because of sleeping position (on our back) or REM stage sleep....both of which is it quite common for our OSA to be worse and/or have more events or and need more pressure.

May you should consider switching over to apap mode and let the machine increase the pressure above the 9 cm to try to better prevent those OAs and hyponeas you see.

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Julie
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Re: Newbie: Still tired and frustrated

Post by Julie » Tue Mar 13, 2018 10:24 am

Yes, I wondered why you're only using Cpap mode when you have access to Apap... I'd definitely try it out for a few nights leaving the max. pressure setting high (15 to 20) and let us know (in this thread) how it goes. You're quite free to make such changes to your therapy yourself as we all do.

TedVPAP
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Re: Newbie: Still tired and frustrated

Post by TedVPAP » Tue Mar 13, 2018 11:09 am

As others have said, your treatment settings are off.
How did the doctor determine that you should use 7? Were you ever titrated via a sleep study?

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cousin_brucie
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Re: Newbie: Still tired and frustrated

Post by cousin_brucie » Tue Mar 13, 2018 1:52 pm

Yes, had a sleep study a few years back. Tried CPAP but could never get used to it and quit. I told my doctor I was ready to try again so we started out at 7, the pressure setting that was prescribed the first time.
Thanks for the apap suggestion. I will try it starting tonight and report back after a couple of nights.

TedVPAP
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Re: Newbie: Still tired and frustrated

Post by TedVPAP » Tue Mar 13, 2018 3:32 pm

I would start off setting the APAP minimum to 9 and max to 15.

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zonker
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Re: Newbie: Still tired and frustrated

Post by zonker » Tue Mar 13, 2018 4:12 pm

TedVPAP wrote:
Tue Mar 13, 2018 3:32 pm
I would start off setting the APAP minimum to 9 and max to 15.
not being rude, just genuinely curious. why do you suggest min pressure of nine?

please bear in mind that i'm not that good at sleepyhead charts; is it something there that you see?
people say i'm self absorbed.
but that's enough about them.
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TedVPAP
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Re: Newbie: Still tired and frustrated

Post by TedVPAP » Tue Mar 13, 2018 4:54 pm

zonker wrote:
Tue Mar 13, 2018 4:12 pm
TedVPAP wrote:
Tue Mar 13, 2018 3:32 pm
I would start off setting the APAP minimum to 9 and max to 15.
not being rude, just genuinely curious. why do you suggest min pressure of nine?

please bear in mind that i'm not that good at sleepyhead charts; is it something there that you see?
An excellent question.
The chart above shows that CPAP pressure of 9 is not nearly high enough to preventing all those OSA events. Since he is switching to APAP, setting the max to 15 or 20 is good so that we can better see how high his pressure needs are. Setting the lower pressure limit can also be important. Generally, you don't want the lower pressure to be too far below where your needs are or the machine may be too slow to respond. Once we get some data using APAP, then we can better refine the lower limit.

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Use data to optimize your xPAP treatment:
how to see your data https://sleep.tnet.com/resources/sleepyhead
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zonker
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Re: Newbie: Still tired and frustrated

Post by zonker » Tue Mar 13, 2018 6:00 pm

TedVPAP wrote:
Tue Mar 13, 2018 4:54 pm
zonker wrote:
Tue Mar 13, 2018 4:12 pm
TedVPAP wrote:
Tue Mar 13, 2018 3:32 pm
I would start off setting the APAP minimum to 9 and max to 15.
not being rude, just genuinely curious. why do you suggest min pressure of nine?

please bear in mind that i'm not that good at sleepyhead charts; is it something there that you see?
An excellent question.
The chart above shows that CPAP pressure of 9 is not nearly high enough to preventing all those OSA events. Since he is switching to APAP, setting the max to 15 or 20 is good so that we can better see how high his pressure needs are. Setting the lower pressure limit can also be important. Generally, you don't want the lower pressure to be too far below where your needs are or the machine may be too slow to respond. Once we get some data using APAP, then we can better refine the lower limit.
okay, thanks. that makes a great deal of sense!
people say i'm self absorbed.
but that's enough about them.
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cousin_brucie
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Re: Newbie: Still tired and frustrated

Post by cousin_brucie » Tue Mar 13, 2018 6:55 pm

Thanks to everyone that replied. I'm looking forward to the apap mode tonight, and hopefully this will be the step forward I've been waiting for.
I'll post some new data by the weekend.

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kteague
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Re: Newbie: Still tired and frustrated

Post by kteague » Tue Mar 13, 2018 10:13 pm

Just a tip to help you manage your disappointment at the time that has passed without feeling better - start counting your time at the time you started having therapeutic settings. It won't seem so long, and gives you a more realistic hope of seeing improvement. My first 5 months were miserable, but once my settings were optimized, the changes began to show up. Good luck with things.

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musculus
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Re: Newbie: Still tired and frustrated

Post by musculus » Wed Mar 14, 2018 8:36 am

leak is controlled and the events apparently clustered in REM stage.

7 cm is very low pressure. I would say increase pressure gradually to the point that you are still comfortable with and leaks are still controlled. My experience is fixed pressure actually feels more comfortable than auto but surely you could try different settings before going to sleep.

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cousin_brucie
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Re: Newbie: Still tired and frustrated

Post by cousin_brucie » Fri Mar 16, 2018 9:11 am

Here's my downloads from the first 3 nights switching to apap mode from cpap. First a couple of observations:
Night 1- Had a great AHI number and slept almost 9 hours. I would say it's the most sound I've slept in years, but the flip side was I was TOTALLY exhausted the next day for some reason.
Night 2- AHI number spiked up, but I hit the 15 pressure for the first time. The reason for the break around 3:00am was I developed a mask leak, small but enough to wake me up, (probably due to the increased pressure) and had to make some mask adjustments. Once again I hit the 8 hour sleep mark, slept totally sound again, except for the minor mask adjustment, and still felt tired the next day, but not as much as the previous day.
Night 3- AHI number came back down and once again hit my max pressure of 15. My sound sleep continued, probably explaining the 8+ hours I've slept all 3 nights, and I had another incremental improvement in my morning drowsiness...not quite totally gone.
I'm interested to hear the response on my new numbers, albeit a small sample size.

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Julie
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Re: Newbie: Still tired and frustrated

Post by Julie » Fri Mar 16, 2018 12:33 pm

bump

cousin_brucie
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Re: Newbie: Still tired and frustrated

Post by cousin_brucie » Fri Mar 16, 2018 3:56 pm

To what...16? 17?