First post, trying to tune the machine

[Pugsy]

Fragmented sleep really messes with how we feel during the day.
It's no wonder you are exhausted and you would likely be just exhausted even if you didn't have sleep apnea.

Any idea what is causing the fragmented sleep?
Take any meds? If so, what?
Have other issues....like the pain? How much does your pain issues affect your sleep???
For me the pain is the big killer for my poor sleep quality.
Fragmented sleep means our sleep architecture goes in the toilet. We don't get the nice normal progression of the sleep stages in the nice normal percentages that we need for restorative sleep to work its magic.

I wouldn't be surprised if the bulk of the flagged events on your reports aren't awake/arousal related and not asleep related.
Your machine doesn't want to increase the pressure because most likely the other stuff that goes along with obstructive events isn't happening to cause the machine to feel the need for more pressure.

In other words I have my doubts as to whether "more pressure" will fix your problems. Wouldn't hurt to try it though just to be sure.
You might want to take the time to learn how to identify awake vs asleep flagged events.
Watch all the videos here
http://freecpapadvice.com/sleepyhead-free-software

[zonker]

I toss and turn so much, I couldn't even begin to count how many times I wake up.

if you want a record of how many times you wake up per night, hit the on/off button on your machine. this will show up in your charts as breaks in therapy throughout the night.

[Miss Emerita]

I’ve also read the suggestion that you spike a leak to mark a wake-up, or that you exhale sharply and deeply.

[jbsims]

Great advice Pugsy, thanks for that. I will check out the video. I am just beginning to understand my condition. I am in constant pain. My glossopharyngeal nerve is pinched in my cranial base, which lights up this area inside my head, from my temporal bone down to the back of my throat. My right stylopharyngeus muscle is as tight as a guitar string 24/7. It causes constant pain in the right side of my head. When I sleep I tend to clench on my right side which just exacerbates the pain. It's this chicken and egg thing. Do I sleep poorly because I am in pain or am I in pain because I sleep poorly? I know I sleep better with the CPAP than without it. About once a week or so I wake up feeling really rested, ready to take on the day (NEVER happened pre-CPAP). The rest of the time I just want to crawl back into bed. I am not taking anything right now. I was on Cyclobenzaprine jan-feb-march timeframe. It did help some but I didn't care for the side effects. Before that it was Carbamazepine. I am currently in the habit of drinking valerian root tea before bedtime. Or this.

[Pugsy]

Give yourself some time and hope that with continued optimal therapy you will have more of those "good" days.
I think that at least having the OSA removed from the equation gives us a better chance to better deal with the pain in general.

I don't have many "good" days where I wake up ready to run a marathon but at least I don't wake up feeling like I just ran a marathon and got run over by a bus at the end. I have learned that the hours of sleep and quality of sleep are what (for me) dictates how I am going to feel the next day. Shorter than 6 hours of sleep and my butt is dragging for sure even without multiple wake ups.
8 hours of sleep that is highly fragmented because of pain and lots of tossing and turning and wake ups...still going to be having my butt drag.
I need both quantity and quality and both are hard to get for me. I keep working at it though...don't really have much choice in the matter anyway. I just turned 67 this past weekend...my pelvis and back from c spine to the sacrum is just a big mess...partly from typical age related arthritis and partly due to trauma from a back car wreck where I got broke up pretty bad.

So I fix what I can fix as best I can...and the easiest thing to fix is the sleep apnea. I may not feel as good as I want to but I have gone without cpap a couple of times and I got a rude awakening as to just how badly I could feel if I add in untreated OSA side effects to my other issues.

Give yourself some time...fix what you can or at least try while using the cpap. Accept that somethings the machine can't fix but maybe fixing the sleep apnea will give your body some additional strength to help manage that other stuff.
It's not like you got much choice in the matter anyway... At least you have an occasional good day....it's better than no good days.

[jbsims]

Last night was a good night. I woke up feeling pretty good this morning. The only thing I changed was, after watching some of the videos Pugsy recommended, I turned off the A-FLEX setting on my CPAP machine. I had turned AFLEX on when I started increasing the minimum pressure from 5 to 6 to 7 to 8 to 9. I think the difference of having the minimum set to 9 plus the AFLEX off together gave me a pretty good night's sleep. Only time will tell if this persists for more than one night. I did have a few events that look like legit OA events. Here is one for example. Does this look like a legit OA event to you? The video Pugsy recommended said disregard anything preceded by a waking event spike. I don't see a waking event spike here.

[Pugsy]

Looks legit to me.

Give the new settings a few nights and see how it goes.

[palerider]

The weird thing about that one, though... No recovery breath...

[Thumper68]

The weird thing about that one, though... No recovery breath...

I noticed that also. What do you make of that? Is this one of those we just shrug our shoulders and move on?

[jnk...]

From my uneducated view, "legit" as a label for an event matters BEFORE therapy with PAP, and "legit" matters AFTER several weeks of uninterrupted effective therapy with PAP at a given pressure or set of pressures. But during PAP initiation and acclimation and following significant changes in treatment pressures, "legitimacy" and "differentiation" as concepts are often anybody's guess for any individual event, even with the additional help of effort belts in some instances. That's one crucial reason that clinical titrations are often less than optimal for establishing effective long-term Rx pressures, in my opinion. And it's a reason that the approach used here by the likes of Pugsy and palerider can pay off royally in the long run for a user optimizing his own PAP by averaging results over several days and over longer stretches of time on a regular basis.

But don't mind me. I HATE squiggly lines. And my ideas of 'tuning a machine' involve making its frequencies match the music in my head.

[palerider]

The weird thing about that one, though... No recovery breath...

I noticed that also. What do you make of that? Is this one of those we just shrug our shoulders and move on?

I'd say so... Worrying about individual events .... Not much use, in my view,. It's trends and overall issues that we can do more about.

[Pugsy]

Well it looks more legit than it looks SWJ ish to me anyway. Maybe we put that one in the "iffy" category.

[palerider]

Well it looks more legit than it looks SWJ ish to me anyway. Maybe we put that one in the "iffy" category.

I *think* it's a central, where the throat closed off during the central time... or breath holding for some reason... We've seen those before. Because while the machine said "throat is closed" there's no recovery breaths, no disturbance, just a stop, and start...

But, that's just a guess.