AHI below 5 but still feeling tired

[palerider]

Do you use a nasal mask? there could be some mouth breathing. Bonjour at the site above has a good mask link to information in his signature, the machine also has a mask fit function that will blow increased air pressure to test the mask, while you adjust it.

what makes you think that, the 95% 0 leak?

[robysue]

Hi, I'm new to the CPAP thing. I've been using my machine for 3 weeks. Usually I use my machine about 7 hours and have an AHI below 5. But when I wake up, I feel very tired. I take off my mask and have a nap without the mask for another few hours. My pressure is set between 8 and 9 cmh2o. Am I doing anything wrong? Should I increase the pressure to reduce AHI? When I increase pressure, I start having aerophagia and mask leaks..(emphasis added)

No one has picked up on that sentence I highlighted.

While I'm not sure why you are waking up feeling tired after 7 hours of sleeping with the CPAP with an AHI < 5, I can say that if you are regularly taking the mask off and then napping without the mask for another few hours, that extra "few hours" of CPAP-less sleep may be at least partially responsible for your overall tiredness.

[LSAT]

Hi, I'm new to the CPAP thing. I've been using my machine for 3 weeks. Usually I use my machine about 7 hours and have an AHI below 5. But when I wake up, I feel very tired. I take off my mask and have a nap without the mask for another few hours. My pressure is set between 8 and 9 cmh2o. Am I doing anything wrong? Should I increase the pressure to reduce AHI? When I increase pressure, I start having aerophagia and mask leaks..

Also, another problem, is I seem to get nasal congestion, and I've been tweaking the humidity and temperature to no luck. Any tips?

Your pressure may need to be increased....

[zoocrewphoto]

nope

that napping sleep is stopping him from being tired
p

WRONG!!!!

Sleeping without cpap when you have sleep apnea means that you are allowing events to happen. That causes sleep disturbances, and get this, oxygen deprivation. This is especially bad if it is at the end of the night as we tend to have more REM sleep then, and many people have more events during REM sleep.

Taking the mask off and sleeping without the cpap for the last hour or two is causing damage, just not quite as much as if you went all night without the machine. If you want to truly feel better, you need to use it every time you sleep.

[ChicagoGranny]

and get this

[Morraine]

I would get the setup manual from http://www.apneaboard.com/adjust-cpap-p ... tup-manual

you are hitting the maximum ceiling of pressure at 9.2, I would raise that to give the machine room to move,
I would raise the max to 12 and the minimum to 9, the median pressure. I would see how that goes.
If you turn down the EPR it may reduce the CA that may come with an increase in pressure, but if they aren't high, I'd leave it. They should settle on their own. New cpap users can have CA, as they get use to it.

Do you use a nasal mask? there could be some mouth breathing. Bonjour at the site above has a good mask link to information in his signature, the machine also has a mask fit function that will blow increased air pressure to test the mask, while you adjust it.

Thank you for the advice. I moved the max pressure to 12 (already knew how to access clinical menu)

CA = central apneas? So central apneas increase with pressure, and lots of EPR exacerbate it?

I use a full face mask (its in my sig), but it seems due to my blocked nose I often open my mouth to breathe. I don't get a blocked nose if I sleep without CPAP.

I have to take actifed (Walact at Walgreens) to be able to use any mask or sleep without one. Either way:

Bedding is filled with stuff we're sensitive to allergic to, so when we lay down our fluids which drain normally and don't bother us 'as much' pool.

Filters that go in the back of the machine where the intake is are an imperative, as is washing those which are washable or replacing them often if they are not washable.

When I take actifed, which is an 'older' drug, it doesn't impact my body like the 'newer' drugs do, I have had pneumonia when taking almost any of the newer drugs which don't have actifed's combination of antihistamine and swelling control pseudoephedrine hydrochloride 60 mg as the nasal decongestant and triprolidine hydrochloride 2.5 mg respectively and the latter is the most important part, not the former.

If you aren't sensitive to the materials you're putting near your face, aka, your mask, then it's something else going through your mask which is concentrating any allergens in the air and delivering them straight to your sinuses.

Filtering and a well tolerated and single dose of actifed can and does keep my nose free of most 'stuffiness' for at least six hours. More than enough time to get enough rest for the next day for most of us.

Here's to finding a quick solution to your very frustrating problem.

[zoocrewphoto]

nope

that napping sleep is stopping him from being tired
p

WRONG!!!!

Sleeping without cpap when you have sleep apnea means that you are allowing events to happen. That causes sleep disturbances, and get this, oxygen deprivation. This is especially bad if it is at the end of the night as we tend to have more REM sleep then, and many people have more events during REM sleep.

Taking the mask off and sleeping without the cpap for the last hour or two is causing damage, just not quite as much as if you went all night without the machine. If you want to truly feel better, you need to use it every time you sleep.

========

Nutz !!!!!!!!!

better to nap with a cpap of course
but he still needs the naps because
he is not getting enough sleep
which is why he needs the naps in the first place

would he need less naps if he always used the cpap
probably
but does he need more sleep than he is getting
absolutely

I have found that quality is more important than quantity. Since sleep without cpap is causing damage, it is actually doing harm. When you tell somebody to go ahead and nap with the machine, you are telling them that the machine is not important. You tell them that it is okay to skip using it. And then it becomes a bad habit that is really hard to break. That is why we never encourage people with sleep apnea to sleep without their machine. We try to help them fix the problems so that they can sleep WITH the machine. Yes, it is hard, especially, when starting out. But adding naps that cause a lot of events can make things worse. Not only is it causing damage doing that nap, but there's enough damage there to offset the benefits of any sleep they did manage to get with the cpap. So, now they think they are using it and not feeling any better. Since they think they are not getting any better, they are more likely to quit. So, telling somebody to nap without the cpap is sending them down the road to quit.

[numnutz]

Acuity AZ and unforgettables

There's a sucker born every minute.

Stoopid sucker every 30 seconds!

[kiri]

Some updates.

I switched to a medium mask and it seems to have greatly reduced the blocked nose problem. Small mask definitely too small.

Still getting aerophagia.

Sleeping longer now. 10 hours a night on the machine.

I'm conscious of less arousals now. Usually seems to be when saliva or humid condensation pools on the side of the mask and I have to wipe it off.

Not as tired, but still much progress to be made. Not getting enough energy to look for jobs. Not getting enough energy to be able to climb out of depression.

Will post graphs when I'm motivated enough, hopefulyl soon.

[Julie]

Sleeping longer - 10 hrs - is not an improvement. Take the advice given and raise your pressure.

[kiri]

Sleeping longer - 10 hrs - is not an improvement. Take the advice given and raise your pressure.

Forgot to mention that I raised the maximum pressure to 12.

[Julie]

Well how do your leaks look... I ask because 10 hrs does sound like you're not getting treated effectively and something is responsible.

[Pugsy]

Are you sleeping 10 hours and using the cpap machine all that time or is part of the time without cpap?
I asked because previously you mentioned sleeping without cpap for parts of the night.

Do you take any medications of any kind? If so, what?

Can you get us a screen shot of the overview graphs showing usage?

Julie...his past reports that he posted didn't show any evidence of major leak problems. A few spikes from mask refitting but for the most part very minimal excess leak. Posted on page one of this thread. Unless leak management has gone to hell really bad since his earlier reports it's doubtful that leaks are the culprit or at least of the magnitude that the machine is clueless.
His profile shows a full face mask unless he has changed masks. Now maybe small leaks are causing wake ups which could be a factor in sleep quality.

[robysue]

Some updates.

I switched to a medium mask and it seems to have greatly reduced the blocked nose problem. Small mask definitely too small.

Good. You've conquered your first CPAP problem. Don't lose sight of the small victories. They're important in keeping you motivated.

Still getting aerophagia.

How bad is the aerophagia? Is it just an irritant where you can burp/fart the excess gas out in 10-15 minutes? Or are you waking up with a rock hard stomach that's bloated and painful in the middle of the night most nights? Or somewhere in between?

Try to make sure you don't eat close to bedtime. Also some people find GERD self-help guidelines will help minimize aerophagia. And are you using EPR? If so, what's it set to? While setting EPR = 3 helps a lot of people with aerophagia problems, there are some people who do better (in terms of aerophagia) with EPR set lower, or even turned off.

Sleeping longer now. 10 hours a night on the machine.

Are you using the machine all night, every night? Are you still taking "naps" without the CPAP?

I'm conscious of less arousals now. Usually seems to be when saliva or humid condensation pools on the side of the mask and I have to wipe it off.

Drooling and rainout (humid condensation) are two common, but separate problems.

Drooling? Some people drool a little, some drool a lot. Some people (like me) can drool up a storm on one night and not drool at all on other nights. Was drooling ever a problem before you started CPAP?

Rainout---condensation of the humidity in the CPAP air---is a common problem. Things to try include: setting the humidifier lower; increasing the hose temperature (if you use a heated hose); putting a hose cozy on the hose; hanging the hose overhead; and putting the machine below the level of your mattress.

Also, are you using a FFM or a nasal or nasal pillows mask? Drooling is a more noticeable problem in a FFM since the drool accumulates inside the mask rather than elsewhere. (If you're a real drooler like I am, you can wake up to a damp pillow or a damp pj sleeve on a night where the drooling is really bad.)

Not as tired, but still much progress to be made. Not getting enough energy to look for jobs. Not getting enough energy to be able to climb out of depression.

Baby steps. Remember that you didn't develop OSA overnight. And it can take several weeks or a 2-3 months to start feeling better---and that's after you are sleeping well with the machine every night.

How bad is the depression? Are you taking any medication for it? If so, what? If you are not taking any medication, are you doing anything nonpharmaceutical to manage your depressive symptoms? If so, what?

See, here's the thing: Depression and OSA are common co-morbidities, and while many people do find their depression symptoms improve after their CPAP therapy is optimized, not everyone's depression automatically improves. So it's important to think about what kinds of things you are willing to do to manage the depression while working on your adjustment to CPAP

Will post graphs when I'm motivated enough, hopefulyl soon.

We need to see those graphs in order to provide you with high quality suggestions about what things you might want to tweak to improve the efficacy of your CPAP therapy.

[kiri]

Thanks for all the advice.

@Pugsy, I'm on CPAP the whole 9-10 hours.

I take antidepressants (escilatopram).

Ever since I switch to the medium mask, i've been getting negligible leakage and nose block problems. Its a full face mask.

I will post some graphs in the morning (its night here in australia)


@Robysue, thanks for the moral support

Aerophagia is medium-level bad I guess. Discomfort from it wakes me up while on CPAP. Makes me fart a lot, and during the day constant feeling of needing to burp but unable to get the air to come out. I'm also sometimes waking up with reflux. I do tend to eat just before bed, which has been a lifelong habit, which I need to try kicking. I'll try to avoid that for a few days and then report back on the results. Not sure if I should turn EPR on because it seems to make the apnea worse, but I'll try it some day.

Drooling/rainout problem: Drooling wasn't a big problem before CPAP. However I'm not sure if I wasn't drooling, or whether the drool just dried in the morning. I'll reduce humidity tonight and see if it drops the water in the mask problem. Hopefully less humidity won't mean dry sinus again.

Depression is quite bad. I've been depressed for 7 years or so (i'm 25). It used to be much worse, I felt very negative each day, but with the medicine I usually only feel neutral or slightly negative. Actually I was hoping CPAP would give me the energy to make a change to my depression, but it hasn't happened yet. I'll need to get rid of all these problems with CPAP I guess.

Will publish graphs in the future.