Leak level is great. Still have dry mouth and feel groggy?

[cubism_dream]

A little background: diagnosed with OSA two years ago and have been on APAP, using ResMed Autoset S9 with SwiftFX nasal pillows. Pressure: 8-12cm (Sometimes adjust to 9-12). AHI has remained below 2.0. I keep the humidity level high. I use Lanolin to help seal the pillows.

The way I feel when I wake up fluctuates practically day to day. Some days I feel good, some days I feel great, but most days I feel groggy with foggy memory. I've had a history of mouth leaks, but I use the paper tape method, which has been proven successful and has kept my AHI low along with the taping my mouth. That said, I am not sure why I wake up with a dry mouth and feel groggy. I went to bed last night around 10:30-11pm (my usual bedtime) and I woke up once at 3:30am and again at 4:45am (an hour ago) and couldn't go back to sleep. I am very frustrated with this inconsistent, unsuccessful CPAP therapy.

What's going on with me? I've only been having this problem for the last few months. I've replaced the filter on my machine, tried a new set of pillows while also cleaning and washing it. I've kept up with cleaning and maintenance. It's also important to note that I am on a few medications that may affect my OSA: Androgel and Mirtazapine. I actually think the Androgel caused my OSA, but that's a whole other post. Is there any information about the possibility of these medications worsening my OSA? Also, is the air that flows supposed to feel warm through the ventilation holes of the mask? I honestly don't remember due to memory problems. Any feedback would be appreciated.

Thanks,
CD

[robysue]

Also, is the air that flows supposed to feel warm through the ventilation holes of the mask? I honestly don't remember due to memory problems.

Are you using the ClimateLine heated hose with your S9 or just a regular SlimLine hose? If you are using the heated ClimateLine, what temp do you use?

How fragemented would you say your sleep is on an average night? How many times do you wake up? How long does it take to get back to sleep? Anything else going on in your life that might be affecting the overall quality of your sleep?

A list of known side effects of androgel over at http://www.drugs.com/sfx/androgel-side-effects.html includes both trouble sleeping, difficulty breathing, and trouble concentrating.

Mirtazapine is an anti-depressant. And perhaps the nonrefreshing sleep is more of a symptom that the depression is not fully under control rather than a symptom that the OSA is not under control since you say that your AHI is low and your leak line is good.

[robysue]

As for the dry mouth with the good leak line.

What's the humidity set to? Are you using the heated hose? If so, is it on Automatic or Manual?

Do you ever get chipmunk cheeks?

[cubism_dream]

Hi robysue, thanks for the reply. I am using the heated ClimateLine with Climate Control set to auto and at 85 degrees, which has worked for me and never been changed. The humidity level on the flow generator has also been set at 6.0 and changed depending on weather/outside humidity but has been consistently set at 6.0.

Regarding sleep fragmentation, this is only the second night that I have woken up in the middle of the night, but during the past few weeks to months, I've been experiencing the dry mouth and other symptoms. The maximum amount of time I've gotten up is twice, which occurred most recently. Excluding this past night, I am usually able to go back to bed.

Regarding the Androgel, I was aware that Androgel may cause minor symptoms but was unaware that it may cause the symptoms you've mentioned. I have just messaged my endrocrinologist (the prescriber of the Androgel) regarding this issue.

I take Mirtazapine for depression. My mood has been better and fairly consistent. Oddly enough, I did a search to see if it interacts with sleep apnea and I found results saying that it may actually help treat OSA, but it's just an early study.

I've gotten chipmunk cheeks only a handful of times. I forgot to mention that I initially used a chinstrap to control mouth leaks. I'd double the chinstrap with taping my mouth but have switched to only taping which seems to be working great according to my data.

My situation is quite complicated. I suffer from symptoms that may be caused by either medications, OSA, depression, or a combination of all these things. I suspect that all of this is caused by Androgel and/or depression, despite my feeling improved and stable mood.

[cubism_dream]

I just wanted to give an update that may be useful to others who may be in a similar situation. To troubleshoot the dry mouth and grogginess, I stopped using Androgel for about two weeks (per endocrinologist's advice) and noticed an improvement in symptoms, but still experienced the same adverse effects a few days later. I already changed the disposable filter for my ResMed S9 Autoset 2 weeks ago (I change it every 2-4 weeks). I decided to replace the filter again, despite having changed it less than 2 weeks.

The dry mouth and grogginess disappeared.

It has only been two days since the day of successful troubleshooting, but I believe I've found the cause of the problem. The strange thing is that I've never had to change the filter more than once per month, but I may have an idea of the change. I switched from using ResMed's disposable filters to CPAP.com's filters. CPAP's may not be as good as ResMed's filters. I noticed that CPAP's filters are gray and dirty when I remove them from the filter compartment. With ResMed's, the color (white) is as good as when I replace it with a new one. It looks like I have to replace the filters more frequently with CPAP's filters.