How could such a small change make a difference??

Hello All- I have been using my Opus on a setting of 10.2 for over a year now and still do not feel rested. I have tried many things to correct this but nothing seems to give me relief from fatique or aerophagia. I have used my machine in APAP and CPAP mode and finally just settled on cpap because the APAP did not alleviate the "gas" either so I just gave up and decided to just suffer with it and every night hope that somehow I will wake up rested. Every now and then I will wake up feeling a little better but it never seems to last.
Anyway, last night (and on other nights in the past) I have set my cpap to 10 instead of 10.2. The "gas" is much better but I usually have what I call a night of "twilight" sleep, you know that kind of sleep where you feel like you are asleep but really awake at the same time. I wake up feeling okay for a day but by the second night I begin to experience some noticable depression. If I keep the setting at 10 for any length of time I become irritable and obviously depressed.
I am wondering how such a small change in pressure could have this effect?? I have done this several times over the last year and the same thing happens every time. I am beginning to think I would just be as well off sleeping without the cpap at all. I feel crappy with it and without it and using it is a major hassle(taping my mouth, getting an irritated face and nostrils, major "gas" and reflux etc, etc.).
Anyone have any suggestions or thoughts on this? I am so tired of being tired and frustrated too. Thanks-GG

BTW- my titrated pressure was 12 but there is no way I can use a pressure that high-I would blow up!!

Are you checking your efficacy data? In your case a small change does seem to make a lot of difference. Maybe you can slowly work your way up to a pressure of 12 and see if that makes any difference. If you feel so bad and frustrated that you are about to give up CPAP you may want to visit the doctor. Good luck.

Does your machine record efficacy data? If it does, what happens to the AHI when you reduce the pressure from 10.2 to 10? Is it possible that once you are down to 10, the pressure is insufficient to keep your airway open? If that's the case, it could explain why you wind up getting twilight sleep instead of real sleep.

As for aerophagia. What have you tried? If you've been working on this for a year or more and you are still dealing with painful aerophagia, maybe it's time to talk to the sleep doc and ask whether a trial of bi-level might be worth it. The PA and sleep doc treating me at the time suggested that I try bi-level after I spent three painful months dealing with aerophagia at low pressures and having my insomnia grow worse and worse. The switch helped the aerophagia and after a retitration and a subsequent switch to a narrow BiPAP range, my aerophagia is now only intermittent instead of night after night.

You didn't mention whether you were using EPR and/or what your settings are with regard to that. Or, whether you've tried tweaking any of those settings.......which COULD affect your sleep quality and/or aerophagia.

But, I agree with Mary........such small changes don't normally show that big of a difference.


Den

You might also set your EPR to the maximum. That should allow you some relief.

I have the Opus 360 mask and prefer it to the Swift FX which I also have. My prescription is for 11 cm. Have not had your problems with aerophagia or reflux. The latter went away when I got on the hose. Re: nose irritation, smear a very slight dab of K-Y or Astroglide on your nostrils and the pillows will seat better and not irritate your skin. And get strap covers to minimize face irritation. http://www.padacheek.com

Re: the change in pressure, one night is not enough to draw any conclusions. A week or so is needed. Try setting the upper pressure limit to 10, then 10.5, then 11 and Try sleeping in a different position. Side sleepers frequently have less problem with reflux. Additionally, don't eat within 3 hours of bedtime and avoid foods that give you reflux.

Hope this helps.

Hello Everyone- I tried the 10.0 setting for a week and actually my results are still confusing me. I do feel better mentally which kinda surprises me because my AI is a little higher than it was when the machine was set on 10.2. I feel like I have slept more - it's really hard to explain. My body does not feel as tired and I feel less depressed. Go figure. HOWEVER, I am having more bloating, more GERD and general tummy issues related to aerophagia. I thought that if I lowered the pressure just a little that I would not have the bloating and GERD.

I am totally confused now. Are these GERD issues related to the fact that I am having more apneas. The difference in my normal results and the AI results of this week are really minimal. Why do I feel more rested and my mental state is better? Seems to me that lowering the pressure and having a few more apnea events would have the opposite affect.

Last night I raised my pressure back to 10.2- my stats this morning were very good but I feel draggy and tired and foggy. What the crap is going on here?? I still had a few events last night but my overall results were AHI- 1.3. So, any thoughts on this would be greatly appreciated.

I loved the results I had with the 10.0 setting-less fatique,less depression and anxiety. The GERD and bloating are just horrible. BTW- I did not wake with the same degree of bloating this morning after a 10.2 setting( I always have some bloating no matter what setting I use). One morning last week on the 10.0 setting I was so bloated I could hardly stand up straight and was miserable for half the morning. I just don't know what to do now?? I cannot take Prilosec or any meds such as that-causes stomach pains and headaches-but I do take Pepcid 20 mg in the morning before I eat. GG

When my pressure is too high, the thing wakes me up. I think you should try 10.0 for 3 days, record how you feel and then drop it to 9.8 and do the same. If you feel better, drop .2 per 3 days until you don't feel better but check the data if you can. If your felling much better but your EHI goes up that may not be a problem but the only way is to look at the data. More 10 seconds events might bet better if your not having any 30 second events which you may not see. Can you post data or graphs?