Somewhat disappointed with my sleep Dr. after 1 mo meeting

[spotteddog]

So I show up for my 1 month meeting to discuss my results. The sleep lab downloads the data from my sd card and WOW AHI is 0.5 TERRIFIC. I state, yes much better than 35, however when I push myself at work in the latter part of the week approaching 60+ hours working my 12-15 cm setting gets maxed out and I'm nearly constant at 15 cm. I expressed that maybe I should bump it to 13 - 16cm. "OH NO You are doing great.. not going to change anything see you in 6 weeks have a great day..end of visit. What they don't see since they only look at the AHI average is that I start out on Saturday, Sunday, Monday and Tue at zero AHI and by Friday I'm a 4. Still much improved but I think I can do better. The technician told me after my sleep study that 16cm only stopped my snoring and did nothing for my apnea, however it seems very sleep dependent with me and I short myself sleep toward the end of the week after 3 consecutive days at 12 to 13+ hour shifts and I begin to sleep less so I feel like I have a "life" not just a job. I feel it now and have been trying to get more sleep because when i don't I feel like I did prior to using a CPAP. The sleep lab got their money and I'm compliant so they is a happy lot. Disappointing.

[mgaggie]

Have you ever thought about cutting back your hours? 12-13 hours a day is a lot even for someone who doesn't have apnea

[Bill44133]

you can change the setting yourself. Here is a youtube video that shows you how to change it: https://www.youtube.com/watch?v=2miZa08XHdE

[Julie]

I would look into whether there's indications of leaks, mouth breathing, etc. as you're using 'only' a nasal mask, and bumping up pressure if you lose Cpap air through your mouth will make things worse (and venture into clear airway territory if that's not really the problem).

[chunkyfrog]

One month was not enough for me. It took more like 4-5 months to feel like I had more energy.
With your numbers, I would give myself more time to get in the groove, before changing things.
Apnea may not be the only cause for your fatigue; the body is very complex.
Have you had any recent blood work?
Your doctor could be treating cpap as a hammer, but you are more than just a nail.

[SleepingUgly]

If you're sleeping less, why wouldn't you be more tired? Whenever I logged less hours on the CPAP (even if I slept without it), my AHI was higher. The events are not spread over a longer period of time. Also if you deprive yourself of sleep, you're going to have some REM rebound, which can also make events worse. I would first look at your sleep amount before switching settings. There's no reason to think your OSA is going to be worse as a function of how many hours of work you do, but the number of hours of sleep will impact everything.

[rkuntz123]

12 and 13 hr days are my norm and 46 days of cpap therapy has really helped relative to my pre-cpap life.

Could you answer a couple of additional questions.

1) How do you feel pre-cpap therapy vs. after starting cpap? I can understand your daytime fatigue, but is it getting better, staying the same or getting worse.

2) How much sleep do you get? For me 9 hrs is the sweet spot and always has been, for me daytime fatigue increases in direct proportion to the amount of sleep time that is less than 9 hrs per night for 5 day 12hr work week, however add a 6th day and 9 hrs of sleep per night isn't enough.

From my Dad after 40 years in the Trades as a Boilermaker. "You can only work men for more than 6 10s for a couple of weeks, work them more than 6 day's per week or 10hrs per day for more than 2 weeks and the Accident/Injury Rate goes up and Productivity goes down."

Until the long sleep, life is a balancing act between sleep and wake periods, where the quantity and quality of each matter and the intent of cpap is to improve the quality of life on both sides of the equation. Some one earlier suggested that maybe you should work less but maybe you need to sleep more. Chances are that given time with cpap you'll find a new balance that works for you. Work safe and enjoy your life.

[oak]

I don't know anyone who works 60+ hours that isn't tired. I don't know how old you are, but most people can't keep doing this for very long. Speaking as a cardiac patient post triple bypass: slow down and enjoy your life-it's the only one you've got.

[khauser]

I would not rush in to changing settings just yet. Your machine offers a wealth of data ... please get sleepyhead or RemScan and if you need help reading them please post the data. It may be that leaks are the issue, snoring, whatever ... but we can't really tell until we see the data.

A 0.5AHI does mean you have great treatment from a pure AHI point of view, but I also had great treatment, AHI-wise ... and was snoring a bit, which wakes you up (at least partially). When I targeted that I started feeling MUCH better.

Here are some links around software, in case you need them.
viewtopic/t88983/Pugsys-PointersSleepyH ... nding.html
viewtopic/t88972/Pugsys-PointersSoftwar ... hints.html

[Sir NoddinOff]

please get sleepyhead or RemScan and if you need help reading them please post the data. It may be that leaks are the issue, snoring, whatever ... but we can't really tell until we see the data.

1+

I like Sleepyhead a lot but ResScan has it merits too.

[spotteddog]

[quote="rkuntz123"]12 and 13 hr days are my norm and 46 days of cpap therapy has really helped relative to my pre-cpap life.

Could you answer a couple of additional questions.

1) How do you feel pre-cpap therapy vs. after starting cpap? I can understand your daytime fatigue, but is it getting better, staying the same or getting worse.

2) How much sleep do you get? For me 9 hrs is the sweet spot and always has been, for me daytime fatigue increases in direct proportion to the amount of sleep time that is less than 9 hrs per night for 5 day 12hr work week, however add a 6th day and 9 hrs of sleep per night isn't enough.


First off I'm a driver and my hours are what they are. I'm a regional driver in the NW and most of my runs are between 450 and 550 miles daily. I agree I can't do this forever I've already pushed my self to a 5-way bypass at the ripe old age of 42 now 47 but driving is what I do and until I'm forced to stop this is what I have for work. Pre bypass I was driving in excess of 700 miles a day and hours were 80+ a week.

I feel much better most days not going to say every day but close to 75%. My daytime fatigue is much less as well but it is less predicable now. When you are always tired you know what to expect but if you feel good then the fatigue can creep up if you're not really keeping tabs on it.

I shoot for 7.5 hours a night and If I'm short hauling or working in the office dispatching that's easily accomplished but on the longer days my sleep time drops to about 5 hours. My second night on CPAP I slept 9.25 hours and it was great because it was the first time since last November that I was able to stay in bed for more than 5 hours without a terrible backache waking me up. But I don't have a schedule that will allow 9 hours sleep a night.

I have sleepyhead and check it daily. I'm still don't quite understand the leak and total leak info and as far as snoring I have from 20 to 200 snoring events a night. I can post screenshots but which ones would be most informative? The heavy snore nights or ??