New user, need sleepyhead help....PLEASE!!!

[SleepyMcgee]

Ok, so long story short. I am self diagnosed sleep apnea (well, primary care thinks I have it too) but insurance keeps denying sleep study since home study was inconclusive. I finally just bought a CPAP/APAP (dreamstation) since I need to figure this out and cant wait for insurance. I am aware this isnt an optimal situation.

Here's the issue. I've been using the machine for over a month. some mornings I feel completely energized...Usually a day or two a week. Wake up early feeling like I slept for a month. Other/most mornings, tired, fatigued etc. The machine has made it so that I am not 'head on my desk fatigued' but I'm still really really coudly an fatigued. Attached are two pieces of data. One 'good' night/morning and one 'average/bad' night/morning.

Any advice on how to tweak the machine to optimize/maximize the 'good nights' would be much appreciate. I take no prescriptions, am 41, not obese, exercise regularly and do not wake up (that I'm aware of) much during the night.

Thanks so much!


BAD:

http://s1233.photobucket.com/user/arcad ... 2.png.html
GOOD:
[img]http://s1233.photobucket.com/user/arcad ... g.html[img]
http://s1233.photobucket.com/user/arcad ... 2.png.html


Ugh, not sure why these arent displaying but the links do work. thanks

[Julie]

Your low pressure setting is at the machine's default bottom... I'd raise it by at least a couple of cms for a few days (to 6 or 7) and see if you feel better, then in time you may want to raise it even higher (those are still very low figs) depending on how things progress. If you're using the ramp feature, esp. at the present setting, just turn it off - I guarantee you won't miss it!

[SleepyMcgee]

Thanks for the reply!!

since those snapshots I've ramped machines lower setting to 6. I had two good nights but am now back to the same old fatigue...Not sure if it was a fluke as I usually get a random 'good night' about 2x a week even if I dont change any settings.

[Pugsy]

Please review the "how to organize" the graphs so that you don't include graphs that aren't needed and make graphs that are needed too small. There are 3 pages so be sure to read all 3.
https://sleep.tnet.com/resources/sleepyhead/shorganize

Photobucket is horribly slow and chocked full of ads and probably not the best place to host the images. It used to be a good place but it isn't now.

Might look at imgur.com for future postings and if you log in and choose the bottom address they show up in your posts.
https://sleep.tnet.com/reference/tips/imgur

and for examples of what we like to see...with Respironics reports...these graphs on the right (Events, flow rate, pressure and leak) along with the usual stuff on the left.
viewtopic/t103468/Need-help-with-screen-shots.html

Examples of current settings instead of what you used to use would also be more helpful.
Since you have already changed the minimum then an example of that new minimum would be more helpful because most of us will tell you to increase the minimum.

How many hours of sleep are you getting on an average?

[SleepyMcgee]

Please review the "how to organize" the graphs so that you don't include graphs that aren't needed and make graphs that are needed too small. There are 3 pages so be sure to read all 3.
https://sleep.tnet.com/resources/sleepyhead/shorganize

Photobucket is horribly slow and chocked full of ads and probably not the best place to host the images. It used to be a good place but it isn't now.

Might look at imgur.com for future postings and if you log in and choose the bottom address they show up in your posts.
https://sleep.tnet.com/reference/tips/imgur

and for examples of what we like to see...with Respironics reports...these graphs on the right (Events, flow rate, pressure and leak) along with the usual stuff on the left.
viewtopic/t103468/Need-help-with-screen-shots.html

Examples of current settings instead of what you used to use would also be more helpful.
Since you have already changed the minimum then an example of that new minimum would be more helpful because most of us will tell you to increase the minimum.

How many hours of sleep are you getting on an average?

Thanks. I believe the data is organized correctly as I reviewed that data prior to posting. I posted data from the settings that I had been using for quite some time. I monkeyed with the settings just last friday.

trying to get these to show up in the post...

BAD:




GOOD:

[Pugsy]

The Respiration rate graph is useless...as is the snore graph (snores are shown on the Events graph)...so omit those and make the other graphs better sized.
Pressure graph and leak graph are teeny tiny and might be better if they were larger.
Again..the main graphs we like to see from a Respironics machines are these
Events
Flow rate
Pressure
Leak
and then if we need anything else we ask.

Since you just recently changed the minimum to 6...do you have a "good" example of the results with the minimum at 6?

Both your examples with the minimum of 4.5 don't show a lot of pressure movement but do show some "events" and while not in huge numbers perhaps these events reflect less than optimal sleep quality and even though you may not remember awakenings....maybe you are having arousals/awakenings along with these events and maybe they are responsible for not feeling as good as you expect.
Those aren't horribly bad reports but they could stand some improvement in light of the fact that you aren't feeling as good as often as you would like.

How long have you been using the machine?
How many hours of sleep do you average?

[Pugsy]

Thank you for embedding the images in the post. They showed up immediately for me this time....when I had to do the link thing it was horribly slow...like several minutes to get one image and then I got a big ad that wouldn't go away without multiple clicks and more minutes to finally see one image. Makes me not want to bother looking at the images when I face these obstacles and without looking at the images it makes it really hard to offer any ideas on how to improve things.

[Julie]

One other thing that may not have come up - if you sleep on your back you're likely to get many more 'events' than otherwise, and if you can side sleep instead (often a temporary fanny or backpack helps to transition) you may see very different numbers of hypopneas if nothing else.

[SleepyMcgee]

Tried to clean these up and switched to imgur. Below you'll find a good night and a bad night.
To answer your two questions:
1) I actually forgot to put my SD card back in the Dreamstation on friday night (the night I bumped min to 6). Ugh. I only have basic data for that night.
2) I sleep between 7-9 hours a night. If I have a 'great night' I find myself waking up at 6 ready to take on the day. All other nights, I'm having to be woken up at 7:15.

Thanks again!

GOOD:


BAD:

[SleepyMcgee]

One other thing that may not have come up - if you sleep on your back you're likely to get many more 'events' than otherwise, and if you can side sleep instead (often a temporary fanny or backpack helps to transition) you may see very different numbers of hypopneas if nothing else.

Thanks Julie. I generally try to sleep on my side(s). I have certainly woken up every now and again on my back though

[Pugsy]

When using imgur for images...
make sure you are logged in
then select the image you wish to share and click on "large thumbnail" at the bottom of the box with all the addresses on it.
Then go copy the LAST line in that box of addresses and post that address in the body of your text here.
What you will get is an image of your report that is large enough to see in general but not so large that the right side gets cuts off but if for some reason we want to make the image large then we can just click on the image and make it full size.

Regarding the SD card not being in the machine....go ahead and insert the card and let the machine write the data that is stored in its internal memory to the card....the only thing you lose is the flow rate breathing wave form data...all the other graphs will be there so there's a lot more than "basic" data available from your machine.
Now if you were using a ResMed machine then you have nothing but summary data but the Respironics machines will actually store the bulk of the detailed data on its internal memory for quite some time.

Regarding sleep...have you taken a long hard look at your sleep hygiene?
Exactly what unwanted symptoms are you experiencing on the "bad" days? Fatigue? Excessive sleepiness? Something else?
I assume that you have had recent lab work that doesn't point to anything physical....were vitamin D and hormone levels like testosterone checked?...in addition to the usual thyroid levels?

FWIW...I have never in my life woke up ready to take on the day I am not nor have I ever been a morning person. The best cpap therapy in the world can't make me into something I am not nor ever have been.

[SleepyMcgee]

When using imgur for images...
make sure you are logged in
then select the image you wish to share and click on "large thumbnail" at the bottom of the box with all the addresses on it.
Then go copy the LAST line in that box of addresses and post that address in the body of your text here.
What you will get is an image of your report that is large enough to see in general but not so large that the right side gets cuts off but if for some reason we want to make the image large then we can just click on the image and make it full size.

Regarding the SD card not being in the machine....go ahead and insert the card and let the machine write the data that is stored in its internal memory to the card....the only thing you lose is the flow rate breathing wave form data...all the other graphs will be there so there's a lot more than "basic" data available from your machine.
Now if you were using a ResMed machine then you have nothing but summary data but the Respironics machines will actually store the bulk of the detailed data on its internal memory for quite some time.

Regarding sleep...have you taken a long hard look at your sleep hygiene?
Exactly what unwanted symptoms are you experiencing on the "bad" days? Fatigue? Excessive sleepiness? Something else?
I assume that you have had recent lab work that doesn't point to anything physical....were vitamin D and hormone levels like testosterone checked?...in addition to the usual thyroid

Thanks. Are the charts/graphs I posted above in a format that allows you to easily review/compare? [I will upload the report from my 'good night' at the 6 pressure shortly].

As far as hygiene, yes. Even tried to correlate food etc to ensure I'm not suffering from allergies. Yes. Recent lab work.
Regarding symptoms of 'bad days'. Its really just fatigue, cloudy head, hard to concentrate. I am not 'sleepy' really (dont feel like I want to nap) but I have no desire/drive to do anything much...

[Pugsy]

Yes, the recent organization makes it easy for me to see what I usually look for.

I don't see anything that just stands out screaming "fix me and you will experience the miracle".
The AHI isn't horrible but it could maybe stand some improvement so it's worth at least trying to see if it helps or not to have even less "events".
A word about Clear Airway events...we have to ignore them...we can't fix them with more pressure so we mentally remove them from the evaluation process unless we see large numbers of CAs on a consistent basis.

Did you have Vitamin D and testosterone included in recent labs? They are not normally part of a general work up.

How long have you been using the machine?

[palerider]

Ugh, not sure why these arent displaying but the links do work. thanks

because photobucket sucks, please use imgur.com instead.

[SleepyMcgee]

Here is the recent 'good night' data. I had a full workup done including thyroid. All were within normal range. Using for 50 days. Compliance ~100%.