Well, It's Been a Year (And Then Some)

[steamfan]

A bit more than a year ago I was introduced to the wonderful world of CPAP machines. I read all the horror stories, the rants about discomfort, being unable to sleep, being unable to tolerate the mask, how hard this all was, and so on. Then I got my machine. Plugged it in stuck the Quattro FFM on my face and uh....went to sleep. I have had absolutely zero problems with the silly thing. Rarely any leakage, pretty AHI number 1.3 to 2.7 mostly. And over the 15 months or so I've used it, I've missed exactly 3 nights.

Why am I telling you this? Because now, 15 months in, I peacefully sleep with my mask on. I sleep more (by about 2 hours) than I did before becoming a hosehead, and I don't think I've ever been this tired in my entire life. Exhausted, worn out, sleepy. Every [bad word] day. Why?

[BlackSpinner]

So and what test have you done to follow up on this in the last 18 months?

[Slartybartfast]

(this damn thing won't let me edit)

[Slartybartfast]

There's lots more having a good night's sleep than freedom from choking on your own throat. And having a low AHI doesn't give you more than a glimpse into the totality of what's going on.

Since you have an S9 Autoset, I presume you also have ResScan. If you don't, pipe up and you soon will. Go into the software and choose a night when you felt you weren't getting the rest you should have gotten. Zoom in on your flow trace at the 1 minute scale and look at the flow waveforms. For reference, I've included a few of mine below.

Below is what normal sleep should look like, or at least what mine looks like. Triangular or dull sawtooth flow waves with not a lot of variation.



Below is what my waveform looks like when I'm awake. Maybe the cat felt entitled at that moment to a massage or the phone rang and some drunk wanted to know where Shirley was. The rounded nearly sinusoidal flow waves gradually tilt to the right and morph into the pattern you saw above as I drop into sleep.



Finally, below is what a period of disturbed sleep looks like.



This is common during REM sleep, or after rolling over into a new position, or following an apnea or some other disturbance. In this case I'm coming out of a 14 second central (or more properly, what ResScan presumes to be a central) apena. The first few breaths are deep and irregular and the tops of the waveforms are rounded, indicating that I might have awakened briefly. Maybe not enough to recall later, but enough to disturb my sleep. Each of these events disturbs one's sleep, and their effect is cumulative. Experience enough of them and you feel lethargic the next day.

As far as I know, the S9 Elite and Autosets are unique in their ability to record data with this level of detail. For most folks, it isn't necessary to look this deeply into the data. But when somelthing goes wrong like you described, the data's there and can give you a good indication of what might be going on.

Look for patterns in your breathing that might indicate a transition from the triangular (dull sawtooth) profile to a more rounded one. If you see many of those, run that by your sleep doc and ask what he/she thinks.

[Mary Z]

I agree with BlackSpinner. If you haven't seen your doctor and scheduled a follow up sleep test perhaps you should. Good for you for sticking with it, but something is wrong if you're feeling this (every bad word) bad.
Good luck.

[kteague]

I'm with those wondering what other possible causes have been evaluated. Because of my history, my mind runs straight to limb movements, but that's just the tip of the iceberg for things that can cause daytime symptoms similar to those seen with OSA. A repeat study while using your cpap as usual would seem to be the most direct route. In a night you would know if you have residual sleep issues or if you need to start testing to rule out other causes. But I wouldn't delay in doing something to start figuring this out. I think it's reasonable to expect to reap the rewards for being a good student and quick learner, or know why not. There will always be the exception to the rule, but don't settle for that being your story without it being proven by ruling all else out.

[steamfan]

New sleep study at the Mayo on September 7th. Mayo read out the last year's data and saw no issues whatsoever. Other than the fact that I feel like [deleted]. Also seeing the pulmonologist as well, since I have COPD (wheefun).

[BlackSpinner]

New sleep study at the Mayo on September 7th. Mayo read out the last year's data and saw no issues whatsoever. Other than the fact that I feel like [deleted]. Also seeing the pulmonologist as well, since I have COPD (wheefun).

But what about this years data that you have on your machine? What does that show?

What blood tests have been run? How is the thyroid?

[kempo]

New sleep study at the Mayo on September 7th. Mayo read out the last year's data and saw no issues whatsoever. Other than the fact that I feel like [deleted]. Also seeing the pulmonologist as well, since I have COPD (wheefun).

When was the last time you had a head to toe Physical with lab work?

[archangle]

What's your pressure setting? Have you experimented with different settings?

My auto machine is pretty happy with leaving me at 10. Very low AHI, etc.

I feel a lot better if I set my minimum pressure at 13.

[Mary Z]

COPD certainly complicates things. Keep us posted on what the pulmonologist says.