2 months on cpap

It's been 2 months of cpap use now. The positives: it's easy to wear the mask every night (I don't exactly love it, but it's certainly tolerable), my anxiety and mental alertness have improved somewhat). The negatives: I am still tired a lot, so I haven't seen an appreciable difference in energy levels, I wouldn't refer to it as a "life changer" as of yet (its a phrase I've heard from so many), I still fall asleep watching TV. I know some of the negatives are because I should try to get a bit more sleep at night. I am hoping, at some point though, to see an improvement in my ahi. I've never had a night below 1, and only 3 nights in 2 months below 2. I average about 4. Definitely envious of all those people who get 1 or lower most of the time! I tend to have about 15-20 hypopneas every night, regardless of how long I sleep. Would love to find a way to lower that. I know some (or maybe most?) are from rolling onto my back. Sometimes I wake during the night and find myself on my back.
I'm currently at a minimum pressure if 7.5, with a high of 15 (never goes that high). I tried a minimum of 8 for a week but my ahi was a little higher and the sound of blowing bothered me. So, I'm more comfortable with 7.5, but not sure it's adequate. Hoping to see improvement in ahi and energy levels during the next month.

You should post your data following the three links below and then the forum can try to help you.

TedVPAP wrote:You should post your data following the three links below and then the forum can try to help you.

She's already done that in another thread(s) and that's how she ended up trying 8 cm minimum and didn't like it.

Yeah, there hasn't really been a big change from what I've posted in the past. Not sure what to try differently. Is it possible it's just a matter of time - like my ahi might possibly lower after I've spent a few more months using cpap regularly? Technically I'm still pretty early along in this process.

Pugsy wrote:

TedVPAP wrote:You should post your data following the three links below and then the forum can try to help you.

She's already done that in another thread(s) and that's how she ended up trying 8 cm minimum and didn't like it.

This forum sure does contain many hidden challenges.

TedVPAP wrote:This forum sure does contain many hidden challenges.

I does indeed and in more areas than just one. I gave up trying to reduce the challenges.
I just happened to remember helping this OP. Her AHI isn't horrible but there is a bit of clutter (those things not included in the AHI) also which if it were me I would try to reduce just in case it was part of the problem with not feeling as good as one hopes.

I don't know that more pressure would fix things anyway. There's some "not enough sleep" issues going on along with some sleep fragmentation going on as well.
So I am not so sure that a nice pretty low AHI would yield the desired results anyway. As we all know a nice perfect AHI doesn't guarantee squat but people sure expect it to.

At any rate she is uncomfortable with more pressure right now and that would be what is needed to reduce the AHI and the clutter. Until she can handle more pressure the AHI is unlikely to change.
Now as to feeling less than optimal...if there are other things involved that can be improved upon then feelings might improve without changing AHI at all.

Just an observation, but you do sound much better than when you first arrived - not nearly as distraught. That's a good start. Hopefully more things will fall into place going forward. Do you feel the back sleeping is enough of a contributor to take steps to prevent rolling onto your back? Some have worn a lightweight backpack with a pillow stuffed in it as a safeguard. As long as the sensations of the backpack aren't even more disruptive to your sleep than now. As my body was trying to recover and I struggled through what I called waiting for my brain to relearn how to sleep, I made special efforts to give myself the nutritional support needed for healing, and worked toward needed medication changes. Even after getting my jumpy legs quieted down, it was like my brain was stuck in old patterns, but at some point I was able to get increasing periods of good restorative sleep. Hopefully that's in your near future.

hi Rainmom17

referring to
viewtopic.php?f=1&t=156161&st=0&sk=t&sd=a

I am wondering why you have at regular interval (8 to 10 min) small peaks in your pressure profile which also are present in the leak rate graph. On the other hand it seems that in these periods you have few events.

Events turn up as the pressure increases above these small peaks. It may be worth wile testing to limit the upper pressure to 10. It could be that the higher pressure is causing more events which then increase pressure and end up waking you up.
Just a thought.

Esel, this is an interesting interpretation. I would love to get feedback from more of you out there to see if you think lowering my upper pressure as Esel suggested would be worth trying.

Btw, thanks to all who responded!

More pressure doesn't/won't cause OAs or hyponeas...instead I suspect that either REM sleep or supine sleeping or maybe both is causing the OSA events happening to need more pressure to hold the airway open.

But you can easily test his theory...limit the max to 10 and see what happens. I don't think it will do anything but allow the airway to collapse even more and you will see more clustering and likely denser.

Everything I have seen in your reports points to needing more minimum to deal with the times when the pressure wants to go higher. The machine only increases pressure when it senses....snores, flow limitations, OAs and hyponeas.
Yours only wants to increase the pressure at random times...not all night and that's what makes me think it is related to either sleeping on your back or REM stage sleep which is pretty much the 2 main causes of rather dramatic changes in pressures like we see with your reports. I know this very well...my OSA is worse in REM sleep. I had reports just like yours until I got a more optimal minimum set so the machine could get to where it needed to go a bit more quickly and better hold the airway open and prevent the collapses.

Hi Rainmom17,

I sure agree with Pugsi, the min pressure is very important. The time the machine needs to reach therapeutic pressure from the min pressure should be as short as possible.

Here some of my data,





higher pressure for me is a problem OK, there are large leaks and maybe the events are artefacts, but sometime there are large leaks and no or almost no events are recorded. I started to look more at tidal volume graphs. This volume goes down when I fall asleep ~15min and jumps all over when not sleeping well.

I have odd breathing pattern some of which seems to be central.



I switched then to an ASV machine and got much better numbers. Just not yet feeling the good numbers...





So for me setting the max pressure not too high gave me the better numbers. You could progressively lower it and see what happens. Good luck

What is AHI to those who post here? Is it the times you wake an hour or times you wake per night? And how does it relate to the air pressure? I have been struggling with fatigue, tiredness and a light headedness or lack of energy etc. for over 2.5 years even on CPAP. Help !!!!! My first sleep test AHI was 15 now at best reached 8 AHI on 15.5 pressure and now runs about 13 AHI I understand to be apneas and hour. Still feel like S___ atb 13 per hour! About 2 .6 hours large leaks with mask at 15 .5 pressure but have achieved an 8 AHI at same pressure and felt pretty good so why the difference?

AHI is Apnea/Hypopnea Index, the average number of apnea events (the number of times you stopped/struggled breathing, regardless whether you awoke) per hour.

OSA is considered "treated" at <5 AHI. With an AHI of 13, you are still *suffering* with mild to moderate sleep apnea and it's no wonder you're struggling with fatigue! This indicates that your apnea is not being treated adequately with the machine settings you currently have, but the folks here in this forum can help you take control of your therapy and get your AHI down so you are better rested.

SBanks wrote:What is AHI to those who post here? Is it the times you wake an hour or times you wake per night? And how does it relate to the air pressure? I have been struggling with fatigue, tiredness and a light headedness or lack of energy etc. for over 2.5 years even on CPAP. Help !!!!! My first sleep test AHI was 15 now at best reached 8 AHI on 15.5 pressure and now runs about 13 AHI I understand to be apneas and hour. Still feel like S___ atb 13 per hour! About 2 .6 hours large leaks with mask at 15 .5 pressure but have achieved an 8 AHI at same pressure and felt pretty good so why the difference?

You should start your own thread. Then people can help you. It is very likely that your treatment has not been optimized. Data is needed. You will be asked to post your data as explained in the three links below. Help is available if you are willing.

OP here. I tried a couple of nights ago to try 8 minimum again. And just like last time, my ahi is up again. 5.2 last night, which I know isn't terrible, but I don't get over 5 very often and I did wake a lot. For now I think I'll just go back to 7.5, since I seem to average around 3.5 ahi with that. Maybe that's good enough for now. I'm in full-on perimenopause, so that may be the reason I can't really get my sleep better than this at the moment.