Does anyone feel their CPAP therapy stopped working for them

TIGMONSTER68 · Post by **TIGMONSTER68** » Wed Sep 12, 2007 12:24 pm

Hi all,
I have only been using APAP for about 2 months, I felt great the first month or so and now I seem to have slipped back into feeling tired all the time again....with little or no energy again. Any suggestions?
Thanks,
Jodie

6PtStar · Post by **6PtStar** » Wed Sep 12, 2007 12:34 pm

What do your numbers say about how your therapy is going? Some times that is the key. If something changed maybe the machine needs to be reset.

Snoredog · Post by **Snoredog** » Wed Sep 12, 2007 12:37 pm

you need to pull out your PSG and read it carefully.

When you go into the sleep lab for a diagnosis, they may diagnose you with more than one disorder. OSA is only 1 disorder, PLMD, spontaneous arousals, RLS etc. are others.

So you leave the lab with a OSA diagnosis or obtain that diagnosis from your doctor with a follow-up visit. They prescribe CPAP, you start using it and feel better the first week or two because you addressed maybe 1 of the 2-3 disorders which may be impacting your sleep.

Then once you catch up on sleep you start downhill again. That is because you have NOT addressed all the disorders that was seen on the PSG that is destroying your sleep architecture.

Even how long you sleep can impact that daily residual fatigue. Once you leave the sleep lab your doctor has NO ideal if the cpap therapy is addressing PLMD's, RLS or even spontaneous arousal. If you had a titration study done using the machine and all those other items disappeared, then they can only guess they are being addressed.

What has the 90% pressure been doing compared to your lab titration?

If you are using a pressure lower than your lab found pressure that can be a reason why you may be falling back. The thing to do is watch the AHI and get that down below 5 then you know you are addressing the OSA and the cause of residual fatigue may be something else.

Other causes/disorders that can contribute to daytime fatigue:

Medications - those taken for allergies, hypertension and even sleep
Cancer - tumors
Lupus and other autoimmune disorders.

TIGMONSTER68 · Post by **TIGMONSTER68** » Wed Sep 12, 2007 12:40 pm

Hi 6Ptstar,
I check my numbers every morning and they haven't changed really at all......leak about .18, AHI about 1.8-2.4, AI is usually 0, HI is usually about 1.8-2.4 making AHI 1.8-2.4...I have an APAP so my pressure is 5-15 but it avg's around 11.8 most of the time. How many hours should I be using the mask per night? I usually get around 7 1/2-9 hours per night .....which to me seems to be plenty but maybe I need more sleep? Not really sure, I just know that I really haven't felt that great lately......
Jodie

Wulfman... · Post by **Wulfman...** » Wed Sep 12, 2007 1:18 pm

TIGMONSTER68 wrote:Hi 6Ptstar,
I check my numbers every morning and they haven't changed really at all......leak about .18, AHI about 1.8-2.4, AI is usually 0, HI is usually about 1.8-2.4 making AHI 1.8-2.4...I have an APAP so my pressure is 5-15 but it avg's around 11.8 most of the time. How many hours should I be using the mask per night? I usually get around 7 1/2-9 hours per night .....which to me seems to be plenty but maybe I need more sleep? Not really sure, I just know that I really haven't felt that great lately......
Jodie

I would venture to guess that your problem is that your bottom pressure is too low and needs to come up closer to where your average is.....like maybe around 10.

Den

dieselgal · Post by **dieselgal** » Wed Sep 12, 2007 1:45 pm

Keep working with it TIG, you don't want to quit now. Sometimes it takes a while just to get completely comfortable and there are nights that NOTHING works. I would try what Wulfman says and see if that makes a difference.

Guest · Post by **Guest** » Wed Sep 12, 2007 2:12 pm

I have been using my CPAP for 19 months and I have had the energy of a teenager, well close I am 60. Check your settings or call your doctor for settings
that he or she thinks you should be at. all the best blessings javascript:emoticon(':)')
Smile

RC

TIGMONSTER68 · Post by **TIGMONSTER68** » Wed Sep 12, 2007 2:26 pm

Wulfman,
Thanks for the advice, I'll try setting my bottom pressure higher .....but I thought the reason you had APAP was so you didn't have to keep messing with your pressures?? But hey, I'll try it, I'm not one to follow all the rules anyway! I was feeling so good for a little while.... I was exercising, and getting up before my alarm, and now....SNOOZE BUTTON every morning! I thought I would lose some weight or at least the edema would go away, but nothing yet.....I'm kind of dissappointed but I'll keep at it, I never had a titration, just a sleep study to see if I had OSA...then I went to the doctor and they sent a lady over with my machine/masks/and instructions......and I was officially a hosehead.
Maybe it has something to do with my son returning from his summer at his Dad's, school starting, new schedule....hmmmmm, never thought of THAT!!!
Have a great day!
Jodie

Wulfman... · Post by **Wulfman...** » Wed Sep 12, 2007 2:45 pm

TIGMONSTER68 wrote:Wulfman,
Thanks for the advice, I'll try setting my bottom pressure higher .....but I thought the reason you had APAP was so you didn't have to keep messing with your pressures?? But hey, I'll try it, I'm not one to follow all the rules anyway! I was feeling so good for a little while.... I was exercising, and getting up before my alarm, and now....SNOOZE BUTTON every morning! I thought I would lose some weight or at least the edema would go away, but nothing yet.....I'm kind of dissappointed but I'll keep at it, I never had a titration, just a sleep study to see if I had OSA...then I went to the doctor and they sent a lady over with my machine/masks/and instructions......and I was officially a hosehead.
Maybe it has something to do with my son returning from his summer at his Dad's, school starting, new schedule....hmmmmm, never thought of THAT!!!
Have a great day!
Jodie

Hi Jodie,

Unfortunately, too many people think an "Auto" does things "automatically".
In my opinion (and others), the best configuration for Auto settings is to get the bottom pressure really close to where it needs to be to prevent the majority of events. If it's too low, it may have too far to go and will take too much time to get there. In the mean time, there may be too many events and desaturations going on and your therapy will suffer.
Some of us have our sleep disturbed by the pressure changes of the Autos, too. If you find that that might be true for you, trying a single-pressure (CPAP) setting may be better. And, with your machine, you could use EPR in single-pressure mode, too......which isn't available in Auto mode.

Actually, I'm glad to see the days getting a little shorter and the nights getting a little longer. It's been tough going to bed this summer when the sun's still out or trying to get by on shorter nights. I'm starting to get more sleep now.

Good luck,

Den (on the other hand, the thought of winter coming isn't comforting, either)

sharon1965 · Post by **sharon1965** » Wed Sep 12, 2007 6:47 pm

Does anyone feel their CPAP therapy stopped working for them

HA! after 8 months i have yet to find my therapy has started to work for me....

hope you get it sorted, though, and get back to feeling great

shippy · Post by **shippy** » Wed Sep 12, 2007 7:27 pm

Go to the light bulb above and read these

How Long Until I Feel Better?
* Seven Stages of CPAP and What Is Feeling Good? (Mike Moran and Perry)
* Recovery and CPAP Adaptation Stages (Mile High Sleeper)
* Thoughts on Improvement (birdshell submitted by ozij)
* OSA Recovery - Specific Conditions and Quality of Life (Mile High Sleep

I think this pretty much explains it

Dale

JeffH · Post by **JeffH** » Wed Sep 12, 2007 7:55 pm

I bet if you set it on straight CPAP at 11 you would start feeling pretty good.

Goofproof · Post by **Goofproof** » Wed Sep 12, 2007 8:42 pm

Might help to use a FF Mask yo make sure you were really getting your treatment. Jim

dsm · Post by **dsm** » Wed Sep 12, 2007 8:54 pm

[quote="JeffH"]I bet if you set it on straight CPAP at 11 you would start feeling pretty good.

Wulfman... · Post by **Wulfman...** » Wed Sep 12, 2007 9:31 pm

dsm wrote:
JeffH wrote:I bet if you set it on straight CPAP at 11 you would start feeling pretty good.
What Jeff has suggested is an excellent way to prove if the Auto low pressure setting is far too low.

Also take note of Wulfman's comments - Den knows his stuff on this particular topic and *any* suggestion he makes is worth topping your list of things to try.

DSM.

Heck, whatever works......
I like Jeff's idea......I sort of hinted at it in my post.
You could START with 11 and see if you need more after a few nights.
Also, by moving the bottom pressure up to 10 (in auto mode), you might end up with a different "average" after a few nights, too. Sometimes the "average" pressure can be a bit too low for effective therapy, too.
In any case, a starting pressure of 5 is apparently/obviously way too low for where the numbers are ending up.....and while the AHI is not exceptionally high, the therapy may not be as effective as it could be.

As Jim said, make sure you're not leaking out your mouth and make sure to get ENOUGH sleep (which it sounds like you are).

Den

Does anyone feel their CPAP therapy stopped working for them

Does anyone feel their CPAP therapy stopped working for them

6ptstar

Re: 6ptstar

Mask

Additional Comments: Equipment isn't correct, S9 ASV w/H5i