3 Days and still tired!!!

[twopu]

I'm a newbie to CPAP so please bear with me. I currently have the S9 Autoset (set on CPAP mode at eight), H5i, and Swift LT. The first night was tough just getting used to the hole set up. It took me a while to fall asleep and I woke up several times throughout the night wanting to rip it off. They told me to use the extra small pillow but it just felt like I was having a hard time breathing. The 2nd night I fell asleep in 20-25 minutes and woke up once. I switched to a small pillow and felt better but not rested. The third night I fell asleep in 10-15 minutes and woke up once. I switched to a medium pillow thinking this might do the trick. The one time I woke up I didn't even notice I had the nasal pillows on but the next morning I was EXHAUSTED. I am hesitant to use the equipment tonight. I'm wondering if I should call the Dr and try to switch to a nasal mask instead of a nasal pillow. I had a nasal mask during the sleep study and struggled with it the entire night but I woke up rested the next morning. Any thoughts?

[Jaylee]

I have only ever tried a nasal mask, so I can't comment on that. But it does take time to adjust no matter what you are using. Plus you could have a big sleep debt to pay off, I know that I did.

[Julie]

If you are using the ramp feature to slowly accustom you to a certain prescribed pressure, and you start off breathing at e.g. 4 or 5 then wait for 10 mins. (or however long) to get up to the scripted pressure, you may feel like you're suffocating. Most of us stop using the ramp altogether very early on, but at least raise the low starting one from 4 to 6 or 7, and maybe shorten the time it takes to get to the desired place. No one can breathe at the very low numbers, only techs and sleep docs don't care so just blithely give us all the same story. If that's not part of the problem, then we'll try to come up with something else. There are also many, many masks out there and you don't need to be regulated to that one.

[bdp522]

You may be mouth breathing or mouth leaking. If you breathe through your mouth when asleep or air escapes through your mouth while asleep, you need to fix that. Some do well with a full face mask, I prefer to tape my mouth shut every night.
Even if you aren't mouth breathing/leaking, it usually takes more than a few days to feel better. Many complain of feeling worse in the beginning. Stick with it, it works.

Brenda

[okitoki]

I am a newbie too, and with my pressure originally set at 4-16cm, I felt as it was suffocating at the begining too... then I asked the RT to turn it up to 5cm which helped abit... a few days ago, I set it up to 6cm and helped me alot with the initial breathing as it does feel like I was breathing really hard, but within 10mins I would end up breathing normally...

Just be careful to check if you are a mouth breather, or if you have end up dropping your jaw down as it would release the air pressure causing you not to have the full benefit of the CPAP.

Also make sure you dont have any nose congestion... last night I had a slightly blocked nose and it was horrible trying to sleeep with the nasal pillow... I used the nasal spray to clear... didnt work... end up falling asleep without it... woke up middle of the night with nose cleared, so put on the nasal pillow, and fell asleep with it...

Good luck

[Janknitz]

3 days is a little bit of time in the scheme of things. Some lucky people feel better immediately, but most of us do not. It takes time, sometimes months, and there may be underlying issues that contribute to your fatigue that the CPAP just can't help. But you have to give it a good chance first!

Sounds like you are tolerating your therapy really well. To be able to adjust to the nasal pillows and sleep through the night in just 3 nights is AWESOME!

Now you need to check your numbers to see how you are doing. The most important numbers are the AHI and the leak data. Also, if you are mouth breathing, you may have symptoms such as a very dry mouth in the morning or a very high leak rate when you check it.

If you are not mouth breathing or leaking and doing well with the hours of use, you may start seeing some benefits, but don't expect immediate miracles.

I started in February. I'm still fatigued, but other things are much better--no snoring, no GERD, and I wake feeling peaceful and calm instead of waking with my heart pounding and a feeling of impending doom.

You've probably had SA for many years, so give this therapy a little time to work!

[pdean44]

For me it has been gradual improvement on the tiredness levels. I have stopped snoring and feel like i have alot more energy now. It has been several months now and the differnce in the way i feel now is pretty amazing. You will get there as well.

[adamr]

Just quit the fiasco and sleep on your side or abdomen.

[twopu]

Thank you all for your input!!! I haven't gotten around to checking the numbers because I really wasn't sure how to do it. I just got my hands on a manual so I"ll do some reading tonight. Last night I couldn't stop thinking about breathing which started to give me the feeling of suffocating again, I'm sure it didn't help that I watched U571where one of the characters drowns at the end. Needless to say I took the mask off after two hours. I'm determined to stick with it tonight. I just don't understand why I felt so rested after my sleep study. I tossed and turned all night and almost walked out but felt great the next day. I used a nasal mask instead of nasal pillows. How long should I stick with the nasal pillows before asking for a different mask?

[twopu]

I'm looking at my AHI and leak #s but I really don't know where they should be.

5/27/2010 - 5/30/2010
Device Settings
Therapy Mode: CPAP Set Pressure: 8.0 cmH2O EPR: Full_Time
EPR Level: 3.0 cmH2O
Pressure - cmH2O
Median: 8.0 95th Percentile: 8.0 Maximum: 8.0
Leak - L/min
Median: 1.2 95th Percentile: 14.4 Maximum: 22.8
AHI & AI - Events/hr
Apnea index: 1.4 AHI: 1.4 Obstructive: 0.3
Central: 1.1 Unknown: 0.0 Hypopnea index: 0.0
Usage
Used Days >= 4 hrs : 3 Used Days < 4 hrs : 1 % Used Days >= 4 hrs : 75
Days not used: 0 Total days: 4 Median daily usage: 7:44
Total hours used: 27:32 Average daily usage: 6:53

[bdp522]

AHI should be under 5. You're at 1.4, so it's good.
Leak should be 0(if the machine is set correctly for the mask being used). Anything over 0 is a real leak. You need to work on the leaks some.
With EPR on 3, you may find that it seems the machine is not giving you enough air for a long enough time. Try turning it down to 2 for a few nights and see if it helps.

Brenda

[twopu]

Thanks Brenda!!!
Just to clarify, the leak can come from the improper fitting of the mask and/or breathing through the mouth? Any suggestions on letting my dr/clincian know the leak #s without them knowing I have the software or does the S9 provide the user with that information on the unit?

[sleepmba]

Yes, the leak can be coming from your mouth or the mask. Keep on experimenting with the mask and its headgear. It took me about a week before I had it perfectly adjusted. Also, I had to get used to the mask with regard to my sleeping style. If you lay with your head on the mask, you will develope a leak. I had to learn to adjust my pillow a certain way to keep my seal. Keep at it and you will have it down!

[Golden-Alpine]

I am a newbie too. It took me a couple of weeks to get used to it. I think the extra exhaustion could be because of the stress of dealing with this new thing. I have been going for nearly 2 months and I am starting to feel better. Not as exhausted as I used to be late at night. Stick with it.