Newbie: Anyone else feel worst in the A.M.?

[lazyace]

I have been on the CPAP machine for 5 nights, but feel much more fatigued in the morning than I do in the evening. Is this normal? It seems counterintuitive. Prior to CPAP I would often fade in mid to late afternoon. Now, I get up take a shower and go to work, only to feel like passing out once I get there.

I also searched this site and found a poll that indicated that nearly half of the people required more than 6 months on the CPAP before feeling considerably better. If that is true, it is so disheartening.

[Pugsy]

When I first started therapy I felt awful the first week. Then I got my software and I could see that my pressure was allowing events to occur, so I upped my pressure a bit and then I started feeling a little better. The nocturia stopped. The morning headaches got significantly reduce. The fatigue remained though. I seem to have less fatigue when I have had a good restful nights sleep of about 8 hour with minimal events. My problem is that it is hard for me to get more than 6 - 7 hours of sleep.

There is more to this therapy than slapping on a mask and firing up a machine.

Can you get to your LED screen data to report what it says? This will help us offer some ideas. If you are not sleeping well for whatever reason, it will affect how you feel the next day. So you have to do some detective work to try to figure out what is going on.
Check leak rates.
Check AHI numbers
did you wake often during the night, trouble sleeping?
Try to isolate possible factors that are influencing therapy.
Software shows ever more possible factors that could be reponsible for feeling poorly.

[fishhead]

lazyace,

i'm just starting out myself - only 5 weeks on cpap, i had read about how some would after only the first night wake up feeling more refreshed and alive than they had in years. i was a little disappointed when i didn't have that same experience. but i think in my case since my OSA is not nearly as severe as many (my AHI was 27), i figured that the results would also likewise not be as dramatic.

i can say however, that my thinking is sharper, my memory is improving, and my general disposition is much improved. my wife says that i've even become somewhat 'chatty' in the morning. and, i'm sleeping straight through the night - 7-8 hours, something i had not been able to do for several years.

i am anticipating that now that my body is getting more sleep, i may actually feel worse for a time as it finally decides it now has the resources to tackle some issues that it had just put on hold. and since, the apnea didn't appear overnight i'm not expecting it disappear over night either.

you have to remember that sleep disorders affect the way we think. it's difficult to see the answers through the fog so it does take a certain amount of faith and trust that it will help.

hang in there and be patient. the improvements will come.

[lazyace]

When I first started therapy I felt awful the first week. Then I got my software and I could see that my pressure was allowing events to occur, so I upped my pressure a bit and then I started feeling a little better. The nocturia stopped. The morning headaches got significantly reduce. The fatigue remained though. I seem to have less fatigue when I have had a good restful nights sleep of about 8 hour with minimal events. My problem is that it is hard for me to get more than 6 - 7 hours of sleep.

There is more to this therapy than slapping on a mask and firing up a machine.

Can you get to your LED screen data to report what it says? This will help us offer some ideas. If you are not sleeping well for whatever reason, it will affect how you feel the next day. So you have to do some detective work to try to figure out what is going on.
Check leak rates.
Check AHI numbers
did you wake often during the night, trouble sleeping?
Try to isolate possible factors that are influencing therapy.
Software shows ever more possible factors that could be reponsible for feeling poorly.

The problem is that until I meet with the sleep doc, I don't know whether I am keeping the machine I have. If I do keep it, then I will work on the data piece. However, I'm not even sure the machine I have is the best fit for me. Because I am such a novice and they couldn't get a pressure during the study, they gave me an auto unit, and I wasn't about to question it. I am quickly finding how much I don't know about this!

[Muse-Inc]

I lust after the machine you have!!! I want the ResMed AutoSet II and my doc wants me on an APAP too...it's insurance saying "no."

I have a compliance-only' dumb' machine which tells me squat about my previous night's sleep. Get a full data capable machine...key term efficacy data in order to be able to tweak to optimal therapy.

[kteague]

Hi. Just some insights from one who didn't get results immediately...

Don't assume you will be the worst case scenario. Your time for feeling better could be a few weeks, not months. In your situaton, data is key to getting this thing right. Once I got a data capable machine (several months after beginning treatment), I found my pressure was inadequate. Whatever happens, I suggest that 3 weeks of data while trying to get used to wearing this foreign stuff is only the beginning of your relationship with data. With your machine set to start at 8, if you were to find for instance that you're usually staying ell above that, your lower pressure could be increased to shorten the climb time from starting pressure to effective pressure. Also, mouth breathing while sleeping is like having sleep apnea - we don't know what we do while we sleep.

Your time for feeling better could be a few weeks, not months. In my early cpap days, my settings weren't effective, and I seemed to be getting worse instead of better so I quit. But when I did start back, it was with the full expectation every night that this coould be the one that ushered in improvement. Now, I knew maybe it wouldn't be, but I was convinced one day it would be the case. And day by day it began to happen for me.

I'm sorry to hear about your wife wanting to leave. You likely did not recently "develop" OSA. Often the case is we've had it for many years and only become aware after our body and brain wears down from it's long term effects. Keep in mind that right now she is sleep deprived too. This is not the best time for either of you making permanent decisions. Hopefully the two of you can figure out how to in the best way for all involved get thru this time, with a plan for periodic reevaluation when you're both getting proper sleep. You have every reason, with your wife and beautiful child and your own future, to jump into this treatment and give it 100%. It may be that a lot of the things she's had to deal with regarding you were in part due to OSA. It can affect our moods and motivation and every aspect of our lives.

Here's the thing about long term goals - if we abort a good plan because it will take so long, the end of that time frame will still arrive, only we'll have nothing to show for it. In 6 months you could be well on your way to restoring your life, or in 6 months you could continue to decline with all the consequences. Rather than be disheartened by what hasn't yet happened, I suggest that hope will serve you better. It helped me to read of the struggles of others who regained their lives, to motivate me to reach for it for myself. May you find hope and the will to persevere.

[Pugsy]

The problem is that until I meet with the sleep doc, I don't know whether I am keeping the machine I have. If I do keep it, then I will work on the data piece. However, I'm not even sure the machine I have is the best fit for me. Because I am such a novice and they couldn't get a pressure during the study, they gave me an auto unit, and I wasn't about to question it. I am quickly finding how much I don't know about this!

You have a great machine. It offers really good information just on the LED screen. There is no rush for the software for the machine that you have because it will show you some very important data right now.
AHI
AI
HI
Leak
and the pressure that you seem to be using most of the time

Go look. There is nothing to stop you and it hurts nothing to look. If your AHI is high it might explain some of your feeling worse. If your leak is high it might explain some of your feeling worse. If they set the auto unit to the basic 4 minimum and 20 maximum to hunt for your ideal pressure that 4 cm minimum is pretty low and depending on what pressures are needed, it may not be the best minimum for your. Go look, you don't have to worry about changing anything, just go look at the numbers. There is no need to wait to see the doctor. You can still look and it might ease your mind a bit if you see something that could be improved on, like a leak....

[TerryB]

I felt like hammered doggie doo doo in the beginning of my therapy. My personal theory is that the machine/mask/pressure /leaks were all causing a much greater disturbance to my sleep that the actual apnea had been. Consider how many times per night you have come sufficiently awake to deal with some minor or not so minor problem with the new therapy. I changed masks to cut the disturbing leaks way down. I bought some essential oil scents to mask the plastic smell and soothe. Though I still can have a rough night and feel bad the next day, it's generally my fault for not getting enough good sleep that night.

Keep fighting to get it right. I guarantee it is worth the effort.

TerryB

[lazyace]

When I first started therapy I felt awful the first week. Then I got my software and I could see that my pressure was allowing events to occur, so I upped my pressure a bit and then I started feeling a little better. The nocturia stopped. The morning headaches got significantly reduce. The fatigue remained though. I seem to have less fatigue when I have had a good restful nights sleep of about 8 hour with minimal events. My problem is that it is hard for me to get more than 6 - 7 hours of sleep.

There is more to this therapy than slapping on a mask and firing up a machine.

Can you get to your LED screen data to report what it says? This will help us offer some ideas. If you are not sleeping well for whatever reason, it will affect how you feel the next day. So you have to do some detective work to try to figure out what is going on.
Check leak rates.
Check AHI numbers
did you wake often during the night, trouble sleeping?
Try to isolate possible factors that are influencing therapy.
Software shows ever more possible factors that could be reponsible for feeling poorly.

Thanks for the insight! Here is the data from the screen. I don't know if this is an average of the last six nights, or just last night.

Pressure 9.6
Leak 0.32 L/s
AHI 13.4
AI 2.8
HI 10.6

Any idea what this means and whether these values are high or low or something I need to adjust?

[Pugsy]

Pressure 9.6
Leak 0.32 L/s
AHI 13.4
AI 2.8
HI 10.6

Any idea what this means and whether these values are high or low or something I need to adjust?

The ideal leak rate should be 0.0 L/sec. Above 0.20 and they say it can impact therapy. Above 0.40 L/sec and they say the leak can impact therapy and affect overall quality of sleep. You are pushing that 0.40 L/sec.

ResMed machines subtract the intentional leak rate for your mask choice before ever giving you a leak rate, so what you see is excess leak.

Your AHI is high enough to give you the symptoms you describe. My first week of therapy I had AHI 6-9 and I still felt awful. Before worrying about pressure increase you need to worry about reducing the leaks.
Also can you check to see what the minimum pressure setting is? I don't remember if you posted that number or not.
Typically the DME will issue an auto unit with the minimum pressure set at 4 cm. With a minimum too low the machine can't adjust the pressure quickly enough to get to where you need to be most of the time.
Also, are you using any exhalation relief, EPR? It can impact therapy also.

So work on the leaks. Check your minimum pressure. If that is indeed set at 4 cm, then an increase in it would be something I would do. Probably to at least 7 cm to start with.

Having AHI below 5 doesn't guarantee that you will see improvement but it gives you more of a chance. I have found that I personally seem to need an AHI of less than 2. But then I have 95% apnea (AI) and rare hypopnea (HI).
Everyone is different. So you have to have some time under your belt before you can spot the trend that works for you.

For sure your AHI needs to come down and your leak rate needs to be at least, cut in half.

[INTHEFOGINMAINE]

I am wondering why I am feeling so foggy most of the morning and early afternoon after using my CPAP. This is frustrating me as I sleep about 6 hours a night and yet feel like there are bags of sand on the eyes and my brain is in slow motion.