Exhausted

[Pugsy]

I have a good example of how a short time with elevated pressures can really screw up the numbers...let me see if I can find it. It shows pretty much not much pressure change at all except for a couple of brief times.

Those old reports of mine are on Photobucket and it is a nightmare to deal with now (I use Imgur.com now for hosting images) but I was able to retrieve one report that showed a high 90% number which I will post below and I also dug up this thread where I have a couple of other examples of high and low and you can see that the bulk of the night the pressure is much lower.

The old thread which has some good useful information in it is here and it is short so won't take long to read
viewtopic.php?f=1&t=61734&st=0&sk=t&sd= ... holy+grail

And the different image I dug up that showed a high 90% number and the relatively few short lived times at higher pressure that drove up the 90% number. The bulk was obviously right at the end of the night...most likely related to REM since my own OSA is worse in REM and this time of the night is when we typically have more REM sleep.

[Sylvia54]

Pugsy;

Oh I see, thanks for educating me on all that. I do have flow limitations that vary from night to night and the two snores that register are pretty consistent. I'll take a look at the detailed pressure graphs, that's interesting.

I'll admit, my sleep studies did not go well. I've had problems with fragmented sleep and insomnia for quite some time now, leg jerks while asleep too they said. So I slept maybe 4.5 hrs the first study and only 2.5 hrs the second, and that's with taking twice the sedative dose than normal. Noise in the clinic woke me the first time and then couldn't get back to sleep. Second study, everything that could go wrong, went wrong! Monitor came off my finger and sleep tech had to come in and wake me, then air rushing from my mouth with using nasal pillows, then sleep techs talking and laughing outside the door, it's amazing I slept at all. Besides that, my bed at home is very comfortable and I probably shift around more often than I did at the clinic. So it adds up.

[Sheffey]

leg jerks while asleep too they said.

Not sure what you mean by that, but PLMD can leave you exhausted even if your CPAP therapy is perfect.

[Sylvia54]

leg jerks while asleep too they said.

Not sure what you mean by that, but PLMD can leave you exhausted even if your CPAP therapy is perfect.

Thanks for the comment but I doubt it's an issue for me. Sleep tech mentioned it like there were just a couple and neither the sleep doc or
NP said a word about it. I've read about PLMD and know what that is. It's a reminder to get my ferritin checked again since it was on the low side
of normal 2 yrs ago and sometimes causes PLMD. Took iron supplements for a few mos. last year and got it up to 44 last Nov.

[Sheffey]

I doubt it's an issue for me.

YOU brought it up.

Took iron supplements for a few mos. last year and got it up to 44 last Nov.

For a person who has PLMD or RLS, 44 nanograms per milliliter is too low. It should be at least 100. I keep mine around 200.

[mjdindc]

I've been on cpap for about 6 months and still waiting to see any improvement in how I feel and energy. So far I know I am sleeping less because of air leakage issues. I've tried 4 different styles of masks. I don't trust what my cpap (resmes air sense 10) says about leakage. There have been several times my partner has been woken up by leakage and the report says minimal (if any)

I am just very frustrated that after 6 months I am getting less sleep, more naps during the day (before cpap if I took a nap it was rarely more than once a month. Since starting cpap I'm so tired its every couple of days and the fatigue is making it hard to concentrate. Has anyone tried any of the non cpap solutions?

I started cpap because I stopped breathing occasionally at night. I rarely snored and while I had fatigue issues, rarely napped or fell asleep watching tv.

Thanks for letting me vent but would appreciate any suggestions including experience with non cpap solutions.

[AvaM]

Sorry slow replying back.... crazy work!! and i have Meneirs everything is spinning. lol

Ok i cant get a new machine until next year so that is out.

I changed the cushion in my mask and helped tremendous no leaking. i feel better except for Air in my stomach almost too much pressure it gets all gargly, burpy, when the pressure is high and going all the way thru. and it WAKES me up!

I upped my # to 12 pressure that helps BUT now i am getting air in my stomach again!! How do i get that to stop?
more pillows?
turn down #?
deal with it? ugg


Thanks again

[Pugsy]

I upped my # to 12 pressure that helps BUT now i am getting air in my stomach again!! How do i get that to stop?
more pillows?
turn down #?
deal with it? ugg

Which mode are you using? Auto mode or fixed bilevel mode?
What settings are you using? all of them....you will likely need to go into the clinical setup menu area to get all the settings.
Are you using BiFlex?...if so at what setting?

What setting did you increase to 12?

You may have some options that might help the aerophagia (air in the stomach) issues depending on what your settings are.

[rizzo01]

Dr Michaelson advanced ENT. It's close to Northside hosp. He's wonderful and considered one of the best

[AvaM]

I upped my # to 12 pressure that helps BUT now i am getting air in my stomach again!! How do i get that to stop?
more pillows?
turn down #?
deal with it? ugg

Which mode are you using? Auto mode or fixed bilevel mode? Auto (the wrong machine is listed in my settings and cant get it to change, i have a Resmed Model M)
What settings are you using? all of them....you will likely need to go into the clinical setup menu area to get all the settings.
Are you using BiFlex?...if so at what setting? No Biflex

What setting did you increase to 12? the Pressure

You may have some options that might help the aerophagia (air in the stomach) issues depending on what your settings are.

[AvaM]

resperonics REMStar Auto M series - Model M series heated humidifier -

my cpap machine this is what i am using.

[Pugsy]

What is the model number of your machine?
I understand it is a M series Auto of some sort... there are M series Auto cpaps and there are M series Auto BiPaps.
We can't help you if we have no idea what you are using.
Is it a BiPap or a cpap/apap? Does it mention AFlex or CFlex or BiFlex on top of the machine?
If the only pressure setting you have available is a single pressure at 12...that's not bipap.

Did you go into the clinical setup menu area? I need you to write down all the settings that you see.
Tell us what they are.

Otherwise without more specific information about all we can tell you is use the Flex exhale option and set it to a setting of 3...get some exhale relief and see if that is enough to help with the aerophagia issues.

[AvaM]

What is the model number of your machine?
I understand it is a M series Auto of some sort... there are M series Auto cpaps and there are M series Auto BiPaps.
We can't help you if we have no idea what you are using.
Is it a BiPap or a cpap/apap? Does it mention AFlex or CFlex or BiFlex on top of the machine?
If the only pressure setting you have available is a single pressure at 12...that's not bipap.

Did you go into the clinical setup menu area? I need you to write down all the settings that you see.
Tell us what they are.

Otherwise without more specific information about all we can tell you is use the Flex exhale option and set it to a setting of 3...get some exhale relief and see if that is enough to help with the aerophagia issues.

*******************Ok i have had this machine for about 8 yr maybe longer

*********************resperonics REMStar Auto M series - Model M series heated humidifier - dom
*********************Model #1051158
I will get the readings when i get home, back out of the clinical settings.

[AvaM]

What is the model number of your machine? 1051158

I understand it is a M series Auto of some sort... there are M series Auto cpaps and there are M series Auto BiPaps.
We can't help you if we have no idea what you are using.
Is it a BiPap or a cpap/apap? Does it mention AFlex or CFlex or BiFlex on top of the machine? mentions CFLEX in settings

Did you go into the clinical setup menu area? I need you to write down all the settings that you see.
Tell us what they are.

Ok here goes:
cflex is on 2
auto ramp 6.0
therapy mode - auto
automax 11.5
auto min 7.0
90 % pressure 7 day avg 10.0
system leak 7 day 31.3
90 day 27.7
Apn-hyp index
7 day avg AHI 2.2
30 day avg AHI 2.7

i think that is everything.

Otherwise without more specific information about all we can tell you is use the Flex exhale option and set it to a setting of 3...get some exhale relief and see if that is enough to help with the aerophagia issues.[/quote]


*******************Ok i have had this machine for about 8 yr maybe longer

*********************resperonics REMStar Auto M series - Model M series heated humidifier - dom
*********************Model #1051158
I will get the readings when i get home, back out of the clinical settings.[/quote]

[Pugsy]

Okay. You have one of the first M Series Auto CPAP machines with CFlex. The later M Series Auto CPAP machines had AFlex in Auto mode.

You don't have a BiPap. BiPaps don't have CFlex...they would have BiFlex.

Your pressures were 7.0 minimum and 11.5 maximum....at those settings your AHI was fine...that's from the 7/30 day AHI averages.

I still don't know if you increased the 7.0 minimum to 12 or the 11.5 maximum to 12.

Changing the maximum from 11.5 to 12 shouldn't really do much in terms of causing aerophagia to be worse because the machine wouldn't go there unless it thinks it needs to and your overall 90% pressure was 10 cm...so it didn't want to go to the max of 11.5 all that much so I don't see it going to 12 all that much.

If you increased the 7.0 minimum to 12...that's the culprit for the aerophagia and I don't think you needed any increase.
Now if you weren't feeling so good and just thought more pressure would help...it might have if your AHI was high but it wasn't...30 day average was under 3.0.
You increased the pressure when there wasn't a need in terms of OSA results to increase the pressure.
Leaks are well within acceptable limits...so that's not the problem.

I don't know what your problem is or was to cause you to increase the pressure but the increase caused a problem with aerophagia and the AHI doesn't support your needing that much pressure so I would suggest changing it back to where it was.

If you aren't feeling the good numbers...probably should be seeing your doctor and starting there...
along with the usual speech...
How many hours of sleep are you getting? Are those hours of sleep fragmented with a lot of wake ups and if they are any idea why?
Do you take any medications of any kind that have side effects that could account for your unwanted symptoms?

More pressure doesn't fix everything and if your AHI is nice and low (and it is) there's no need for more pressure.
Now it doesn't hurt to use a little more pressure than might be technically needed UNLESS it causes a problem like the aerophagia issues you are having.