Regression

[Nathan C. Morales]

Hi all,

I've been on CPAP now for about 3 months. Things went well initially. Most of my fatigue went away. I considered myself a success story.

Over the last week it feels as though I am not on my machine--you know, the usual zombie walking, fatigue, and zero motivation. My AHI goes from 2-4 on most nights, and I can't seem to find a correleation between the Sleepyhead numbers and how I feel.

Do you see anything in my numbers or know of anything I can do?

Thanks!

[JDS74]

Nathan:
Was the 18th a "bad" night and the 17th a "good" night. If so, it looks as if you woke up a few times on the 18th.
Also look the 18th at about 0:40, 3:30, and 5:30. Your machine is chasing something with the pressure.
Respironics machines are a little slow in raising pressure and altogether too fast in reducing after the event.
If your EPAP pressure was 14 cm H2O instead of 12.5 cm H2O, your machine might not have to chase as much because it would have a head start and your sleep might be some better. Some people don't respond well to pressure changes (I'm not one of those fortunately) and they get disturbed with relatively rapid changes.

You might try creeping up on 14 cm H2O by raising to 13, then 13.5, etc. and let it stay at the intermediate pressures for a few days each and see if things improve.

[Nathan C. Morales]

Thanks for the reply. Both nights were poor nights. Last night was too, but I forgot to put my card back into the machine.

I raised the minimum pressure to 13 last night, which was a poor night. I raised it to 13.5 for tonight.

I'm just surprised at how fatigued I am. I feel like I am off the machine.

[Julie]

One of those times I can't explain what in your story prompts me to suggest this, but have you tried a soft cervical collar - it keeps your head up, so your airway's larger, and it helps to stop mouth leaks. Many people find them helpful.

[JDS74]

Nathan:

If both nights resulted in you feeling lousy the next day, then it is unlikely that ineffective therapy is the culprit.
Moving the EPAP pressure up a little will help the machine react to your apnea events but probably won't solve the problem.
So:
Take a look at other things in your life.
Are you under any new or particular stress (work?, home?, relationships?) that started about the same time the feeling bad the next day started?

Have you looked at your sleep hygiene to see if anything has changed?
-Getting to bed at about the same time each night?
-Only getting in bed and masking up when you are sleepy, not just when you are tired?
-Lying in bed watching TV? That interferes with developing the new and important habit of "I'm in bed, I'm going to sleep."
-Napping in the afternoon without using your machine?
-Change in diet - Stimulants during the day to cope with being tired? Food with caffeine in it? New foods you haven't eaten before?

About forgetting to insert the SD card. We've all done that - not a big deal.
However, a good habit to cultivate is always checking for the card during your masking up ritual. Doing that every night fixed my SD card failures because, even if I forgot, the check found it in time to insert the card each night.

[Nathan C. Morales]

After some consideration, I think my mouth is opening up during the night (I use a nasal pillow).

I wonder if that shows up on sleepy head?

I may need to get a chin strap.

[Pugsy]

Air escaping out the mouth creates a leak situation and the machine will pick up on it and flag/record the leak and then it will show up on SleepyHead reports. Leak is leak no matter what the cause.
It's pretty easy to spot on the leak graphs.