Newcomer had questions

[OSADad]

I was recently diagnosed with OSA - after many years of tiredness. I was glad for the diagnosis because CPAP seemed like a reasonable treatment. But I'm having problems. Here is the deal. When I sleep with CPAP, I don't feel like I enter a very deep sleep. I sleep (without apneas because I have software which monitors that) but I wake up feeling sorta wired. Still tired, but like I've been drinking coffee or something. I've tried several masks and now am trying C-flex. Does CPAP make anyone else feel worse rather than better? Any advice?

[Snoredog]

I would suggest going back to your original PSG and re-reading it carefully, if you don't have that, try and get a copy of it from either your doctor or the sleep lab where it was performed. If you had a follow-up study, you want to review what was on the subsequent studies as well and how you responded with cpap.

Many times doctors just look at the obstructive apnea part and pressure and that is it. But the PSG most likely included other hints as to why you don't feel fully refreshed after sleep, so cpap may only addresse one aspect of your sleep disorder.

For example, you can have central and mixed events not addressed by cpap, you can have arousals from RLS or PLMD and even spontaneous arousals also not addressed by cpap. Cpap therapy only reduces obstructions from hypopnea/apnea events, it can also help restore oxygen to normal levels, but even that doesn't allow you to have restful sleep if an arousal is kicking you out of deep or REM sleep.

[DreamStalker]

What mask(s) are you using? What machine are you using? What pressure(s) is your machine set to?

It is possible to have zero or low AHI and still suffer from low oxygen ... perhaps you are not getting enough CO2 flushed out from your mask?

Anyway ... some of the more experienced should chime in here soon.

Best of luck,

- r

[IBTeri]

[quote="DreamStalker"]What mask(s) are you using? What machine are you using? What pressure(s) is your machine set to?

It is possible to have zero or low AHI and still suffer from low oxygen ... perhaps you are not getting enough CO2 flushed out from your mask?

Anyway ... some of the more experienced should chime in here soon.

Best of luck,

- r

[DreamStalker]

[quote="IBTeri"][quote="DreamStalker"]What mask(s) are you using? What machine are you using? What pressure(s) is your machine set to?

It is possible to have zero or low AHI and still suffer from low oxygen ... perhaps you are not getting enough CO2 flushed out from your mask?

Anyway ... some of the more experienced should chime in here soon.

Best of luck,

- r

[JohnD]

Osadad,

I had similar problems and felt the same way as you did. As it turned out, after 13+ years on a straight cpap at 11, I switched to an apap and now I do not have those strange feelings you talk about. I attribute the way I feel now, which is fantastic, to the auto cpap and how it is regulating my pressure throughout the night and giving me the correct deep REM sleep I was missing these last years. I do not need a straight 11 pressure, but more like a 9. All those years of over-pressure was causing me to wake up several times in the night and as a result, I had interrupted sleep. As an example, my AHI was down to 0.7 last night, first time it has been that low since I had this new machine 3 weeks ago. By adjusting the machine according to my Encore Pro Data, I was able to up the min to 8.5, which has pretty much eliminated the OSA's and HI's!

I hope that helps. What type of machine do you have?

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CPAPopedia Keywords Contained In This Post (Click For Definition): auto cpap, Encore Pro, CPAP, AHI, APAP

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CPAPopedia Keywords Contained In This Post (Click For Definition): auto cpap, Encore Pro, CPAP, AHI, APAP

[inacpapfog]

IB Terri, Sure sounds like you are not getting enough pressure to fend off an event when it occurs. What limits have you set on your auto? Maybe you need to do some tweeking now ?

[ColoradoDreamer]

Are your just starting out? You are describing how I felt when I left the sleep lab and for three weeks following faithful use of CPAP at home. I would have waves of being awake and tired. It’s a strange feeling but am now definitely feeling more alert than tired in the morning. I didn’t think the feeling was worse, just different. I took it as an indication that it was working, especially when I found that I was not nodding off when reading a book.

[OSADad]

Gosh thanks for all the interest! I am using the newst brand of C-Flex and a ResMed FF mask. My sleep study did not show any central apena events, nor anything else of interest aside from moderate OSA. I've got it here in front of me. So I don't think that is the issue. I do find that my problems are worse on a nasal mask. The FF mask helps some. As does increasing the heat on my humidifier. I may tinker around with my pressure. My titration didn't go well because I slept horrible so my doctor is not real sure what my idea pressure should be. I am running it at 11 now.

But I believe all of this has to do with CO2 washout levels. Does anybody have anything to say about CO2 washout?

[oldgearhead]

Does anybody have anything to say about CO2 washout?

The Hybrid has the highest passive exhalation port flow of any mask. I feel absolutely great after using it. However, for me, the "dry mouth" that is a result of this very high "CO2 washout", kind of makes it a mixed blessing.

[DreamStalker]

... However, for me, the "dry mouth" that is a result of this very high "CO2 washout", kind of makes it a mixed blessing.

Dry mouth is the result of mouth breathing and/or insufficient humidity of the PAP system ... not CO2 washout. There is nothing wrong with having a high CO2 washout ... in fact, elminating exhaled CO2 from the PAP system is a very good thing.

My titration didn't go well because I slept horrible so my doctor is not real sure what my idea pressure should be. I am running it at 11 now.

But I believe all of this has to do with CO2 washout levels. Does anybody have anything to say about CO2 washout?

As snoredog stated ... your problem may also be related to RLS or other issues unrelated to your PAP treatment. If you are certain that you are not restricting the exhaust ports on your FF mask, then CO2 may not be your problem.

Are you using an APAP or CPAP? If your titration did not go well ... you may well want to tweak your pressure although you stated you had no apneas with your current pressure setting. You may want to try lowering your pressure until apneas return then raise it back up by 0.5 or 1 cm.

Best of luck ... hope you find your deep sleep.

- r