CPAP works but no relief of symptoms

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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palerider
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Re: CPAP works but no relief of symptoms

Post by palerider » Wed Apr 22, 2015 9:36 am

yaconsult wrote:@JissaP: Yes, sleephead is wonderful - that's why we all recommend it so much!

When you want to post images, please use the Img tag above the text box rather than the URL tag as you did above. This will cause the graphs to appear right within your post without people having to click on a link to go to another site in another tab or window. The images are downloaded directly to the viewer's browser and don't take up any room on the cpaptalk.com server.
you still have to click on them to get a readable size but it does give a nice overview

you don't want to use the img tag, anyway, you want to use the embedded bbcode link, so it gives a large thumbnail here, and then you click and get a large pic... like here:

https://sleep.tnet.com/reference/tips/imgur

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Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

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JissaP
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Re: CPAP works but no relief of symptoms

Post by JissaP » Wed Apr 22, 2015 11:11 am

Thank you so much for your suggestions everyone! I'm glad there was at least one or two things that seemed wrong (which I didn't see), because then that means there's still room for improvement!

I will try 9-10 starting tonight and I will adjust my humidity setting to keep the CPAP on for the entire night. I'll post the results following the guidelines!

If that doesn't work, I'll try the CPAP mode at 9 for a while.

Thanks again! I'm excited to start and see what happens.
Machine: AirSense™ 10 AutoSet For Her
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palerider
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Re: CPAP works but no relief of symptoms

Post by palerider » Wed Apr 22, 2015 11:44 am

JissaP wrote:Thank you so much for your suggestions everyone! I'm glad there was at least one or two things that seemed wrong (which I didn't see), because then that means there's still room for improvement!

I will try 9-10 starting tonight and I will adjust my humidity setting to keep the CPAP on for the entire night. I'll post the results following the guidelines!

If that doesn't work, I'll try the CPAP mode at 9 for a while.

Thanks again! I'm excited to start and see what happens.
also, give it some time, when trying to make the fine adjustments, it's usually recommended to let it settle for a few days, because even when things are going well, everybody has the occasional bad day.... and you don't want to discount something new you're trying because you happened to have a bad day that day

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Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

yaconsult
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Re: CPAP works but no relief of symptoms

Post by yaconsult » Thu Apr 23, 2015 11:31 pm

palerider wrote:
yaconsult wrote:@JissaP: Yes, sleephead is wonderful - that's why we all recommend it so much!

When you want to post images, please use the Img tag above the text box rather than the URL tag as you did above. This will cause the graphs to appear right within your post without people having to click on a link to go to another site in another tab or window. The images are downloaded directly to the viewer's browser and don't take up any room on the cpaptalk.com server.
you still have to click on them to get a readable size but it does give a nice overview

you don't want to use the img tag, anyway, you want to use the embedded bbcode link, so it gives a large thumbnail here, and then you click and get a large pic... like here:

https://sleep.tnet.com/reference/tips/imgur
Not for me, I don't. But maybe it's because I have a 24 inch screen with a resolution of 1920x1200. I can usually see almost the entire sleepyhead graph right on the cpaptalke.com page without clicking anything - the full size image is embedded in the posts I make. And then if I click on it, it takes me to my image host snag.gy. Whatever works for the poster is fine - different strokes for different folks!

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Re: CPAP works but no relief of symptoms

Post by kteague » Fri Apr 24, 2015 1:18 am

JissaP wrote: ... I use the CPAP for around 6-7 hours and take it off when I wake up because my nasal passage is usually kind of dry and irritated, and then I go back to sleep for another 2-3 hours. So I always sleep at least 8-9 hours a night. I wake up a few times during the night, maybe 4-5 times, but it varies a lot from night to night...
I agree with BlackSpinner on this. The last 2-3 hours of your sleep time should be a chunk of REM sleep, where apneas are often at their worse. So you're waking up with having just endured 2-3 hours of probable low oxygen, sleep stage arousals, stress hormones... everything that goes with untreated apnea. Easy to see how that could make you feel pretty crappy during the day. I would challenge you to commit to never sleeping without the mask. After a period of consistency reassess if your symptoms have improved.

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Re: CPAP works but no relief of symptoms

Post by 49er » Fri Apr 24, 2015 2:56 am

JissaP wrote:Oh I forgot to answer your question regarding how much sleep I get: I use the CPAP for around 6-7 hours and take it off when I wake up because my nasal passage is usually kind of dry and irritated, and then I go back to sleep for another 2-3 hours. So I always sleep at least 8-9 hours a night. I wake up a few times during the night, maybe 4-5 times, but it varies a lot from night to night.

Sleeping less or more does not change how I feel, and going to sleep earlier and waking up earlier also doesn't change much (I've tried it for 2-3 months before I got the CPAP).
If dry nasal passages are a problem causing a wakeup, you might want to try Simply Saline Nasal Mist. As someone who is 5 weeks post septoplasty, I am finding this works better than anything else I have tried.

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palerider
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Re: CPAP works but no relief of symptoms

Post by palerider » Fri Apr 24, 2015 9:04 am

yaconsult wrote: Not for me, I don't. But maybe it's because I have a 24 inch screen with a resolution of 1920x1200.
I'd be willing to bet that most people on the forum don't browse it full screen on a 1920x1200 or better screen.

I know *I* don't. I almost never full screen my browser, because I've got other stuff going on in other windows.

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Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

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JissaP
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Re: CPAP works but no relief of symptoms

Post by JissaP » Fri Apr 24, 2015 12:00 pm

Thanks for the suggestions guys! I'll definitely try the saline mist. The dry nasal passage thing is driving me nuts.

I've been on the 9-10 pressure for the past two nights, but I forgot to put my SD card back in the CPAP on the first night (scatterbrain much?), and last night I only managed to keep it on for 3 hours (but there were no events!). I'm struggling a lot with swallowing air at that pressure, but I'm not giving up. I wanted to wait until I got a reasonable amount of time to post results, but I'm curious to know if we can already assess the Flow Limitation problem at this point.

Here are the results from last night:

Image
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Pugsy
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Re: CPAP works but no relief of symptoms

Post by Pugsy » Fri Apr 24, 2015 12:16 pm

Try increasing your EPR from 1 to 2 to see if helps with the air swallowing issues.

Your flow limitation graph from last night shows a little activity but I have seen much, much worse.
Need more nights and more hours to better evaluate.

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archangle
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Re: CPAP works but no relief of symptoms

Post by archangle » Fri Apr 24, 2015 12:26 pm

If you're willing,post a copy of your SD card on dropbox so others can look at your data in detail.

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JissaP
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Re: CPAP works but no relief of symptoms

Post by JissaP » Fri Apr 24, 2015 12:42 pm

Pugsy wrote:Try increasing your EPR from 1 to 2 to see if helps with the air swallowing issues.

Your flow limitation graph from last night shows a little activity but I have seen much, much worse.
Need more nights and more hours to better evaluate.
I'll try to increase the EPR, thank you! Is it normal that I'm constantly maxing out at 10 or almost? Does it mean I need to increase the pressure even more?
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joeljjk11
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Re: CPAP works but no relief of symptoms

Post by joeljjk11 » Fri Apr 24, 2015 12:43 pm

I am new to CPAP therapy but have you tried different types of masks? I have realized that this can have a big impact on the quality of the therapy and that everyone is different.

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Re: CPAP works but no relief of symptoms

Post by Pugsy » Fri Apr 24, 2015 1:04 pm

JissaP wrote:ll try to increase the EPR, thank you! Is it normal that I'm constantly maxing out at 10 or almost? Does it mean I need to increase the pressure even more?
Since the AHI itself is low and the machine still wants to add more pressure we assume it is in response to snores or flow limitations which may or may not actually be a problem worth increasing the pressure for if the increasing pressure is going to cause more air swallowing (aerophagia) issues. Sometimes we have to pick the lessor of 2 evils.
Increasing EPR sometimes offers enough overall relief so that a person can maybe use a little higher pressure and not have the aerophagia issues complicate the situation.

I don't know that your flow limitations are the cause of your not feeling the good numbers you are otherwise seeing on the reports. They certainly are far from horrible but this whole flow limitation thing is a bit hard to evaluate unless we see some graphically ugly FL graphs (which yours aren't anywhere close to ugly).

You certainly won't ever feel well if your belly is bothering you during the night (messing up your sleep quality for sure) and/or making you feel miserable during the day.

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palerider
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Re: CPAP works but no relief of symptoms

Post by palerider » Fri Apr 24, 2015 1:15 pm

Pugsy wrote:
JissaP wrote:ll try to increase the EPR, thank you! Is it normal that I'm constantly maxing out at 10 or almost? Does it mean I need to increase the pressure even more?
Since the AHI itself is low and the machine still wants to add more pressure we assume it is in response to snores or flow limitations which may or may not actually be a problem worth increasing the pressure for if the increasing pressure is going to cause more air swallowing (aerophagia) issues. Sometimes we have to pick the lessor of 2 evils.
Increasing EPR sometimes offers enough overall relief so that a person can maybe use a little higher pressure and not have the aerophagia issues complicate the situation.

I don't know that your flow limitations are the cause of your not feeling the good numbers you are otherwise seeing on the reports. They certainly are far from horrible but this whole flow limitation thing is a bit hard to evaluate unless we see some graphically ugly FL graphs (which yours aren't anywhere close to ugly).

You certainly won't ever feel well if your belly is bothering you during the night (messing up your sleep quality for sure) and/or making you feel miserable during the day.
I was going to say, the only reason I suggested higher pressure is due to the flow limitations, AND her saying she was still feeling tired... and the possibility that the FLs are causing extra respiratory effort, and impeding rest. if it weren't for the aerophagia, I'd say "more pressure" and see what it takes to get rid of the flow limitations, and then see if that makes for a more refreshing nights sleep.

the aerophagia complicates things though

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Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

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JissaP
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Re: CPAP works but no relief of symptoms

Post by JissaP » Fri Apr 24, 2015 1:17 pm

Thank you for the explanation! Makes sense.

Would you also recommend trying another type of mask?

In the meantime, I'll try with the new EPR for a week and post results at the end.

Once again, thank you everyone for your help!
Machine: AirSense™ 10 AutoSet For Her
Mask: Philips Respironics' Nuance Nasal Pillow
Humidifier: HumidAir™ Heated Humidifier with ClimateLine air heated tube