Results at Week 6 and Adjustment Help Please

[bobcpap]

Hey Everyone:

I hope you are all sleeping soundly

I'm 6 weeks in and I still feel really groggy, hung over, and almost sick to my stomach, but sleeping much better. Very frustrating as technically the CPAP is working, but I'm feeling even worse then with broken sleep without it. I'm using APAP setting, 7.5 hours avg sleep, 10.5 median pressure (11.5 max), 1.5 AHI, no leaks, no mouth breathing, and tried both large and medium nose pillows. I like large a little better as I feel air flows better, but they really eat up my nose even with CPAP lotion, so I'm stuck with medium (I was told size doesn't really matter if it's not impacting results - same amount air flows thru large and medium).

I read about sleep debt and was so hopeful this was the issue as I've had at least 5 years bad sleep, but 6 weeks should be enough to now be past that (although, I have read stories where people feel it took closer to 3 months, so I still have hope). I have a Mac, which makes it harder to get software as I need external drive, so I'll look into that, but my respiratory therapist sends me the ResMed report each month, which is probably okay for now - not sure I want to be overanalyzing things yet or if software gives me much more info than that report.

I had a follow-up visit with sleep medicine specialist and we are going to try the following for two weeks before other any further changes:

* CPAP vs APAP setting at 10.6. I've read that some have awakenings on APAP with all the pressure changes and these aren't captured on the report, so results look good, but person feels terrible, but they do much better with constant pressure. I can't find the article to reference unfortunately.

* Moved EPR to 3 cm vs 2. It's shocking how useless most sleep doctors and respiratory therapists are. I was very concerned and struggling with exhale and neither mentioned anything about being able to ease exhale with this setting. I stumbled upon an article last night.

* I was wondering if maybe I had UARS vs OA and about BiPAP vs CPAP. I read a BiPAP is much better as someone with UARS will feel worse on CPAP because of challenge with exhale against pressure and UARS was stated as one of the primary reasons that many patients do not achieve an optimal response. But, he said that according to my sleep study report, I have moderate obstructive sleep apnea and by definition, people with obstructive sleep apnea will have upper airway resistance, but this is not considered UARS. UARS is a milder form of sleep breathing disorder and it is diagnosed in patients who do not meet criteria for obstructive sleep apnea. Interesting.

* I'm also seeing a dental sleep apnea specialist tomorrow just to see if he thinks a MAD would help. One of the reasons is that I have bit down on my tongue really hard a couple nights - perhaps when pressure gets a little too high or pushes tongue too far forward, I clench my teeth, and tongue gets caught. My prior dentist was the one who thought I had sleep apnea and said it was likely due to the fact they pulled 6 of my teeth when young and moved my jaw back. There's now no room for my tongue and it created a narrow passage - add weight gain - and presto, sleep apnea due to tongue collapsing.

* I'm going to weight loss center to start getting my weight under control as well.

I would certainly welcome any other thoughts. Thanks so much!!