HELP diagnosed w/ apnea; still very tired; CPAP doesn't work

[tan]

So you can't ignore the GERD, but you need to be aware that conventional medical treatment for GERD usually makes things worse, not better.

I'm highly skeptical of your blanket dismissal of the current theory and treatment of GERD. Let's not forget that GERD has some long term side effects, including cancer risk.

I have also seen a lot of articles saying that the conventional treatment of GERD by acid reducers actually hurts.

[Janknitz]

Low fat yogurt has either a lot of sugar or a lot of artificial sweetener in it and not much variety in probiotics. For me (YMMV) dairy triggers GERD, so it's a pretty bad way to get probiotics.

I ferment my own sauerkraut, pickles, beet kvass, and kombucha so I'm getting it from my diet, but a refrigerated probiotic supplement will do better than yogurt, especially low fat yogurt--milk sugars are concentrated when they remove the fat.

[tigerbear]

Tigerbear, I had issues similar to yours: mild OSA (AHI around 5) and moderate UARS (RDI around 17). Low AHI (even 0.0) was not relevant to how refreshed I was in the morning.

See if the following could be of any help:
you should not use such a wide range of pressures. That coupled with Airfit F10 was a failure for me (leaking, dry mouth). I would rather gradually raise the minimum pressure (0.5-1cm increments a day or less frequently, as tolerated) till your flow limitations are down to see whether that result in any improvement. Of course, you should not experience sleep-disrupting discomfort like aerophagia, leaks

I finally settled on a combination of a miniumum pressure (EPAPmin=9 with PS=4 to have Flow Limitations at a minimum), "vertical" mouth taping with Quattro Mirage Mask (better for leak control in my case).

Tan, thanks for sharing your experiences. I may try out the Quattro Mirage Mask, as the F10 doesn't work for me either. Just to make sure I understand -- the Quattro Mirage is a full face mask, but you tape your mouth vertically? (I presume that means the long axis of the tape is perpendicular to your mouth line, I've never heard of that, I might have to try that too.) If you tape your mouth while using a full mask, why use a full mask at all?

I have not really been tracking flow limitation. What should I be looking for and how do I use that data? Should I calibrate my pressures so that flow limitations are eliminated or fall under a certain number? I noticed while reviewing some of my Rescan results, that there are flow limitation spikes, generally ranging from 0.10-0.25, sometimes higher.

Thanks again for your help, tan.

[tigerbear]

Pugsy: thanks for the comments. Yes, the decongestant is a bit of a stimulant, but my problems preceded my taking it, so I know it's not a big part of the problem. I will definitely try playing with the humidity some.

archangle:

The bottom of my CPAP says Resmed Air10.

Look where this picture says "AirSense 10 Elite" on the bottom right corner of the front panel. Does yours really say "Air 10"? If so, I'd love to see a picture. Are you outside the US? Sometimes the labeling varies. If that's a label on the bottom, a picture of that would be interesting, too.

Does your machine look like the picture? Is it white or grey?

You can get clumps of apnea when you wake up for other reasons and they don't necessarily mean much. However, bad bouts of apnea that do mean something can cause you to wake up.

Not sure how to put up an image. However, it really does say "Air10." I noticed that the Rescan software identifies my machine as an Airsense, though.

Thanks for the comments!

[archangle]

So you can't ignore the GERD, but you need to be aware that conventional medical treatment for GERD usually makes things worse, not better.

I'm highly skeptical of your blanket dismissal of the current theory and treatment of GERD. Let's not forget that GERD has some long term side effects, including cancer risk.

I have also seen a lot of articles saying that the conventional treatment of GERD by acid reducers actually hurts.

I've seen a lot of articles saying that vaccines cause autism, and that this or that miracle food is the cure for all your ills. I remember when the Pillar procedure was going to be the new cure for apnea that would eliminate CPAP. There are even articles on UPPP as the miracle cure for apnea.

It's possible that the current theory and treatment for GERD is all wrong, but it's foolish to assume it is based on a few articles challenging the currently accepted medical theory.

I will agree that there are significant problems with the drugs used to treat GERD. However, there are also problems with untreated GERD as well.

[archangle]

Not sure how to put up an image. However, it really does say "Air10." I noticed that the Rescan software identifies my machine as an Airsense, though.

Interesting. It's good to know about different labeling. As if it wasn't already confusing enough to figure out what machines people have.

To post an image, upload it to a site like imgur.com. Right now, imgur is one of the easiest sites to use. Sign up, upload an image, and then post the link here. You can make it appear as a picture rather than a link here with a little extra effort.

I see that for some reason, my picture didn't post before. Most of them say "AirSense 10 xxxx" like this at the lower right.



You mention a pressure range. If your machine does a pressure range, it must be an AutoSet or AutoSet for her. The one you have in your profile is a manual CPAP. Does ResScan say "AutoSet or AutoSet for Her" as the machine type?

[palerider]

Not sure how to put up an image. However, it really does say "Air10." I noticed that the Rescan software identifies my machine as an Airsense, though. !

could you check on the back, and tell us what the REF number is on the label?

[tan]

Tigerbear, I had issues similar to yours: mild OSA (AHI around 5) and moderate UARS (RDI around 17). Low AHI (even 0.0) was not relevant to how refreshed I was in the morning.

See if the following could be of any help:
you should not use such a wide range of pressures. That coupled with Airfit F10 was a failure for me (leaking, dry mouth). I would rather gradually raise the minimum pressure (0.5-1cm increments a day or less frequently, as tolerated) till your flow limitations are down to see whether that result in any improvement. Of course, you should not experience sleep-disrupting discomfort like aerophagia, leaks

I finally settled on a combination of a miniumum pressure (EPAPmin=9 with PS=4 to have Flow Limitations at a minimum), "vertical" mouth taping with Quattro Mirage Mask (better for leak control in my case).

Tan, thanks for sharing your experiences. I may try out the Quattro Mirage Mask, as the F10 doesn't work for me either. Just to make sure I understand -- the Quattro Mirage is a full face mask, but you tape your mouth vertically? (I presume that means the long axis of the tape is perpendicular to your mouth line, I've never heard of that, I might have to try that too.) If you tape your mouth while using a full mask, why use a full mask at all?

My mask is this: https://www.cpap.com/productpage/resmed ... dgear.html
I merely followed the advice of few people here on vertical taping. A strip of 1' tape attaches to the upper lip right under the nose and goes down to the chin. It help prevent excessive jaw drop and dry mouth -- something I couldn't accomplish with any other means such as mouthguards, chinstraps, cervical collar.

I would be happy to use P10 like yours and even did for some time, but couldn't tolerate it well for I had to fully tape my mouth, had "chipmunk cheek" effect and bloodied my nose on multiple occasions.

Forgot to mention, I have to use nasal strips to expand my nostrils. Don't know whether you need them

I have not really been tracking flow limitation. What should I be looking for and how do I use that data? Should I calibrate my pressures so that flow limitations are eliminated or fall under a certain number? I noticed while reviewing some of my Rescan results, that there are flow limitation spikes, generally ranging from 0.10-0.25, sometimes higher.

Thanks again for your help, tan.

Flow limitations *may* result in arousals. Hard to tell whether they actually occur without specialize equipment. But if they are present, your AHI is low and you don't feel refreshed upon awakening, they may need to be addressed. Please include them in the screenshot

[tigerbear]

Not sure how to put up an image. However, it really does say "Air10." I noticed that the Rescan software identifies my machine as an Airsense, though.

Interesting. It's good to know about different labeling. As if it wasn't already confusing enough to figure out what machines people have.

To post an image, upload it to a site like imgur.com. Right now, imgur is one of the easiest sites to use. Sign up, upload an image, and then post the link here. You can make it appear as a picture rather than a link here with a little extra effort.

I see that for some reason, my picture didn't post before. Most of them say "AirSense 10 xxxx" like this at the lower right.



You mention a pressure range. If your machine does a pressure range, it must be an AutoSet or AutoSet for her. The one you have in your profile is a manual CPAP. Does ResScan say "AutoSet or AutoSet for Her" as the machine type?

archangle and palerider:

My device looks exactly like the one in the picture, including the label on the lower right. I might have misunderstood you -- on the back there is an "Air10" label, but the front looks exactly as you have shown. Thanks!

[tigerbear]

Tigerbear, I had issues similar to yours: mild OSA (AHI around 5) and moderate UARS (RDI around 17). Low AHI (even 0.0) was not relevant to how refreshed I was in the morning.

See if the following could be of any help:
you should not use such a wide range of pressures. That coupled with Airfit F10 was a failure for me (leaking, dry mouth). I would rather gradually raise the minimum pressure (0.5-1cm increments a day or less frequently, as tolerated) till your flow limitations are down to see whether that result in any improvement. Of course, you should not experience sleep-disrupting discomfort like aerophagia, leaks

I finally settled on a combination of a miniumum pressure (EPAPmin=9 with PS=4 to have Flow Limitations at a minimum), "vertical" mouth taping with Quattro Mirage Mask (better for leak control in my case).

Tan, thanks for sharing your experiences. I may try out the Quattro Mirage Mask, as the F10 doesn't work for me either. Just to make sure I understand -- the Quattro Mirage is a full face mask, but you tape your mouth vertically? (I presume that means the long axis of the tape is perpendicular to your mouth line, I've never heard of that, I might have to try that too.) If you tape your mouth while using a full mask, why use a full mask at all?

My mask is this: https://www.cpap.com/productpage/resmed ... dgear.html
I merely followed the advice of few people here on vertical taping. A strip of 1' tape attaches to the upper lip right under the nose and goes down to the chin. It help prevent excessive jaw drop and dry mouth -- something I couldn't accomplish with any other means such as mouthguards, chinstraps, cervical collar.

I would be happy to use P10 like yours and even did for some time, but couldn't tolerate it well for I had to fully tape my mouth, had "chipmunk cheek" effect and bloodied my nose on multiple occasions.

Forgot to mention, I have to use nasal strips to expand my nostrils. Don't know whether you need them

I have not really been tracking flow limitation. What should I be looking for and how do I use that data? Should I calibrate my pressures so that flow limitations are eliminated or fall under a certain number? I noticed while reviewing some of my Rescan results, that there are flow limitation spikes, generally ranging from 0.10-0.25, sometimes higher.

Thanks again for your help, tan.

Flow limitations *may* result in arousals. Hard to tell whether they actually occur without specialize equipment. But if they are present, your AHI is low and you don't feel refreshed upon awakening, they may need to be addressed. Please include them in the screenshot

tan, thank you for the tips, that is very helpful. I'll definitely try that vertical taping technique.

I'll also look at the flow limitations. I currently use the Resmed Rescan software, and it's not clear to me how to extract an image that I can post. Does anyone know? Otherwise, maybe I will switch to the Sleepyhead software, which a lot of people in the forums seem to like.

tan, I also had one more question: why do you tape your mouth, yet use a full face mask? I'm wondering if there is some special reason that might relate to my own condition. Thanks!

[palerider]

I might have misunderstood you

there's a REF number on the label somehwere, five digit number starts with a 37.. what is it please?

[tigerbear]

I might have misunderstood you

there's a REF number on the label somehwere, five digit number starts with a 37.. what is it please?

The REF number is 37028.

[palerider]

The REF number is 37028.

37028;Resmed;AirSenseTM 10 AutoSet

select this on the equipment list: AirSense™ 10 AutoSet CPAP Machine with HumidAir™ Heated Humidifier

[archangle]

My device looks exactly like the one in the picture, including the label on the lower right. I might have misunderstood you -- on the back there is an "Air10" label, but the front looks exactly as you have shown. Thanks!

Thanks again. I've never seen the label on the back of an AirSense machine. I didn't know they said "Air 10" back there.

[tigerbear]

as tan suggested, I've put up my sleepyhead results below. Any comments are welcome.

The night represented in the report was a somewhat atypical one, in that I used nasal plugs, not a nasal mask, but it is typical in the sense that, despite a low AHI and low leakage, I felt pretty bad afterward. I used some Resmed P10 nasal pillows; taped my mouth. I used CPAP for about five hours. Afterward, I was very tired, lots of aches, actually more than usual.

If people have any reflections on why CPAP doesn't seem to be effective based on this report, I'd appreciate your comments. Thank you!



(Having looked at in preview mode, I can see that it's not very clear. To create the image, I created a pdf from the report in the software, and then posted it directly. If someone has some tips on generating a clearer image, please let me know.)