I feel more tired on APAP than before

I am on day 4 of therapy and I was not expecting any miracles but neither was I expecting things to go downhill. My APAP pressure is 7-20 H20 cm and my 95 percentile pressure from the sleepyhead data is 12.8. I have a feeling my APAP pressure range might be too wide and causing arousals. Any suggestions?

Move your minimum up to about 10 and see what things look like and how you feel.
If you're closely following your reports, watch how many pressure changes you're having and WHY they're happening and maybe you'll need to switch to straight pressure. The pressure changes may be bumping you out of your needed sleep stages and leaving you feeling unrested.


Den

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What does the data show? What is your AHI? Are your events in clusters? How much time do you actually spend at your 95% range?

Hi guys,

I think my pressure is all over the place

Yeah, that'll definitely disturb your sleep.
You might want to post the sections of the reports with the events, flow limitations and snores.


Den

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chefmate wrote:Hi guys,

I think my pressure is all over the place

your data says to me "minimum of 11 for now", as well as "read and follow this:"

https://sleep.tnet.com/resources/sleepyhead/shorganize

Do you have or can get your sleep study/titration study reports?
Take a look and see if it mentions non-breathing related arousals. If you're having many of those the result can be a reasonable AHI and still feeling lousy.

Just a thought.

Changing pressures (particularly rapid increases in response to clusters of events) can disturb some people's sleep and cause arousals, which can leave you feeling even more wiped out on APAP than you felt before.

One question is why was your pressure range set essentially wide open? Are you currently doing a trial home-titration study where the doctor will look at the data in a week or two and use it to set up your "permanent" pressure setting(s)? Or did you have a formal in-lab titration study before being given the APAP? And if so, what were the pressure recommendations from that study?

You might very well be more comfortable and less likely to arouse if your APAP was set to a much tighter range. Since your median pressure level (10.62) and your 95% pressure level (12.86) are only a couple of cm apart, you might be more comfortable if the machine was set in a range that was something like 10.6-14.0 instead of the current 7-20. Finally, if you had a formal in-lab titration study that resulted in a specific pressure recommendation, you might want to try straight CPAP mode at the lab-titrated pressure setting to see if you are someone who sleeps better at fixed pressure than the varying pressures of an APAP.

My pressures aren't as high as yours, but I find that I am sensitive to the changing of the pressure during the night. So I set my S9 Auto to CPAP mode at the level that gets rid of the vast majority of my events - for me that is 9, for you it would be higher than that. I would try the suggestions to raise the minimum before switching to CPAP mode. For one thing, you still aren't sure what the right pressure is - frequently, when you raise the minimum pressure, the max pressure comes down a little bit.

It looks like you had a big cluster of events about 30 minutes before you turned off the machine - do you think you were awake at that point?

It looks like you had a big cluster of events about 30 minutes before you turned off the machine - do you think you were awake at that point?

No i was not awake. But I think I might have been sleeping in supine position and I always get the most events in supine position.

You might very well be more comfortable and less likely to arouse if your APAP was set to a much tighter range. Since your median pressure level (10.62) and your 95% pressure level (12.86) are only a couple of cm apart, you might be more comfortable if the machine was set in a range that was something like 10.6-14.0 instead of the current 7-20.

Hey Thanks for your recommendation. I slept with minimum pressure of 10.6 and maximum of 16 last night and I feel much better today. My AHI dropped from 2.1 to 0.55. Here is my my Sleepyhead result from last night.