still tired, wake up a lot...new update, new mask e more AHI

[keroseneburner]

I have been on Cpap (Apap now) for many years. It worked well and I felt much better. About 1 year ago something happened and I wake up a lot at night and and very tired. I Got some help a while back from Pugsy and Nan (thank you) but still not feeling much better. I have had every DR. test and work up you can imagine and all shows good, even got another overnight sleep study which shows OK but I now have PLMD (twitchy legs). My job does not allow me to take meds that treat this so here we are. I wake up it seems after pretty much every REM cycle as I remember waking up and the dream I previously had. Any ideas? I also have bad problems with mouth leaks so I tape and use my homemade ACE bandage mouth/chinstrap. I just want to wake up feeling great again

[leeuniverse]

The twitchy legs thing and the poor fitting mask may be what's waking you up?
The only things I can think of of maybe helping with those issues are getting a better fitting mask and maybe start exercising if you don't already and doing Yoga.
I know it seems "clique" but if you go on YouTube there's a guy who perminantly walked around with crutches due to his knees or something, he was a paratrooper, he started doing Yoga, and after a year+ of doing it, he lost weight and was able to run again, not even needing the crutches to walk.

Exercise, stretching exercises etc. related stuff really does do miracles. So, such might get rid of your twitchy legs problem without having to use drugs to maintain it since you can't take them per your job.

You're lucky though, at least you're still able to work. Me, I've become so tired that I literally couldn't even function anymore, they thought it was depression, and after having severe sleep apnea (though better before) for like 15 years undiagnosed, gaining another 100 pounds, and being thrown away unjustly by my wife etc., I became unable to take care of myself, so very tired all the time. I'm still working out the CPAP issues, there's improvement, but not there yet, and I'll need to exercise myself so I'm stronger, lose the weight and thus further not be as tired. I've only gotten 7 hours of sleep like 3 times now on my CPAP, not waking as much, so still working out the kinks myself.

[blownaway]

Your AHI isn't too bad but the rest of your graphs are terrible. No wonder you feel bad. Start with leak rate problem, which is EXCESSIVE.

Also sounds like you have restless legs syndrome, as do I, for which I take Mirapex that sometimes works, sometimes not so much. RLS will definitely wake you up, if not keep you awake, plus causing excessive movement that is likely the cause of your leak problem, as it is mine. When RLS is in abeyance, my leak rate drops to only a few percent. RLS is a disease that only gets worse over time so you should see a Dr. about that. There are 3 drugs used to treat RLS and you have to try one 'till you find one that works as not all will work for you. It also takes a little time before they start working, like a couple weeks.

[keroseneburner]

I exercise Cardio and light resistance training 1.5 hours 4-5x a week. Have lost 40lbs trough diet over the last year or so. I have the best equipment I Can buy but still have a high leak rate and have tried many masks. As stated before drugs are out, I lose my career over that.

[nanwilson]

I have a suggestion for the restless legs.... might help. Plain old over the counter calcium pills . It has helped me with leg cramps and leg twitching.. and its not a drug. I thought it was a nutty solution when it was suggested to me, but it helped a lot. I take 2 250mg (500 mg) at noon every day, it might help or it might not, if it works for you its a 2 for one solution........... no drugs and no restless legs .
Cheers
Nan

[keroseneburner]

Thank you Nan, I have calcium citrate but have not taken them. Do you know if that is the type you are referring to?

[nanwilson]

Thank you Nan, I have calcium carbonate but have not taken them. Do you know if that is the type you are referring to?

No, calcium carbonate is for heart burn same as tums and rolaids.... I made the same mistake when I got my first bottle.... do you want a huge bottle of it??????????????? The proper one (live and learn) is calcium citrate.
Nan

[keroseneburner]

I had to edit it, I went and looke it was citrate.....good it is the right stuff. I do have carbonate too but since stomach surgery I no longer need that

[OkyDoky]

I'm unable to get helpful information from your screenshots. Not sure where the excessive leaks are. I see one large leak flagged but we need to see the Statistics on the left side. Here are tips I put together for a screenshot that gives us the information we need.

On the left side turn off the calendar by clicking on the triangle by the date.
Also the pie chart doesn't give us very much info so you can turn it off by going to File - Preferences -Appearance - Uncheck Show event break down pie chart
That allows us to see the machine details on the left.

The graphs that are usually helpful are:
1. Event Flags
2. Flow Rate
3. Pressure (not mask pressure)
4. Leak
5. Flow Limit (only with Resmed machine)
Put your graph in that order by grabbing, by the labels, with your mouse and dragging it where you want it.
Now grab the line between the graphs and resize them until you get them in one screenshot.

Take a screen shot after you organize your graphs. You can push F11 ( or click file - view - fullscreen toggle) on your keyboard before you take your screenshot and it makes it full screen with no ID info.
Take a screenshot by pushing F12 or under View - click on Screenshot.
Screenshots are found on my computer under Documents - SleepyHeadData-Testing - Screenshots

And this is a link on how to post using Imgur that way we can enlarge the images wehre we can see. https://sleep.tnet.com/reference/tips/imgur

[keroseneburner]

I will work on better screen shots this evening

[OkyDoky]

I will work on better screen shots this evening

Great. You might also PM kteague if she doesn't see this and reply. She might have ideas on your PLMD.

[keroseneburner]

Until I can post the screen shots
The AHI over last week is 1.98 with .10 obstructive 1.69 hypopnea and .19 clear airway
average leak rate 6.99 average 90% leak rate 19.20 % above leak rate threshold 5.38%
average pressure 12.01 90%12.82

I am thinking of trying a nasal pillow mask as that is the only one I have not really tried much.

According to my sleep data on a Basis watch I am tossing and turning 50-60 times a night

[Wulfman...]

I have been on Cpap (Apap now) for many years. It worked well and I felt much better. About 1 year ago something happened and I wake up a lot at night and and very tired. I Got some help a while back from Pugsy and Nan (thank you) but still not feeling much better. I have had every DR. test and work up you can imagine and all shows good, even got another overnight sleep study which shows OK but I now have PLMD (twitchy legs). My job does not allow me to take meds that treat this so here we are. I wake up it seems after pretty much every REM cycle as I remember waking up and the dream I previously had. Any ideas? I also have bad problems with mouth leaks so I tape and use my homemade ACE bandage mouth/chinstrap. I just want to wake up feeling great again

Since I don't see that this has been mentioned previously.........I will.

To me, it's pretty plain to see. It's the pressure changes that are disturbing your sleep.
Since you were on straight pressure all those years before, I would suggest you configure this machine as close to how your straight pressure machine had been configured.
For all those years, your system got used to sleeping with a constant pressure and now it's being subjected to all those pressure changes. Some of us users can't tolerate the pressure changes and it's sleep-disturbing to us. I'm one of them.

Another potential benefit will be that you'll see how well the previous pressure was working (especially if you weren't monitoring your therapy with software all that time).

The benefits of using an APAP is that they have more options......including straight pressure......CPAP mode.
I urge you to try it again. You just might wake up feeling great again.


Den

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[OkyDoky]

Hey Den,
I was going to wait to comment till I could see his info better. It does look like it is set in a close range of 11 minimum to 13 maximum and he reaches the maximum several times. Also, apparently he was on the old CPAP for a year with decreased results before he switched to APAP if I understand him right. I will wait to suggest changes until I can see more but I think I would leave in APAP mode to keep the Flow Limitations graph. The range just may need to be tightened some.
We might try some pressure changes but it's a very good possibility it is the leg movement and I hope someone else has ideas since medication is out.

[Wulfman...]

Hey Den,
I was going to wait to comment till I could see his info better. It does look like it is set in a close range of 11 minimum to 13 maximum and he reaches the maximum several times. Also, apparently he was on the old CPAP for a year with decreased results before he switched to APAP if I understand him right. I will wait to suggest changes until I can see more but I think I would leave in APAP mode to keep the Flow Limitations graph. The range just may need to be tightened some.
We might try some pressure changes but it's a very good possibility it is the leg movement and I hope someone else has ideas since medication is out.

He can still achieve "straight pressure" and get that data by setting the minimum and maximum pressures to the same setting in APAP mode. He's obviously having some significant flow limitations and/or snores driving up the pressures. The pressure changes could also be contributing to the mask leaks, too.
It also doesn't take much of a pressure bump to awaken some of us and those are some pretty sharp pressure increases on his reports.

Edit to add:

We also had this discussion way back in this thread......

viewtopic/t110509/viewtopic.php?f=1&t=1 ... 6#p1019996


Den

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