Not Feeling Better - Am I Leaking?

[mrnine]

I have been on CPAP now for about 60 days. Still getting the hang of it but a bit surprised I'm not really perceiving relief yet. I know there are many factors and I'm being patient and sticking with it. But wonder if anyone has any input. I posted some Sleepyhead data here awhile back. But wanted to take time to settle in before I posted more and asked questions.

I'm using a DreamStation APAP with a Dreamwear under the nose mask. I am not sure what to expect on leak rate but know that can have some impact. My 30 day average leak rate though is 11.09 and that sounds within range for my mask and my pressure. Last week average was 20.55 though so there is some variability there. My 30-day average AHI is 2.8.

Here are a couple days of activity:



So...it seems reasonable to have some sense that this is working after 60 days. Though admittedly this has probably been going on for 5+ years. I knocked my mask off the other night about 60 minutes in and slept for the next 6 hours before realizing it. I noticed that I felt extremely tired all day. Which did make me reconsider that perhaps it really is making a difference.

Any advice greatly appreciated.

[mrnine]

Also, I'm sleeping 8 hours a night typically. But sometimes I may take my mask off at 6 or 6:30 and grab a bit more sleep unencumbered. Again, still acclimating to this.

[Pugsy]

Your machine isn't flagging any large leaks so unless small leaks that aren't hitting large leak territory are waking you up then leaks aren't likely a problem.

Do you take any medications? If so, what?
Do you have any other health conditions that might impact how you feel or sleep?
Are you waking often during the night?
What is it that you feel you still have room for improvement on? Daytime fatigue? Need to nap during the day?

BTW...cheating and going back to sleep at 6 AM without the mask....guess what the body remembers and it isn't the 6 hours of cpap sleep...it's the last hour or two of non cpap sleep that it remembers. Not a good habit to start because as with all bad habits...they are easy to make and hard to break.

You've got a few less than 4 hours of cpap therapy on the usage graphs...along with 4 or 5 big blank spots so no cpap use at all....how come?

[mrnine]

Your machine isn't flagging any large leaks so unless small leaks that aren't hitting large leak territory are waking you up then leaks aren't likely a problem.

Thanks. That's how I was interpreting it.

Do you take any medications? If so, what?
Do you have any other health conditions that might impact how you feel or sleep?
Are you waking often during the night?

No, no, sometimes. No meds and no known conditions. For the past few nights I wake a few times. I have had nights in the past 30 days where I felt I awoke 20+ times.

What is it that you feel you still have room for improvement on? Daytime fatigue? Need to nap during the day?

Daytime fatigue. Yes. I don't actually need to nap during the day. I've never been a napper. But I feel like I could.

BTW...cheating and going back to sleep at 6 AM without the mask....guess what the body remembers and it isn't the 6 hours of cpap sleep...it's the last hour or two of non cpap sleep that it remembers. Not a good habit to start because as with all bad habits...they are easy to make and hard to break.

Ah, no. I get it. At the start it was that "sore septum" thing. Still just adapting to the mask. I have had some nights where I have worn it for the large majority of the night without going "maskless" in the morning.

You've got a few less than 4 hours of cpap therapy on the usage graphs...along with 4 or 5 big blank spots so no cpap use at all....how come?

Knocked the mask off on the nights of limited use. Fell asleep before I got the mask on for the blank spots.

Thanks as always for the response, Pugsy.

[Julie]

Raise your min. setting from 4 to e.g. 6 and see how you feel - 4 is way low for much more than being the machine's default low... hard to breathe at and not a lot better therapeutically.

[Pugsy]

Raise your min. setting from 4 to e.g. 6 and see how you feel - 4 is way low for much more than being the machine's default low... hard to breathe at and not a lot better therapeutically.

The minimum isn't 4 cm...it's 9 cm.
The statistical 4 cm that you see is just the ramp being used for a short period of time.
The settings are minimum 9 and max of 14 and looks like ramp might be used for 10 or 15 minutes.

[Julie]

Oh... so I need to go by 'machine settings' below all that rather than what shows in the color bars? Finally makes sense!

[Pugsy]

Oh... so I need to go by 'machine settings' below all that rather than what shows in the color bars? Finally makes sense!

Yep. Just go by the machine settings (hopefully they can be seen but sometimes people cut them off) shown under the main overall AHI number where it also says which brand & model machine and mode or when in doubt look at the pressure graph.
In this case the minimum is 9 so it's fairly easy to see the ramp time but sometimes if the minimum is 6 or 7 it's not so easy to see sometimes.
Quit looking at the minimum pressure statistic to try to judge what the settings are. It's too easily messed up by not only the ramp but by any exhale relief that might be used.

It does look like from the summary colored bar graphs that she did use minimum of 4 but fairly quickly moved it up.