Reading OSCAR #2

[palerider]

Suggests that going forward

Suggests that going forward, you should post somewhere else.

[chunkyfrog]

Suggests that going forward

Suggests that going forward, you should post somewhere else.

Yep!

[colomom]

Hello,
I submitted a post back in May(viewtopic.php?f=1&t=186631&p=1439596#p1439596) asking for help reading my results, I made the necessary changes, and have since switched masks, I tried out the dreamwear FFM as an alternative to the F30i, which I did not like, and have since switched to the F20 Airtouch FFM, but I still feel tired although i feel like i got decent sleep. I just wanted to get your guys opinion, and see if there's anything obvious, or if you have any other recommendations. Anything is greatly appreciated…

Back in May you said:
I am a 26y/o male, 5'10, 140lbs and have been on CPAP since December of last year. Initial sleep study revealed mild OSA with an AHI of 7.7 (AASM).
I have been battling constant fatigue everyday, nearly all day. Before CPAP therapy and currently, I wake up with sleep inertia, exhausted feeling like i got no rest, and i just want to continue sleeping. I have not noticed any changes regardless of the number of hours I sleep. During the day this had lead to excessive fatigue, trouble concentrating, etc. I've tried a number of medications(can provide specifics if helpful), and while some have been somewhat beneficial, I still feel tired.

Questions that come to mind are:
Has your sleep improved since May?
How does the mask you settled on feel, any issues still?
What meds are you currently taking? What are the reasons you were prescribed the meds?
Have the docs looked into any other potential problems that may contribute to your continuing fatigue?

[fawe]

Apologies, I will certainly keep posts in the same thread. Happy to hear that nothing from the report is jumping out at anyone.. Thanks for everyone's time, I appreciate the responsiveness and insight from this community.

[fawe]

Hello,
I submitted a post back in May(viewtopic.php?f=1&t=186631&p=1439596#p1439596) asking for help reading my results, I made the necessary changes, and have since switched masks, I tried out the dreamwear FFM as an alternative to the F30i, which I did not like, and have since switched to the F20 Airtouch FFM, but I still feel tired although i feel like i got decent sleep. I just wanted to get your guys opinion, and see if there's anything obvious, or if you have any other recommendations. Anything is greatly appreciated…

Back in May you said:
I am a 26y/o male, 5'10, 140lbs and have been on CPAP since December of last year. Initial sleep study revealed mild OSA with an AHI of 7.7 (AASM).
I have been battling constant fatigue everyday, nearly all day. Before CPAP therapy and currently, I wake up with sleep inertia, exhausted feeling like i got no rest, and i just want to continue sleeping. I have not noticed any changes regardless of the number of hours I sleep. During the day this had lead to excessive fatigue, trouble concentrating, etc. I've tried a number of medications(can provide specifics if helpful), and while some have been somewhat beneficial, I still feel tired.

Questions that come to mind are:
Has your sleep improved since May?
How does the mask you settled on feel, any issues still?
What meds are you currently taking? What are the reasons you were prescribed the meds?
Have the docs looked into any other potential problems that may contribute to your continuing fatigue?

I feel like my sleep is relatively the same, I've tried other things like using a sleep mask, ear plugs, etc to improve sleep quality, and some nights they do seem to help, where I'll briefly feel refreshed in the morning, but quickly feel tired, and other days I don't feel much different.
I liked the structure of the F30i more, especially with the hose at the top, but neither the F30i or dreamware seemed to work for my face.. This mask generally feels good with the memory foam, as I couldn't handle the AirFit F20 because it hurt my nose, but the hose placement isn't super ideal for me, but may get used to it more with time..

Meds, I am not currently taking anything now, but have previously been prescribed most recently wellbutrin, Adderall xr, vyvanse, as well as a number of others in the past both for ADHD/Depression to combat lack of focus and the tiredness/fatigue.

My doctors have mainly went the route of adhd/fatigue and tried to combat it with medications, like described above including some others, but I've had either bad reactions with them or just haven't really helped me.. They have also run blood tests for thyroid problems, or any deficiencies, etc.. But say that everything looks normal. I'm relatively healthy and have gone to the gym actively, and ate healthy, drank plenty of water and didn't really notice any improvements.

Other than that, my doctor(s) don't really know what's going on or what the case could be, they don't really seem to have an idea so it's come to just trying different meds to see if anything helps.

I do plan to go see my prior ENT dr to discuss some issues I have as well with not breathing too good through my nose and to see if my airway is too narrow etc. I've researched and wonder if it could partially be due to UARS. Brief example of what i've found: Upper Airway Resistance Syndrome (UARS) is a sleep-related breathing disorder characterized by increased resistance in the upper airway during sleep, leading to frequent arousals and fragmented sleep. Although UARS is not as well-known as sleep apnea, it can still cause significant sleep disturbance and daytime symptoms.

[MattS]

Question on this topic to the more experienced .. (I am a newb and trying to learn) ... would the OP potentially benefit with some home oximetry to see if the SPO2 levels are still dropping, potentially pointing to some other issues to work on or at least some O2 addition to the CPAP therapy if there is desaturation? (I promise, no CA % questions )

-Matt

[dataq1]

Question on this topic to the more experienced .. (I am a newb and trying to learn) ... would the OP potentially benefit with some home oximetry to see if the SPO2 levels are still dropping, potentially pointing to some other issues to work on or at least some O2 addition to the CPAP therapy if there is desaturation? (I promise, no CA % questions )

-Matt

Obtaining more data (recording oximeter) is always useful. It cannot cause harm.
But determining the causative factor(s) of the the OPs clear airway events is a principle key towards helping.

[ozij]

@fawe
Looking at the data, the pressure is rarely stable for long periods.
The pressure at which you spend at least half the night is almost 0.8 higher than the minimum pressure. And, furthermore, whenever you get to the minimum, you have flow limitation that make the pressure go up.
And, you report your sleep is not very refreshing.

This is where I start wondering if the pressure changes, or possibly the flow limitations preceding them are causing microarousals (MA in the following quote). The emphasis is mine

An observation worthy of particular note is that the percentage of pressure-dependent MA among the total number of MA shows considerable interindividual variation (Figure 2). For most patients the proportion of pressure-depen-dent MA was low and did not result in any significant sleep fragmentation, but in some individuals up to 61% of the total number of MA were classified as pressure dependent. This seems to point to a considerable individual variability of this phenomenon

Here's how I would proceed:
Set minumum to 8: because both the median (50%) pressure and the charts indicate that whenever you are lower than that, your breathing is not stable, and the pressure has to be pushed up again. Leave the max where it is. I would wait for a week to see how this affects a) how I feel b) the stability of my breathing as shoen in the charts.

If there's no change in how I feel, I would use the data from the above experiment to chose a fixed pressure - based on that weeks's data.
If I want to start out with a fixed pressure, I'd start by setting my fixed pressure at 8.