diminished returns

[foxhunter]

I started CPAP November 2009 and was pleasently surprised to find that I had no problem adjusting to the machine. The mask of course was a different matter and it took quite a while and a lot of experimentation to settle on something that worked for me.
Nevertheless, I stuck to it and never missed a night.
I was amazed by the difference it made. From sleeping on feather pilloes that felt like bricks to what I swear was a situation where I could sleep on a brick and it would feel like a feather pillow. It was that dramatic. I would fall asleep in what seemed like minutes and sometimes sleep for 8 to 9 hours at a stretch.I dreamed beautiful dreams!
That brings me to today when it all seems to have gone! With the same equipment and settings "C Flex with a #12 pressure, I am now back to where I started on the comfort level. Fitful sleep if any, tired in the morning and extreme disappointment.
My statistical results are OK. AI 0.0, AHI 7.0 and this from 83.6 at my initial sleep test.
Has anyone experienced this? Am I now cured and should resume a normal sleep pattern? What am I missing here?
Frustrated in Florida

[Wulfman]

I started CPAP November 2009 and was pleasently surprised to find that I had no problem adjusting to the machine. The mask of course was a different matter and it took quite a while and a lot of experimentation to settle on something that worked for me.
Nevertheless, I stuck to it and never missed a night.
I was amazed by the difference it made. From sleeping on feather pilloes that felt like bricks to what I swear was a situation where I could sleep on a brick and it would feel like a feather pillow. It was that dramatic. I would fall asleep in what seemed like minutes and sometimes sleep for 8 to 9 hours at a stretch.I dreamed beautiful dreams!
That brings me to today when it all seems to have gone! With the same equipment and settings "C Flex with a #12 pressure, I am now back to where I started on the comfort level. Fitful sleep if any, tired in the morning and extreme disappointment.
My statistical results are OK. AI 0.0, AHI 7.0 and this from 83.6 at my initial sleep test.
Has anyone experienced this? Am I now cured and should resume a normal sleep pattern? What am I missing here?
Frustrated in Florida

I'm confused.
You mention "C-Flex" but your profile shows an S8 Elite II......which doesn't have C-Flex......it would have "EPR".
You also didn't mention anything about leak rates. You show a nasal mask in your profile, so my first suspicion is that you're leaking your therapy air out your mouth during the night.

More information needed.......


Den

[Janknitz]

This happened to me, I had great nights for a few months, and then back to one of my worst symptoms (in my perception) which was waking in the middle of the night in a sweat, heart pounding.

Looking carefully at all the factors, the first thing I identified was that my nasal pillows were getting really leaky. The Swift LT for Her pillows only last around 1 month before they get soft and mushy and no longer seal well. But a new nasal pillow didn't entirely fix the problem.

Looking at the data, I had great numbers as far as AHI's and leak rates (with the new pillows), but the one thing I noticed is that my pressures were bumping against the upper limit a lot of the time. In other words, the pressure "ceiling" was set at 12 and I spent a good part of each night at 12 cm. I pointed that out to the RT I'm working with, and she bumped up my pressure to 15. The symptoms disappeared. They shouldn't have been there in the first place according to the AHI rate, but raising the pressure helped. My pressure is significantly higher than we thought I would need after the initial titration. So things do change a bit, too (I think it has to do with summer allergies I'm currently experiencing).

It might be time to have your sleep professional take a look at your data and see if something needs tweaking.

[foxhunter]

you are right Den. My initial titration used CFlex to ease exhalation at a level of 2. As CFlex appears to be owned by Respironics, i am assuming that my scrip to the DME took that into account and EPR gives some kind of similar result? I can say that I am not breathing through my mouth but The LT junk pillows may have something to do with it.
I am currently trying the "O ring" fix that I gleaned from this forum, then I will try adapting the Breeze? pillows I also learned from here.
It's a damn shame that members of this forum have to invent fixes that Resmed should have addressed long ago!
Notwithstanding...This dramatic change in sleep pattern or lack thereof has got to be more than that!!!

[Wulfman]

Are you getting ENOUGH sleep?

Beyond that, I'd suggest bumping your pressure up 1 - 2 cm. and see what things look like......and how you feel (assuming you have no or have solved leak problems).


Den

[foxhunter]

Sounds like a plan to me Den...What do I have to lose!

[DoriC]

Hi, just some thoughts, since you started in Nov, could you be having your first spring/ summer allergies causing mouth leaks? Has your room temperature changed down there in Sarasota? You also don't mention your humidifier setting. Since you've been doing so well I think you just need some tweaking.

[sleepmba]

Excellent suggestions so far. I have one to add... Is your mask and headgear in good shape? Maybe it's time for a replacement.

[foxhunter]

Thanks all for the input. I have reverted to the LT mask for most of the time and I changed the headgear yesterday. Last night saw some real improvement so you may be right that a little tweaking may solve the problem. Just have to be patient and try one tweak at a time so I have a definitive answer rather than shotgunning.
In answer to the questions. It's 95 degrees in florida and high humidity so my humidifier is never any more than 2.5. I don't seem to be prone to allergies. Patience I am sure will bring its reward!

[Wulfman]

Thanks all for the input. I have reverted to the LT mask for most of the time and I changed the headgear yesterday. Last night saw some real improvement so you may be right that a little tweaking may solve the problem. Just have to be patient and try one tweak at a time so I have a definitive answer rather than shotgunning.
In answer to the questions. It's 95 degrees in florida and high humidity so my humidifier is never any more than 2.5. I don't seem to be prone to allergies. Patience I am sure will bring its reward!

You could even try turning your humidifier setting to "Off" (or at least much lower). Some of us don't do well with heated humidity.


Den