One night without CPAP and I felt better.

The only symptoms of OSA I had was daytime sleepiness and even that wasn't that bad. I scored under 10 on the Epworth scale. I would never fall asleep sitting at my desk or in meetings or driving. I've had insomnia since my teens so not falling asleep or waking up in the middle of the night wasn't anything new. I just never felt rested.

After I started the CPAP I woke up more than ever. My doctor started the pressure from 10cm-15cm. I only slept for 2 hours of my titration study so I am sure it was a wild guess. I had to take Ambien to fall asleep and use the ramp because once the pressure got to 10 it was horrible I couldn't breath. The pressure never went higher than 12.6. The numbers looked good but I felt worse and worse.

A few weeks after starting I had my deviated septum fixed. I went five nights without CPAP post surgery. Once I started back, I changed the pressure to 8-15. Seemed logical since it's an auto titrating machine. The pressure has never gone over 10.5 so I changed it to 8-10.5. Then when looking at the numbers I could see that every time the pressue went up to 10 I would wake up. So I tried using CPAP at 8.5 pressure for a few days. Didn't have OA but my hypopneas went up. So I finally settled back at 8.5-10.5. The max pressure has only gone up to 10. My leaks are low and everything looks good on paper. Even though my total AHI was always good, my OA is ususally 1 or less but hypopneas and clear airway events increased.

My ENT told me the pressure would go down post surgery and it did. I've also dropped 20 lbs since my titration study on 7/15 (239-219), I'm 6'0 tall - that hasn't changed but surely cleaning up my diet and working out has helped. I can't figure out why I feel worse.

Well you recently wrote this,

by nycdug on Sun Aug 24, 2014 6:38 am


I remember waking up several times especially when I rolled over to my right side (my preferred side) because my mask would leak and the air blowing in my face would wake me. I also noticed leaking through my mouth a few times later in the night so I tightened the chin strap. For me, the chin strap is worse than the mask in terms of comfort and I have the Respironics Premium which is relatively comfortable but not if I have to wear it that tight
viewtopic.php?f=1&t=99938&p=932521#p932521

I am suspicious that your mask leaks and your mouth leaks were never under control.

Wouldn't that show up in the leak report?

Masks are the hardest thing about adjusting to cpap therapy... maybe you simply need a different mask.. you really need to work at overcoming the problems, I had many in my first few weeks. Mask liners will help with the leaks, which while you won't get rid of them all, they will abate, and stop making the noises they make so that you can sleep. I did not sleep during my first week because of a very leaky noisy mask... there is a mask feature on the machines that I used, which helped, but I still had difficulty, and when I found out about mask liners (who knew there was such a thing?) and started using them, that was a game changer for me. After a month, I was sleeping through the night with just one wake up, not from mask or cpap problems, but to use the bathroom.

Another point I'd like to make is that with OSA you are at greater risk of heart attack or stroke. This leads to two issues: 1) If you have children, I'm sure you'd like to play ball with them and see them graduate from school, go on to college or marriage and family, then play with your grandkids. 2) People who have strokes often have to live in a nursing home or have home health aides help with their daily needs, some even have to wear diapers. Both of my grandfathers died too early. One had a stroke that was so bad he died two days later; the other had a heart attack and died the next day. Neither one lived to see any of their grandchildren graduate.

Wouldn't you really rather have an active, healthy life? Work with us on your difficulties; we can help as we've all been where you are now, the only difference being that we accepted our condition for what it is, and worked to solve the problems.

nycdug wrote:The only symptoms of OSA I had was daytime sleepiness and even that wasn't that bad. I scored under 10 on the Epworth scale. I would never fall asleep sitting at my desk or in meetings or driving. I've had insomnia since my teens so not falling asleep or waking up in the middle of the night wasn't anything new. I just never felt rested.

After I started the CPAP I woke up more than ever. My doctor started the pressure from 10cm-15cm. I only slept for 2 hours of my titration study so I am sure it was a wild guess. I had to take Ambien to fall asleep and use the ramp because once the pressure got to 10 it was horrible I couldn't breath. The pressure never went higher than 12.6. The numbers looked good but I felt worse and worse.

A few weeks after starting I had my deviated septum fixed. I went five nights without CPAP post surgery. Once I started back, I changed the pressure to 8-15. Seemed logical since it's an auto titrating machine. The pressure has never gone over 10.5 so I changed it to 8-10.5. Then when looking at the numbers I could see that every time the pressue went up to 10 I would wake up. So I tried using CPAP at 8.5 pressure for a few days. Didn't have OA but my hypopneas went up. So I finally settled back at 8.5-10.5. The max pressure has only gone up to 10. My leaks are low and everything looks good on paper. Even though my total AHI was always good, my OA is ususally 1 or less but hypopneas and clear airway events increased.

My ENT told me the pressure would go down post surgery and it did. I've also dropped 20 lbs since my titration study on 7/15 (239-219), I'm 6'0 tall - that hasn't changed but surely cleaning up my diet and working out has helped. I can't figure out why I feel worse.

But, at 8.5 cm., you said:

Last night's AHI numbers look a lot better! I did not take my usual Ambien to fall asleep

I think you've either got "APAP-itis" or "My whiz-bang APAP has to be better than straight CPAP-itis"

You stopped posting in that thread and now you're back to "doing the same thing over and over and expecting different results".

I'm confused.


Den

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nycdug wrote:Wouldn't that show up in the leak report?

Not necessarily. Sometimes little leaks can be more disturbing than the big ones......depending on how sound asleep you are.


Den

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Still not sure what pressures your dealing with and what the exact symptoms are that are keeping you awake? We could all help more if we understood more....

nycdug wrote:I just finished my first month of CPAP. Needless to say it was the worst month of my life. I felt horrible which I'm sure was due to the fact I couldn't sleep through the night even though my AHI was in check. Last week my AHI was all over the place. Anywhere from .95 to 4.6 and I was a train wreck. My OA were always less than one if any at all. The score came from hypopneas and CA events.

Since I already obtained compliance for BCBS to pay I decided to ditch the CPAP for a night and today I woke up feeling better. No fog and no feeling like my head was going to explode and no feeling like I need a nap. Sure it was just one night but I'm curious if anyone else has done this?

Yeah, I did that at one week into my therapy......took one night off to see if I could tell a difference. "Maybe a little" (but worse). Then, about two weeks after that, I came down with "something" (cold or whatever) that had me coughing so hard I couldn't keep my mask on.......so, I suspended therapy for about 10 nights until I could manage to keep the mask on. That daytime sleepy feeling came back in a hurry and that's when I knew how much my therapy was working. I didn't let it happen again.


Den

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When I got my APAP so it was a bit difficult to sleep in the beginning but it gets better and better apply.Now i have my Apap for 6 month and i sleep better and better but i have problems with my masks !Find wakes at high pressure so I have to close the APAP and start again .Some nights I have 20-30 central apneas between 15-51 and part no and AHI between 0.0 to 3.5 and it is normal .Just keep using CPAP and it get better and better !
Kjell

I also noticed leaking through my mouth a few times later in the night

nycdug wrote:Wouldn't that show up in the leak report?

A full face mask might make a huge improvement in your therapy. It would maintain the therapeutic pressure even when air is leaking from between your lips.