Feeling so tired after 1 month of using Resmed Autoset Airsense10

[Psyth]

Hi everyone, i'm a french 25yo male who was diagnosed with 21 IAH/h and 40 RERA/h (and this for sure since years and years.. i heard that's big), I used the Bipap for more than 1 month with little conscious improvement in my sleep despite the number of IAH dropped to less than 1.

Since the start, my doctor and the technician proposed me to use autoset with a config at 5 to 13.
I justed use app to see how this parameter value evolves during the night and here is the screen (i suspect my brain react to these (lot of) change of pressure by doing arousals - is it possible ?)

I'm pretty sure i can have a total change in my mood, energy, brain logic capacity because I wake up with very clear minded a few times using an other treatment (advancement orthesis) until i dropped it because it was working 1 time each 5 days (or so) for obscure reasons.

Thanks for any kind of help.

[ChicagoGranny]

(i suspect my brain react to these (lot of) change of pressure by doing arousals - is it possible ?)

You are getting a lot of pressure swings because your minimum is set too low. If this were my therapy, I would change the minimum to 8.0. Try that for a night and reevaluate the charts.

Check the links in this post to find instructions for formatting screenshots of OSCAR.

Welcome!

[Psyth]

Do you think it would be a good idea to ask to set settings at a fixed pressure around 11 ?

[Julie]

Why would you want to do that?

[Psyth]

Because i'm suspecting my brain to react a lot (awakening) from changes of CO2 value.

The night where I did my sleep exam I have been found doing 21 IAH (which is moderate) for 40 RERAs (which is 4x time above the critical limit) per hour.
This amount seems to me to be quite abnormal when I compare it to IAH/Reras from others patients.

[ChicagoGranny]

Do you think it would be a good idea to ask to set settings at a fixed pressure around 11 ?

Give it a try for one night and check the results in OSCAR the next day. If you feel like you slept well and your AHI is good, you're a winner. If things still aren't right, the OSCAR detail can help to know the next move.

[Psyth]

Hi !

After 1 month, my problems have never been so real.
I'm still pretty sure all is related to having poor quality sleep (I had 40 awakenings/hr on my sleep eval) but I have just no idea on why and what I can try next step.

Since 3 weeks I had a switch to a fixed pressure at 13 (and my IAH is still great with less than 1 per night but i feel so exhausted) and here are my data :

Flow rate :

flow rate.png (64.35 KiB) Viewed 3661 times

And flux limit, leak speed, snoring :

data.png (76.45 KiB) Viewed 3661 times

Do you see something strange in these ?
Btw I'm suspecting mouth breathing during night but I used strap for few days with little to no perceived difference.

[Julie]

Have you been checked for other medical conditions that might be causing your tiredness? Not everything's about OSA.

Also, why are you on fixed pressure vs Apap?

[Psyth]

Not as serious as I did for my sleep problems but I'm kinda sure it's due to that !

I had some incredible sleep when I tried to use mandibular advancement orthosis, I just wake up being a totally different person with a huge self-confidence and a will to do something in life.. but unfortenaly it didn't work for every sleep I had, which is the reason why I switched to CPAP.

I moved on fixed pressure as it was advice to me, and because I'm suspecting my brain to react a lot from
CO2 change..
You know here in France you can have a CPAP paid by social security for two conditions : IAH > 30/hr or Awakenings > 10/hr
And as I said my Awakening was found being at 41/hr, which is more than 4x the value of the limit where they say it affects the quality of your life..

These two points are why I expect such changes from being cured.

[Julie]

Lots of people have higher (worse) events on testing, but the trick now is to get Cpap/Apap working for you and stop imagining problems with CO2 and other things.

Would you try Apap for a few nights at e.g. 6 and 20 to see how it goes? Post Oscar results in this thread so experts can interpret them.

[NoOnesPerfect]

The flow limitations could be causing micro-arousals too, which might lead to not feeling refreshed but still having low treated AHI.

[Miss Emerita]

Psyth, it'd be helpful if you could reformat the next daily chart that you post. Please show the left panel after closing the calendar and the pie chart. (Unclick under View.) Then include the following graphs only:

Events
Flow rate
Pressure
Leaks
Flow limitations
Snores.

You can fit those six in by grabbing the horizontal gray bars that separate the graphs and pushing them up.

I agree with NoOne'sPerfect that flow limitations may be contributing to the fragmentation of your sleep. You have also mentioned that you find pressure changes disturbing.

Would you be willing to try an experiment? If so, please set your pressure at a constant 11 and use EPR (expiratory pressure relief) of 2.

There doesn't seem to be much reason from what we've seen so far for the higher pressure of 13. With EPR of 2, your pressure on exhalation will be 9. Enough to prevent obstructive events? We'll see. The EPR might help some with the flow limitations, because it provides you with a little pressure boost as you inhale, which can help overcome flow limitations, which are a problem of inhalation. In addition, many people find EPR makes for more comfortable breathing; if that's true for you, this could also help you sleep more soundly.

If you try the experiment, please post a chart showing what happened, using the formatting directions above. The results will help us figure out what direction to try next.

[Psyth]

Thanks so much for help guys !!
I'm having hard times speaking with french sleep professionnel because they are not in point at all to analyze technical datas.

I just screned informations below the way you asked Miss Emerita.

In this screen, in order, you have Events, Flow rate, Pressure, Leaks, Flow limitation

cpap1.png (79.96 KiB) Viewed 3559 times

And here is snoring

cpap2.png (12.88 KiB) Viewed 3559 times

By the way, and I just can't stand for it, in France you have not the possibility to adjust yourself the machine, so I always have to call doctor/technicals for a change, which results taking a lot of time and being boring for both of us..
I hope that I will be able to move and try 11 fixed pressure with EPR 2.
I keep you all in touch asap, and if some have any inspiration about my current datas (which is 13 fixed no EPR) I will love to read some of your ideas.

[ChicagoGranny]

in France you have not the possibility to adjust yourself the machine

Sure you can. See page 14 - Accessing the Clinical Menu and Adjusting the Clinical Settings - https://www.respshop.com/manuals/ResMed ... %20her.pdf

Instructions can also be found on youtube.

[Psyth]

I mean I know how to change settings but it's not allowed by medical providers.

I just can't because they would see and stop to lend me the machine, unfortunately.