Cognitive Fog

[DrumminD21311]

Hey I posted this message on another forum, and they said it was against the rules. I've been using my machine and a chin strap for over a year and still have problems. I have the "cognitive fog" and am not able to focus. I use a chin strap, and it seems that my symptoms are even worse than they were before I ever even got the cPap. Due to a post on another forum, I think I may stop using the chin strap. I'm in law school, and I can't focus at all. I can't understand what the teacher is saying and can't respond. My pressure was set at 13. I amped it up to 15, then lowered it to 13.5, and neither helped. It was also creating terrible problems with my sinuses that stopped once I started putting Vicks in the humidifier. I can't see a doctor anymore because my insurance doesn't cover anything related to sleep apnea, and I've moved away from where my previous doctor is at. What do you think I should do?

[Pugsy]

What do you think I should do?

Add your equipment to your Profile so we can see what you are using.
Here's how.
wiki/index.php/Registering_Equipment_in_User_Profile

Don't add Vicks to humidifier water. Put some on a cotton ball at air intake in back of machine.
Instead what setting is the humidifier on? Some people do better with more humidity, some do better with less.

If you are lucky your machine has full data and there is software available to see up close what is going on with your therapy.

Bet I know which forum...they don't want anyone even talking about changing their pressure. Always saying a person needs to consult with their doctor....well sometimes people can't. Their approach assumes it is a perfect world but we all know that it isn't.

[moresleep]

It is very important to get sinus problems and mouth leaking problems solved; otherwise, you can't expect the CPAP therapy to work. I had both, and that was my experience. Sleep doctors are often not very helpful with these.

Even if sleep apnea is not covered by your medical plan, you should still be able to get treated for any sinus issues, preferably by an ENT. Sinus rinses helped a lot for me, and I still use them. I used them maybe 4 times a day back when I had chronic sinus infections. I use Neilmed packets of salt/soda and their squeeze bottle.

Are you sure air is not escaping from your mouth while you sleep, even with the chin strap? At first, mouth breathing kept CPAP from having any chance of working for me. I tried full-face masks, which are a solution for some mouth leakers, but did not get along well with them. Chin straps did not work at all for me. I had to use (and still use) 2" wide 3M Micropore/Nexscare paper tape. You can find in the pharmacy and online.

13 is starting to get moderately high. Maybe you need it, but you might try inching it lower, to see if that works better. For some people (me), higher pressures cause centrals and other problems and lower pressures actually work a bit better. What machine do you have? If it records data other than just compliance, you should get the software and look at what is happening.

It might sound odd, but one thing that did work a bit for me back before I got CPAP working right was a cup of black tea before bed. Apparently, the stimulants helped with my airways and breathing reflexes.

[DrumminD21311]

I have Encore Pro 2 and just downloaded my statistics for the past week. They say:

Average Time in Large Leak Per Day: 0 secs.
Average AHI: 8.7
CPAP Pressure: 13.5 cmH2O
Obstructed Airway Apnea Index: 5.1
Hypopnea Index: 3.6
Vibratory Snore Index: 80.9
Average Max Leak: 40.9
Average 90% Leak: 26.7
Average Leak 15.9

I noticed that when my snoring was at its highest, my apneas were at the lowest, which seems to indicate snoring is helping me breathe. What do you guys think?

[Pugsy]

What mask do you use?
What machine do you use?

While some of the reported snores could possibly be from hose rubbing against bedding...they can also be a sign of some small flow limitations. I use APAP and if I have many snores that seem a bit obstructive in nature my machine will increase the pressure trying to prevent the events.

We generally try to get our AHI less than 5...so yours is a bit high. I will share this with you. When I first started therapy and was seeing AHI of 7 to 10..I felt like total crap with zero improvement. I increased the pressure a bit (RX was 8 cm) to 9 cm and saw the AHI drop to 4 to 5...felt some better but still had a few event clusters so increased the pressure to 10 cm minimum (since I use APAP) and the AHI dropped to below 3 and I actually felt more improvement. Still didn't want to run a marathon but the morning headaches ceased and the nocturia ceased.

Could you post a screen shot of one of your single night's daily detailed report? Not the summary but a single night.
Pick a good one with minimal leak and lower AHI. Then we can see what you are seeing and perhaps offers some ideas to help manage things.
Don't know how to post an image? Here's how I do it.

Open the image to full size so it is easily read.
I use Vista snipping tool to create a screen shot and crop the image at the same time.
Prt/scr key will also take a screen shot if using XP. If laptop is used sometimes the Fn key has to be pushed at the same time as the prt/scr key
I think windows 7 Home Premium has the snipping tool, Basic may not.
Once the screen shot is created save it in jpg format.
Upload the image to a host site. I use Photobucket it is free, there are others.
Once the image is uploaded then copy the ENTIRE IMG address. Be sure to include the opening and closing IMG in brackets. Paste that copied address into a post here.
Use the preview button. If you can't see the image try again because if you can't see it we can't.

[ameriken]

I have Encore Pro 2 and just downloaded my statistics for the past week. They say:

Average Time in Large Leak Per Day: 0 secs.
Average AHI: 8.7
CPAP Pressure: 13.5 cmH2O
Obstructed Airway Apnea Index: 5.1
Hypopnea Index: 3.6
Vibratory Snore Index: 80.9
Average Max Leak: 40.9
Average 90% Leak: 26.7
Average Leak 15.9

I noticed that when my snoring was at its highest, my apneas were at the lowest, which seems to indicate snoring is helping me breathe. What do you guys think?

Not necessarily, the two may have absolutely nothing to do with each other and one cannot tell just from the averages. Like pugsy said, it helps to add your equipment and mask and then post an image of a night where this has occured.

[Emilia]

Please take a minute to go up to the User Control Panel (under search, top left) and then to your Profile and then Edit Equipment. Choose your gear from the pull down menus and the choose to show those in TEXT, not pictures. This will put your equipment at the bottom of every post your write automatically, like mine below. Those with the same equipment can help you better than having to constantly ask you what you use!

[DrumminD21311]

I tried to add the equipment, but nothing seemed to exactly match what I have. I have a Respironics mask, but I didn't see one on there. My cpap is a RemstarPro M Series and it has C-flex. The model number is 1051158. I will try to add screen shots. I noticed the nights that I had the highest amount of leaks and the highest snoring index was when my apneas were at the lowest.

[Muse-Inc]

Nuts to change anything until you understand your current baseline. Withou knowing what xPAP & mask & seeing several nights' data, it's next to impossible to understand what might be causing those symptoms, er, lack of significant improvement. Could be the device (CPAP, APAP, biPAP...gotta know), could be the type of mask, could be the anxiety we all experience in the beginning, could be other issues preventing you from experiencing good results.

[ameriken]

I tried to add the equipment, but nothing seemed to exactly match what I have. I have a Respironics mask, but I didn't see one on there. My cpap is a RemstarPro M Series and it has C-flex. The model number is 1051158. I will try to add screen shots. I noticed the nights that I had the highest amount of leaks and the highest snoring index was when my apneas were at the lowest.

I've had larges leaks that coincided with low apneas. I wondered how can that be until someone explained that you cannot trust the data when you are having large leaks...because of the leaks you may be having more and longer apneas/hypopneas since your therapy has been compromised, and at the same time the leaks are not registering because the pressures are off. All the machine can tell you is that you are having leaks, but because of those leaks it doesn't know what's going on otherwise.

So don't trust the data when you have large leaks.

[DrumminD21311]

Trend
http://i1187.photobucket.com/albums/z38 ... /Trend.jpg

Bad Night
http://i1187.photobucket.com/albums/z38 ... dNight.jpg

Good Night
http://i1187.photobucket.com/albums/z38 ... dNight.jpg

[archangle]

I tried to add the equipment, but nothing seemed to exactly match what I have. I have a Respironics mask, but I didn't see one on there. My cpap is a RemstarPro M Series and it has C-flex. The model number is 1051158. I will try to add screen shots. I noticed the nights that I had the highest amount of leaks and the highest snoring index was when my apneas were at the lowest.

That's listed as "M Series Pro CFLEX" or some such.

We really need to make the equipment list names match what's on the actual machines a little better. For instance, most people don't figure out "PR System One REMstar..." because it doesn't say anything like that on the actual machine.

[DrumminD21311]

You know, on the "bad night," I think my mask may have just fallen off my face while the machine still ran.

[ameriken]

You know, on the "bad night," I think my mask may have just fallen off my face while the machine still ran.

Actually, your leak rates, even on the 'bad' nights are ok. If it was bad, it would register as a 'large leak' on the right side of the chart and you would definitely see the difference on the graph. Next time you go to sleep and put on the machine wear the mask for 5 or 10 minutes, then take it off for a minute and just let it blow, then put it on again. Then see how it registers the next morning and how it is reported on the chart.

You'll see a huge difference.

[DrumminD21311]

So should I amp up my pressure? What's the diagnosis?