Sleeping more but feeling more tired

[Mikecpaine1]

Hi, I was wondering if anyone has ever experienced what I am currently experiencing.
I have been trying various masks and various settings in the hope of increasing my sleep times.
The last two nights have been the most I have ever slept, however I have also woken
up the next morning feeling worse than the other nights when I slept less. It was so chronic that I actually
nearly fell asleep at the wheel a couple of times.

Does anyone have any ideas as to why I should feel worse.

regards
Mike

[Mary Z]

Hi, I was wondering if anyone has ever experienced what I am currently experiencing.
I have been trying various masks and various settings in the hope of increasing my sleep times.
The last two nights have been the most I have ever slept, however I have also woken
up the next morning feeling worse than the other nights when I slept less. It was so chronic that I actually
nearly fell asleep at the wheel a couple of times.

Does anyone have any ideas as to why I should feel worse.

regards
Mike

Mike, I hope you are not making changes more than once a week. Are you keeping track of your AHI? Keeping a diary as to what works and what doesn't? I see you registered in December, don't know how long you've been on therapy, but my "sleep debt" came due after months on therapy. I would keep as many parameters as constant as possible. For instance if you are changing masks and settings at the same time it muddies the waters. Find a comfortable mask and stick with it, and then change one thing at a time to monitor the results. Review basic sleep hygiene which seems so simple it is often overlooked. For instance you may be extra sensitive to caffeine and find it impacts your sleep, so can a drink before bed, or exercise too close to bedtime.
What settings are you adjusting? This may help us help you pin things down.
Good luck.

[Mikecpaine1]

Hi Mary, my last nights settings were:

6.5 Hours Run Time
6.5 Hours Usage
2.5 Flow Limitation
Humidity 4.0
Ramps 0.0
AHI = 12.4
90th percentile Leak = 33.0 l/min
Pressure = 10

The previous night I had on the same settings and my AHI was 7.0

I have been told that these statistics are good but I still feel like I am dog-tired the next morning.
Will it take time for my body to adjust? I have not been using my machine consistently because I had a mask that was too
small and suffered from panic attacks. Since I got the nasal pillows it has been much better. No anxiety but just soooooo
tired the last two nights.

Incidently, before the 21st feb I could only manage on average between 3 and 4 hours sleep and I felt like I had slept better.
Admittedly most of the times I would wake up throw the mask off at 2am in the morning and sleep the other 4 hours without cpap
on the couch.

Very confused about why cpap is so inconsistent. To me everything seems like trial and error.

regards
Mike

[Emilia]

First... why do you show Smart Link software when you have an ICON machine? Smart Link is for the Intellipap machine. Secondly, your AHI is not "good statistics" .... your AHI should be below 5 to be considered normal. I don't know what the acceptable leak is for your mask, but 33 doesn't seem abnormally high to me. If you truly have software for your machine, are you using it? I didn't think the ICON's software was readily available so I am assuming you don't have it. Sleepyhead will eventually be able to work with your machine, but it is still in development for the ICON.

Since your machine is straight cpap only.... at least I think it is.... you should try bumping up the pressure by either .5 or 1.0 and stay there for a couple of nights to see what happens. You don't want to jump up to a higher pressure too quickly in case it sets off centrals. It may take you a week or longer to find your sweet spot. In the meantime, be sure your mask is not leaking and know that once you can get the AHI below 5, you will begin to feel much better. There is also sleep debt to pay off so don't expect to feel like running a marathon right away.

Hopefully, some other ICON users will be along to offer suggestions. I am not familiar enough with the machine to do that for you.

[Mikecpaine1]

Hi would like to know more about this sleep debt. Last night I slept for 6.6 hours and my settings were:

6.6 hrs runt time
6.6 hrs usage
1.2 hr Flow limitation
Humidity 3
Ramps 0
AHI = 1.4
24 l/min (90th Percentile Leak)
Pressure 6.5

Feeling slightly better this morning. This report is positive right?

regards
Mike

[Pugsy]

Feeling slightly better this morning. This report is positive right?

AHI = 1.4

Yep. This report is a good report. You need that AHI to be as far below 5 as you can get it to have a chance to start feeling better. AHI of 5 is our "cut off line" so to speak. The lower the better but don't go chasing AHI 0.0 because that will drive you crazy.

Your leak is fine. F & P machines report total leak and I think up to nearly 90 L/min is within acceptable limits. I don't remember exact number but it is quite a generous number and very close to 100 L/min..that I do remember.

So whatever you did last night....do it again tonight and don't change anything for a few nights so that you can see if this is consistent. We don't sleep the same each night and we can't gauge things too well based on a single night of data because of normal variations.

One question....are you having frequent awakenings during the hours of sleep for any reason?
If so, what reason and how many awakenings?

[Emilia]

Yep... looks good for last night! Sleep debt is generally considered the condition of 'catching up' on all the sleep you missed or did poorly before you were diagnosed and on the machine. For some, they don't seem to have any debt, but for many it takes days, weeks, months to 'pay it back' and get caught up so you start to feel better. Think of it this way.... you didn't become so sleep deprived and suffer hypoxia overnight so don't expect to be fine overnight, either. It will take time for most of us to not only get adjusted and caught up on deep, restorative sleep... we also have probably done some damage to various body systems due to loss of oxygen, and these need time to heal and recuperate as well.

[Mikecpaine1]

Hi, all. Another quick question. Do any of you have swollen ankles, or had swollen ankles and cpap HELPED SOLVE your problem?
Please let me know.

regards
Mike

[Mikecpaine1]

Hi all, I seem to now have a 3 consistent day pattern for my sleep. Last nights sleep details were almost identical to the
day before which I hope is encouraging because i feel that I am at least becoming consistent.

This is the report.

Run time = 6.3hrs
Usage Time = 6.3hrs
Flow Limitation = 2.4
Humidity = 3
Ramps = 0
AHI = 1.9
90th Percentile leake = 26.0 l/min
Pressure = 6.5

Fairly happy with this. How much better could I get on treatment. Starting to feel a bit better in the mornings too.

regards
Mike

[hades161]

So far so good =)

I would just leave it be now for a week or 2 and see how you feel. Personally, I am happy with 2.0 and anything under it is gravy. Now all you need to do is give it time and keep things as consistent as you can.

As far as the Edema goes Pap does help but doesn't Cure it. Pap treatment helps your heart by making sure you don't desat on your O2 levels and stress the heart. This leaves it free to do its job IE moving blood around. I have chronic Edema mainly because I behave badly but I do know how to fix it. Well, at least this works for me anyway. An I am a big guy with high blood pressure.

First, figure out a way to elevate your feet just above your heart when laying in bed via cushions or an adjustable bed or my favorite an Air mattress/cushion even a 20$ one. Simply inflate it a little and fold it over to fit under your legs. The air mattress supports your raised legs and joints very comfortably and is very adjustable just add or lose air. You get the idea.

Second, sleep with your legs up like this for as long as you can and try to hit 10 hours a day with your legs n feet up.

Third no soda ! no caffeine let your heart work normally without extra stimulants. Drink water don't think to stop drinking fluids as you can get dehydrated even with Edema, I know I have done it.

Lastly a 30 minute walk everyday. The walking action will help your blood circulate and help hold off the edema once it subsides.

You will go to the bathroom alot during the first few days as your body "catches up" with filtering your blood and allowing the heart to work more easily and the fluids in your legs will have the help of gravity to aid in circulation. Once it's gone you can relax the duration of laying down, remove the air cushion, drink whatever, as needed but I would keep the walks. Mine came back after adding soda and not keeping up with the walks. But like I said I behave badly.

Good Luck !