New member with a couple questions

Hi all - this is my first post here and I had some questions. It might be a little long but I want to give as much detail as I can.

For a little over a year now I’ve been feeling fatigued and had a feeling of brain fog, I’ve seen it described on Reddit before as drunk without the feeling of ecstasy and it feels like I’m not really present ever. It feels like I’m looking through life through a window or there’s bubble wrap around my head, it’s a little hard to describe. I am typically able to fall asleep easily, don’t wake up in the middle of the night, but I never feel well rested when I wake up and feel tired throughout the day and have a consistent fog present in my head.

I’ve went through my PCP to rule things out by taking MRI, EEG, blood test for iron, vitamin B, thyroid conditions, lyme disease etc. but everything comes back normal. I am in my 20s and would say I am pretty healthy in general so my PCP didn’t think sleep Apnea was possible so I took two at home tests through Lofta and Wesper. Lofta showed an AHI of 14.0 and hourly RDI of 34.0 and Wesper gave an AHI of 5.7. I was wondering what people’s thoughts are on these services and if they are very accurate at detecting sleep apnea.

I got an RX through Lofta and ordered a CPAP through Apria with my insurance and was told over the phone that it would be a Resmed Airsense 11 but I got a 3B Luna G3 instead which at the time I thought was fine because I was happy to finally get a CPAP. From what I understand now however, this data is not compatible with the OSCAR software so I can’t interpret the data at all to tweak my settings. Should I call my DME and have them switch it or is this not possible because I’ve started using the Luna G3 already? I don’t think the RX mentioned a specific model and I guess the alternative would be to pay out of pocket for the Resmed which I really would prefer not to do if my insurance can cover it.

As for the results of the CPAP from a little over a week of using it, I have attached them below. So far I have been feeling mostly the same and I understand that the CPAP takes a while to work for most people but I have had one day (9/8) where I woke up feeling great and had energy all day even though I still felt brain fog and not feeling present, I didn’t feel fatigued.

I guess I am wondering a few things at the moment: are at home sleep tests generally reliable or does it depend on other things? Should I try to exchange my device for another one so I can actually interpret the data better? Thank you all for any advice you have, I can provide any other information that's needed

Welcome!

It's encouraging that you've had one day feeling rested and energetic. It's possible the brain fog will start to lift as you have more days like that one.

Can you think back and identify anything special about the day and night before the good day? Time you went to bed? Temperature of the room? Use of alcohol or screens before bed-time? Exercise or exposure to sunlight the day before? Reduction of stress the day before? -- You get the idea.

You should immediately get in touch with the DME to ask about swapping the Luna for a ResMed Airsense 10 Autoset (or an Airsense 11 Autoset). You'd get much more useful data that way, as you've noted.

The data you have suggest some encouraging things. You aren't having any large leaks; you're spending reasonable amounts of time most nights using the machine; and your AHI is mostly low.

I couldn't quite figure out what your settings are. Could you go into the clinician menu and check? (Turn machine on, then scroll right to the SETTINGS option. Press and hold HOME button and RAMP button (round) together at the same time, for about 5 seconds.) Especially, what are you minimum and maximum pressures? And are you using a feature that lowers your pressure when you exhale and then raises it when you inhale?

If you could scan and post your sleep studies that might be helpful. Be sure to black out your personal information. In general, in-lab sleep tests are regarded as the gold standard, but many of us are diagnosed well enough using home tests. Could you describe the paraphernalia involved with those two tests?

Miss Emerita wrote: ↑

Sun Sep 15, 2024 11:24 am

Welcome!

Thanks so much for all of the insights. Nothing about that day jumps out to me in particular, I try to exercise daily and I don't drink. I also sleep at the same time every day, around 10:30pm and don't use screens before bed and I'm generally not stressed about things. I've started to keep track of factors like these on my phone to see if I can find any patterns. One thing I forgot to mention is that I will typically wake up at around 5 or 6 am, I'm not sure if this is because my body has decided it has had enough sleep but that's what I have read online. My guess is probably yes because if I was waking up due to discomfort, I would think I would wake up at random times, not consistently in the morning. The CPAP mask, a nasal one from resmed I believe, has been comfortable for me and I have an easy time falling asleep. I generally sleep on my back but sometimes move around to my side or stomach.

When I ask the DME about swapping, is there a possibility they would say no and what type of reason would I have to provide? I'm new to all of this so I'm not quite sure how it works.

The settings are as follows:
Mode: AutoCPAP
Initial P: 4.0 cm
Min APAP: 4.0 cm
Max APAP: 20.0 cm
SmartA: Off
Sensitivity: 4
Max Ramp time: 0
Reslex: 2
Humidifier: Auto
Heated tubing: Auto

I believe the only changes I made were turning the Reslex on 2 because exhaling was a little difficult and putting the heated tubing on Auto.

I've attached my tests below. The Lofta test is a one night test that uses the WatchPat One device which I believe has a pulse oximeter and wristband for heartrate. The Wesper test was two nights with a pulse oximeter and two patches that go on the chest and stomach which I believe measure breathing, heartrate, and sleeping position.

Thank you again so much for the helpful response

Can you look at your Rx to see whether the make and model of the prescribed machine is specified? If it isn't, I'd suggest you tell the DME that (a) you were told you'd get an Airsense 11 Autoset and (b) although you are compliant with the Luna, you remain tired with brain fog during the day and want to see whether the Airsense 11 (or 10, preferably) algorithm would benefit you.

Another thought: can you go back to whatever company issued your prescription and ask that it be revised to specify the Airsense 10 or 11 Autoset?

Your second sleep study showed a pretty high RDI (respiratory disturbance index). This measures arousals that are related to respiration. For some people, a high level of "flow limitations" corresponds to a high RDI.

Flow limitations are limitations to the flow of air within the airway. They can originate in the nose or further down. If they originate in the nose, a PAP machine can't do much of anything about them, but if they originate further down, a PAP machine can help. It can help via its pressure settings and also via settings that produce a differential between exhalation pressure (lower) and inhalation pressure (higher). For your machine, that's Reslex.

Let me know whether you have a stuffy nose or structural issues inside your nose, but in the meantime, I'd suggest raising your minimum pressure to 7 and setting your Rexlex to 3. I'd also suggest turning off your ramp, unless you need it to fall asleep.

Miss Emerita wrote: ↑

Mon Sep 16, 2024 11:36 am

Can you look at your Rx to see whether the make and model of the prescribed machine is specified? If it isn't, I'd suggest you tell the DME that (a) you were told you'd get an Airsense 11 Autoset and (b) although you are compliant with the Luna, you remain tired with brain fog during the day and want to see whether the Airsense 11 (or 10, preferably) algorithm would benefit you.

So in my Rx the make and model of machine isn't specified and I was able to call the DME today and let them know I wanted to see if I could switch machines, waiting on that right now.

I can also try reaching out to original company which gave me the prescription, Lofta in this case, and get the Rx changed for the Airsense model.

Yes, I've been dealing with some congestion issues that vary throughout the day and sometimes I can't breathe out of one nostril. I'm not really sure when it began but it might have coincided with when I started having symptoms of fatigue/fuzziness/brain fog. I am seeing my ENT about it but they said there is nothing structurally wrong with my nose/tongue/tonsils and I also took a blood test that tested negative for allergies. Regularly using a Nettipot and I need to start Flonase which they also recommended so I'll probably start that today.

I'll try those settings you suggested tonight, thank you for all the helpful advice

Just so you know, it can take a week or two for Flonase to kick in, so be patient.

Keep us posted!