Poll: Length of time on xPAP before feeling 90-100% restored

General Discussion on any topic relating to CPAP and/or Sleep Apnea.

Length of time on xPAP before feeling 90-100% restored?

1 month
9
15%
3 months
4
7%
6 months
7
12%
12 months
4
7%
18 months
2
3%
24 months or more
2
3%
still waiting: 3 months
6
10%
still waiting: 6 months
6
10%
still waiting: 12 months
1
2%
still waiting: 18 months or more
19
32%
 
Total votes: 60

User avatar
Dirtyhands0321
Posts: 14
Joined: Wed Jan 14, 2015 6:18 pm
Location: Atlanta, GA USA

Re: Poll: Length of time on xPAP before feeling 90-100% restored

Post by Dirtyhands0321 » Mon Mar 09, 2015 9:23 am

I've been on apap for 25 days straight with 95% compliance, it would of been 100% if my power didn't go out and I didn't have to leave early to work out of town. My sleep study I had 140 ahi and now with apap I have less than 1.0 ahi. I thought I would feel completely different, but honestly I just feel normal. Before I felt like I was out all night drinking jägermietster when I woke up, though I never drank a drop! Now I just wake up and feel fine. I also had issues with acid reflux, now I don't have that anymore whilst laying in bed. I just keep with the apap therapy and I know even if I don't feel like superman, I know it's doing my body good! I'm 34 years old and I thought I was active, I mountain bike, backcountry snowboard, hike, eat healthy, and weigh 165 pounds, the truth is ANYONE can have and treat apnea!

tan
Posts: 565
Joined: Sat Aug 30, 2014 11:58 am

Re: Poll: Length of time on xPAP before feeling 90-100% restored

Post by tan » Mon Mar 09, 2015 7:10 pm

SteveGold wrote:Got an immediate boost, now I'm chasing consistency and predictability. After 2 years I've finally figured out my main problem is probably centrals. AHI has always been enviably low (average 0.5) but I still feel like pure death half the time.

I doubt I'll ever be "fully restored," but knowing what kind of brain I'm going to have day to day would be life changing.
If you still suffer while having low AHI and consistent sleep hygiene, you should review your case for possible UARS. Having low AHI was not satisfactory for me, so I kept digging...

SteveGold
Posts: 72
Joined: Fri Jan 04, 2013 5:31 pm

Re: Poll: Length of time on xPAP before feeling 90-100% restored

Post by SteveGold » Mon Mar 09, 2015 8:46 pm

tan wrote: If you still suffer while having low AHI and consistent sleep hygiene, you should review your case for possible UARS. Having low AHI was not satisfactory for me, so I kept digging...
Thanks for the tip. That's actually what I'm trying to figure out right now. My flow limitation line has always been ragged (at any settings) and most of my events are centrals. There's no correlation between my AHI and how I feel (I've felt great on 1.2, and wretched on 0.3). And my sleep hygiene is great, it just hasn't translated into consistent good sleep.

I see you're on a VPAP - did that solve things for you?

tan
Posts: 565
Joined: Sat Aug 30, 2014 11:58 am

Re: Poll: Length of time on xPAP before feeling 90-100% restored

Post by tan » Mon Mar 09, 2015 9:08 pm

SteveGold wrote:
tan wrote: If you still suffer while having low AHI and consistent sleep hygiene, you should review your case for possible UARS. Having low AHI was not satisfactory for me, so I kept digging...
Thanks for the tip. That's actually what I'm trying to figure out right now. My flow limitation line has always been ragged (at any settings) and most of my events are centrals. There's no correlation between my AHI and how I feel (I've felt great on 1.2, and wretched on 0.3). And my sleep hygiene is great, it just hasn't translated into consistent good sleep.

I see you're on a Bi-Level - did that solve things for you?
Yes, it helped. I felt like even EPR==3 was not good enough, though my doctor was sympathetic and didn't brush me off with my complaints of still being sleepy, yet my health insurance consisted of dickheads, so I had to go further and purchased a VPAP from a craigslist seller (risky but best investment my money could buy). I had to tweak it a bit: PS==4 and both trigger and cycle settings from med to very high. What completed my therapy was fixing dry mouth with partial taping. Now I sleep and feel like I should have. The only thing I regret is not pursuing this treatment 15 years ago, but who knew then.

Guest1

Re: Poll: Length of time on xPAP before feeling 90-100% restored

Post by Guest1 » Tue Mar 10, 2015 12:02 am

SteveGold wrote:
tan wrote: If you still suffer while having low AHI and consistent sleep hygiene, you should review your case for possible UARS. Having low AHI was not satisfactory for me, so I kept digging...
Thanks for the tip. That's actually what I'm trying to figure out right now. My flow limitation line has always been ragged (at any settings) and most of my events are centrals. There's no correlation between my AHI and how I feel (I've felt great on 1.2, and wretched on 0.3). And my sleep hygiene is great, it just hasn't translated into consistent good sleep.

I see you're on a VPAP - did that solve things for you?
SG: Have you ever tried straight pressure. Sometimes, the problem may not be UARS but microarousals caused by pressure changes of APAP. This was the case with me as well (AHI less than 0.5 but felt like crap and then suddenly an AHI of 1.4 and feeling good). I went to straight cpap with Aflex on my PRS1 60 series auto. And it has made a huge difference. Try it for 10 days by putting your machine on straight pressure = 95% pressure of SH for last 2 weeks+.

Sometimes, the simpler technology (CPAP) is the answer vs. a more complex one (VPAP).

tan
Posts: 565
Joined: Sat Aug 30, 2014 11:58 am

Re: Poll: Length of time on xPAP before feeling 90-100% restored

Post by tan » Tue Mar 10, 2015 11:16 am

Guest1 wrote:
SteveGold wrote:
tan wrote: If you still suffer while having low AHI and consistent sleep hygiene, you should review your case for possible UARS. Having low AHI was not satisfactory for me, so I kept digging...
Thanks for the tip. That's actually what I'm trying to figure out right now. My flow limitation line has always been ragged (at any settings) and most of my events are centrals. There's no correlation between my AHI and how I feel (I've felt great on 1.2, and wretched on 0.3). And my sleep hygiene is great, it just hasn't translated into consistent good sleep.

I see you're on a VPAP - did that solve things for you?
SG: Have you ever tried straight pressure. Sometimes, the problem may not be UARS but microarousals caused by pressure changes of APAP.
I don't really believe this is true, based on my experience and what other UARSers reported, who have much bigger range of inhale/exhale pressures on Bi-level machines.

Also, if micro-arousals were due to change of pressures rather than UARS, then why changing pressure to the 95% value, if flow limitations don't matter that much and if it is all about "unnecessary" pressure changes? Or was "sometimes" the key word? I probably mistake you for another big proponent of CPAP

Guest1

Re: Poll: Length of time on xPAP before feeling 90-100% restored

Post by Guest1 » Tue Mar 10, 2015 3:12 pm

tan wrote: I don't really believe this is true, based on my experience and what other UARSers reported, who have much bigger range of inhale/exhale pressures on Bi-level machines.

Also, if micro-arousals were due to change of pressures rather than UARS, then why changing pressure to the 95% value, if flow limitations don't matter that much and if it is all about "unnecessary" pressure changes? Or was "sometimes" the key word? I probably mistake you for another big proponent of CPAP
Tan: Please review this article on Pubmed:
PMID:12150317.
Auto-CPAP therapy for obstructive sleep apnea: induction of microarousals by automatic variations of CPAP pressure?
Fuchs FS et. al.

You can just google it.

Taking my case, I was on APAP with a range of pressure 7 - 12 with good RDI (< 0.5) but still didn't feel rested. I had 2 options:
1) UARS. I can play with pressure settings until I feel rested. The machine data on FLs may help as a proxy for UARS.
2) MicroArousals associated with pressure changes. In this case, I should try straight pressure or straight bilevel pressure to see if I feel rested. The article I have referred talks about this in a bit of detail.

The straight pressure definitely worked for me. For me a straight pressure of 8 with Aflex on(so EPAP is actually 6), worked.
So if one's pressure setting is modest and tolerable, it is worth a try.

Sometimes, low tech CPAP may work than going to a hitech VPAP/ASV. But one needs to eliminate whatever is keeping him from feeling rested. Is it Apnea events, is it UARS, is it MicroArousals, is it other sleep disorders.....

tan
Posts: 565
Joined: Sat Aug 30, 2014 11:58 am

Re: Poll: Length of time on xPAP before feeling 90-100% restored

Post by tan » Tue Mar 10, 2015 3:31 pm

Guest1 wrote:
tan wrote: I don't really believe this is true, based on my experience and what other UARSers reported, who have much bigger range of inhale/exhale pressures on Bi-level machines.

Also, if micro-arousals were due to change of pressures rather than UARS, then why changing pressure to the 95% value, if flow limitations don't matter that much and if it is all about "unnecessary" pressure changes? Or was "sometimes" the key word? I probably mistake you for another big proponent of CPAP
Tan: Please review this article on Pubmed:
PMID:12150317.
Auto-CPAP therapy for obstructive sleep apnea: induction of microarousals by automatic variations of CPAP pressure?
Fuchs FS et. al.

You can just google it.

Taking my case, I was on APAP with a range of pressure 7 - 12 with good RDI (< 0.5) but still didn't feel rested. I had 2 options:
1) UARS. I can play with pressure settings until I feel rested. The machine data on FLs may help as a proxy for UARS.
Thank you, I will read that. In the meantime, if you have an RDI that good, why did you even consider UARS an option?

UPDATE: do I read it correctly that APAP's changing pressure has caused "microarousals for only 16% of subjects?
Last edited by tan on Tue Mar 10, 2015 4:28 pm, edited 1 time in total.

SteveGold
Posts: 72
Joined: Fri Jan 04, 2013 5:31 pm

Re: Poll: Length of time on xPAP before feeling 90-100% restored

Post by SteveGold » Tue Mar 10, 2015 3:47 pm

Thanks tan and Guest1, you've both been very helpful. I'm going to check out that article, too. I think my next step will be to try EPR (I've never bothered with it) to see what affect that has for me. I might be able to finagle a sleep study with a VPAP without having to jump right in with my own machine, but I can kick that can down a road for now.

Guest1, I've been on straight pressure for most of my time on CPAP and haven't noticed an appreciable difference between it and a narrow range in terms of how rested I feel, so no dice there (at least for me).

Guest1

Re: Poll: Length of time on xPAP before feeling 90-100% restored

Post by Guest1 » Tue Mar 10, 2015 5:56 pm

tan wrote: Thank you, I will read that. In the meantime, if you have an RDI that good, why did you even consider UARS an option?

UPDATE: do I read it correctly that APAP's changing pressure has caused "microarousals for only 16% of subjects?
Tan: RDI was one of the things under consideration because PRS1 RERA reporting was suspect at that time. But then my googling showed that there is a 80% chance that a PRS1 RERA is an actual RERA on a EEG. So I excluded that. Then the only thing remaining was the MicroArousals.

The full article, that I referred in my earlier post in this thread, is available as a pdf on sleep journal website. (www DOT journalsleep DOT org). It was published in SLEEP, Vol. 25, No. 5, 2002.

For me, one of the pertinent conclusion in the article was:
For most patients the proportion of pressure-dependent 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.

So I guess I am one of those individuals for whom the pressure dependent MAs cause sleep fragmentation. Its supported by the observation that the straight pressure works for me very well.

tan
Posts: 565
Joined: Sat Aug 30, 2014 11:58 am

Re: Poll: Length of time on xPAP before feeling 90-100% restored

Post by tan » Tue Mar 10, 2015 6:56 pm

SteveGold wrote:Thanks tan and Guest1, you've both been very helpful. I'm going to check out that article, too. I think my next step will be to try EPR (I've never bothered with it) to see what affect that has for me. I might be able to finagle a sleep study with a VPAP without having to jump right in with my own machine, but I can kick that can down a road for now.

Guest1, I've been on straight pressure for most of my time on CPAP and haven't noticed an appreciable difference between it and a narrow range in terms of how rested I feel, so no dice there (at least for me).
well, can we look at your sleepyhead charts?

wilsonintexas
Posts: 406
Joined: Thu May 24, 2012 7:15 am

Re: Poll: Length of time on xPAP before feeling 90-100% restored

Post by wilsonintexas » Fri Mar 13, 2015 10:40 am

I like many others have been on cpap for 3 years. I am better, but not 100%. BUT, I have other complicatons. I would hate to see what I am like without it. (desats ti the numbers in the 70s is not good. This is where I was before cpap. Bow my stats stay up, but still have other problems.

GlowGal
Posts: 12
Joined: Fri Mar 13, 2015 11:14 am

Re: Poll: Length of time on xPAP before feeling 90-100% restored

Post by GlowGal » Fri Mar 13, 2015 12:19 pm

I've been on CPAP therapy for about 7 years (I'll be 50 this year) and while I felt better with a few months, I will never be greatly or fully restored. The mere fact of having to sleep with bulky hoses and headgear contributes to not having a really comfortable restorative sleep.

tan
Posts: 565
Joined: Sat Aug 30, 2014 11:58 am

Re: Poll: Length of time on xPAP before feeling 90-100% restored

Post by tan » Fri Mar 13, 2015 1:16 pm

it took me about 7 months... CPAP therapy helped initially, I say, for about two months. Then things went back to be normally bad in spite of low AHI. I am not longer sure what helped. But the last thing that cemented my success was partial taping of my mouth even though I use a full-face mask, which fixed jaw dropping during sleep and dry mouth issues. I will be now experimenting with lower pressures

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ClarkK
Posts: 23
Joined: Wed Feb 25, 2015 10:36 am

Re: Poll: Length of time on xPAP before feeling 90-100% restored

Post by ClarkK » Fri Mar 13, 2015 5:42 pm

I was in a desperate situation before CPAP and it saved me from that. The rest of the benefits I expect to come much slower.

I'm using the forums as a tool to help optimize my therapy -- and am grateful for the suggestions I've found here and in other forums.

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