Making progress or should I discontinue APAP? Trying to figure out if apnea is the cause of my daily exhaustion

[Doce]

Edit 5:53pm
Data posted (3 images per post is allowed. see posts below)


Edit 6:12pm

As mentioned from my sleep study:
-AHI 4.6
-AHI during REM 13.6
-Sleep efficiency 67.5%
-Sleep spent in rem 22.7%
-REM latency of 165 minutes
-No significant PLMD
-61 spontaneous arousals which equates to 10.4 per hour
-patient experienced 6 apneas in total - of these, 6 were obstructive apneas, 0 were mixed apneas, 0 were central apenas. Resulted in an apnea index of 1.0
-patient experienced 21 hypopneas in total which resulted in a hypopnea index of 3.6
-AHI results by body-position showed: supine AHI=2.4, right-side AHI=N/A, left-side AH=9.8, and prone AHI=N/A
-0 occurrences of Cheyne Stokes breathing, and 0 respiratory effort-related arousals (RERAs)
-mean SpO2 of 97.3%, minimum SpO2 of 94.0%

Previous thread
viewtopic.php?f=1&t=175921&p=1307366#p1307366


Recap: sleep study said I have an AHI of 4.6 but 13.6 in rem sleep. I have been experimenting with APAP since May but have yet to notice a difference in my fatigue and sleepiness.

At first I started with a pressure setting of 4-20. There were a couple of days I thought I may not be as tired as usual but not a huge difference. I check my data on Oscar and noticed my pressure would sometimes go slightly above 10, but that high pressure would wake me up.

So the next month I did another experiment dialed my pressure down to 4-5. My hopes was to see what my AHI number would be and to see if I did in fact need to use the machine and if I would still awake from the pressure. Usually my pressure stayed at 5, with some lapses of time at 4. The pressure did not wake me - only leaks and mask comfort issues did.

So, I start analyzing the data and decide my pressure obviously needs to be raised since it would spike to 10 at times during the first experiment. Also, I noticed I do not have many hypopneas or apneas - more so central’s that seem to occur while I was in arousal or awake.

What I did notice that stood out in many of the night’s data was that my flow rate would look like waves with periods transitioning from deep to shallow and simultaneously, a pressure increase. These events could last a couple of minutes to a hour, sort of like I was having obstructed breathing, but not enough to cause a flag on the machine.

To prevent the machine from trying to react to an event, I gradually raised my minimum pressure the last couple of days and now at 7 with a max of 11. Last night I was awoke at 4am due to high pressure blowing my cheeks out like I had my mouth open in front of a fan. I checked my machine and it was at a pressure of 10.89. Interestingly, I was not very tired when I woke up at 4. I was not able to fall asleep until 6. Alarm went off at 7, and I felt miserable and still do.

AHI score on Oscar throughout these experiments remained relatively the same, 1-3.


Does it sound like I’m benefiting or could benefit from continuing use? My thoughts are the pressure wouldn’t be spiking to 10 or so if I did not need the machine, but I’m new to this. I’m just not noticing anything, maybe more tired than usual and it’s been 2.5 months.


Thank you for reading.

[SDBud]

So the next month I did another experiment dialed my pressure down to 4-5.

TOTALLY opposite to what is usually required. But you need to KNOW what your reaction and problems are before you start changing things.

Get Oscar, read your data, and post it here, then it will be likely someone can help you.

[zonker]

So the next month I did another experiment dialed my pressure down to 4-5.

TOTALLY opposite to what is usually required. But you need to KNOW what your reaction and problems are before you start changing things.

Get Oscar, read your data, and post it here, then it will be likely someone can help you.

he has it. he has posted in his other thread. but for some reason, has decided to start another.

[palerider]

Recap: sleep study said I have an AHI of 4.7 but 13.9 in rem sleep. I have been experimenting with APAP since May but have yet to notice a difference in my fatigue and sleepiness.

At first I started with a pressure setting of 4-20. There were a couple of days I thought I may not be as tired as usual but not a huge difference. I check my data on Oscar and noticed my pressure would sometimes go slightly above 10, but that high pressure would wake me up.

No,the breathing obstructions that caused the pressure to go up are what woke you up.

Usually my pressure stayed at 5, with some lapses of time at 4. The pressure did not wake me - only leaks and mask comfort issues did.

It stayed at 5 because it's too low and the machine needs to higher to stabilize your breathing.

due to high pressure

My pressure *starts* at 12 and goes to 18 when I inhale. 10 something is *not* "high pressure"

Does it sound like I’m benefiting or could benefit from continuing use? My thoughts are the pressure wouldn’t be spiking to 10 or so if I did not need the machine, but I’m new to this. I’m just not noticing anything, maybe more tired than usual and it’s been 2.5 months.

I’m hoping to get some screenshots up from oscsr after work.

Thank you for reading.

Many people feel worse if their ahi is over 2... You have room for improvement and need to learn more... We can help.

[Wulfman...]

How many hours of sleep are you getting? You need to get ENOUGH sleep.

Leaks? What mask? Mouth breathing? Bed pillow? (they can make a significant impact on sleep quality and leaks)

You're not going to "make progress" until you get your therapy optimized.

How about filling in your profile (including all of your settings) so we know what you're using.

At some point, you may want to try a straight pressure rather than a range of pressures. Some people have their sleep disrupted by the changing pressures. As with setting a range of pressures, you want to set your pressure (minimum with a range) to where it eliminates almost all of the events. And, some people don't have the precursor events (Snores and/or Flow Limitations) that are needed to trigger pressure increases with APAPs in a range of pressures.


Den

.

[Doce]

Thank you for the replies everyone and sorry for the confusion. I’ve linked my previous thread at the top and will continue in this thread going forward.

The opposite route with the decrease in pressure was intentional to analyze data and get use to wearing the mask with air flow.

Last night I definitely didn’t get enough sleep from the maintenance insomnia after the arousal. I average 6 hours of sleep (according to Fitbit sleep tracker, which aren’t very accurate) but give myself 7-8 hours for sleep. I’m hoping to fine tune the pressure Incase straight pressure is the way to go for me.

I’ve updated my profile with equipment. Currently on the dreamwear full face mask and will try the air touch.

[zonker]

for those wanting to see the poster's past-

viewtopic.php?f=1&t=175921&p=1307366#p1307366

got some charts there, if'n you wanna see.

[palerider]

At some point, you may want to try a straight pressure rather than a range of pressures. Some people have their sleep disrupted by the changing pressures.

I've heard this allegation but have never seen any reputable evidence that it is the pressure changes that wake people up, it's much more likely that what wakes them up are the breathing events that cause the pressure changes.

Breathing events are documented to disturb sleep. That, plus not being as dead tired as without the CPAP, and the added stimulus of the mask is enough to wake people up enough to blame the pressure for waking them up.

[Doce]

for those wanting to see the poster's past-

viewtopic.php?f=1&t=175921&p=1307366#p1307366

got some charts there, if'n you wanna see.

Sadly the images have expired. I’ll have more uploaded tonight.

[kteague]

Have you posted copies of your sleep study report? Just thinking that how much you slept, time in each stage, and position in each stage could give you an idea if the data captured is likely to be reflective of your usual sleep. It is not unusual for studies to be short in information and the patient is left making decisions on incomplete information.

I was unable to tell from your posts how consistently you use the machine. Consistent use of optimized settings is the goal. I will defer to the data gurus on here on your machine settings. My non-guru suggestion would be to work on tongue positioning to help with the blowouts. Training the tongue to stay suction sealed against the roof of the mouth transformed my CPAP experience. It enabled me to stop mouth taping and stop using a chin strap. Well, using a flat firm pillow also helped keep my jaw up. To help with tongue position when side sleeping, hanging my head off the edge of the pillow causes the front of my face to tilt slightly downward, putting the tongue in the perfect position to maintain the seal and stay out of the throat.

Have your doctors already checked you for things like anemia, thyroid function, blood sugar, blood pressure, B vitamins, Vitamin D, etc? Have any meds you are on been assessed for side effects that match your symptoms? Your sleep apnea may be all or part of your problem. By using the treatment consistently, at least after some time if your symptoms persist you can reasonably expect to need to look for additional contributors. Deal with the known factors (sleep apnea) and see what you're left with. Not seeing symptom improvement after consistent use does not mean you should stop treatment. It means you should add to it.

If I said all that in your other thread I apologize for the repetition. Good luck with sorting through things.

[Doce]

Data! In no particular order, with various pressure settings displayed and a couple examples of the wave-like flows rates.

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[Doce]

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[Doce]

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[Doce]

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[LSAT]

You are driving yourself nuts with all the pressure changes. Set it at 6/20 and forget about it for a couple weeks. Your daily exhaustion could be from agonizing over your pressures.