Not so new newbie still feels tired after 455 days

[Freerider]

Hi All,

I will try and keep this brief but give you as much detail as possible, I was diagnosed with severe sleep apnea in June 2017 my sleep study over two nights gave an AHI of over 70. I don't have the sleep study as to be honest I didn't think about asking for it, it was a home study so not so detailed as some I have seen. I had constant brain fog, struggled to drive over 30 minutes without feeling like I was going to drop off and I was very forgetful (all classic signs). I was also on citalopram for 10 years but came off in 2016 after a year of lowering the dose and don't take any medication now.

I have a friend who is on Apap therapy and she said "the difference is amazing" "you will feel like a new man" urmmm nope. This just hasn't happened for me and I do understand that everyone is different but...... I actually feel some days worse than before. I have noticed I am starting to struggle to find words ( I use two languages which doesn't help) I feel irritable, unmotivated to do anything and have put on 10KG since starting the treatment.

I have struggled with CA events since starting the treatment and did some research to try and get my settings as best as I could. I have discussed the events on two occasions with my doctor and I got "but your doing great from where you were" and " ok lets prescribe some anti depressants but only to keep you asleep" I flatly refused the drugs saying it had taken me a year to get off these drugs so I have no interest in going back on.

So I am looking for advice, I have awake periods in the night ranging from moving as I have a dead arm (normal) to lying there for up to an hour. I fall asleep really quickly, like a minute! but when I wake I really struggle to drop off quickly.

I never seem to have consistent results which you will see below. Anyway here are my charts for the last few nights, I would appreciate your thoughts/advice and if you have any questions please ask.

[Pugsy]

Welcome to the forum.

Few questions....looks like EPR is off...is that correct?
and do you take any medications of any kind and if so, what?
How many times do you think you wake up during the night and do you ever spend prolonged periods of time with mask and machine on laying there awake?
Where are you located?

For tonight....every time you wake up reach over and push the button to turn the machine off and then turn it right back on again.
This will give us a clear break in therapy where we know you were awake and any apnea events flagged in close proximity we know will be awake events and not real.
If you have one of those prolonged periods of time where you can't seem to get back to sleep....every now and then reach over and push that button again.

[Freerider]

Hi Pugsy,

Thanks for the welcome!

I take no medication at all now, (well the occasional headache pill lol) I was told to take EPR off as this can contribute to CA events, I had a lot when I first started. My worst night was an AHI of 63 in August 2017. The norm now ranges from 6-20 events, there seems to be no rhyme or reason to the difference (ie alcohol or diet etc).

I normally wake 4-6 times which I believe is fairly common but its the longer periods that are frustrating.

I am located in Switzerland but from the UK.

I will knock the machine off as requested when I wake.

Many thanks for your help and input.

[Pugsy]

You probably should also take a crash course in identifying real vs awake/post arousal flagged events.
If those flagged events are indeed real...then we have a problem for sure.
If not real and instead awake flagged or post arousal flagged events then we work on what is causing the crappy sleep.
Go here and watch all the videos and read.
http://freecpapadvice.com/sleepyhead-free-software

Darn...I wish you had been taking some meds that might cause sleep maintenance insomnia. Makes it easy to blame something.

Yes...EPR can cause some people to have more central apneas but it's really a small number of people and not all that common but I have seen it myself in some people. Turn off EPR and the centrals go away....obviously not in your case so I don't know how much EPR is a factor or not in your situation.

I have seen this type of thing occasionally...those people who just have a truckload of centrals late in the night for no reason and the people are indeed asleep. Not too long ago Palerider was working with just such a person.

Do you just have to use a full face mask because I am not comfortable offering how that person got his issues resolved with your current mask?

[Freerider]

Thanks for the link I will do some homework!

I am not sure if the EPR really helped or not, I don't find it an issue being off though. Strangely I could never really feel the difference

I use a full mask as I tried the pillows but I couldn't get on with them as I kept having my mouth blow open. Tried taping and chin straps to no avail, which is a shame as they were actually pretty comfy. I went from a quttro fx to the amara to the airfit which for me is pretty good and seems to solve the issue I had with the other masks. The quiet exhaust is great for me and my wife, although I do feel it has a fundamental flaw in not being able to clean it properly as it doesn't come apart,,,, anyhoo thanks again for your help.

[Julie]

I may have missed it above, but is there a reason you're on straight Cpap vs Apap?

[Freerider]

Hi Julie,

I have the remed autoset 10

Best regards,

[weroberts75]

Hi Julie,

I have the remed autoset 10

Best regards,

That would be the AirSense 10 AutoSet.
It sounds like you just selected the wrong machine in the dropdown box when filling out your profile.

[Pugsy]

You have the wrong machine chosen in your profile.
I didn't notice because I was just looking at the SleepyHead report which clearly says what machine you are using.
You probably couldn't find the choice for the AirSense 10 AutoSet and that's because it's down in the "R" section of the choices instead of being up with the "A" choices for the others.
So when you have time you might correct your equipment menu selections to avoid potential confusion.

[Pugsy]

We can have a chat about masks later once we figure out if you were awake or asleep when those centrals got flagged.
You didn't happen to try the DreamWear FFM from Respironics did you?
Relatively new to the market
https://www.cpap.com/productpage/pr-dre ... k-headgear

[Freerider]

You have the wrong machine chosen in your profile.
I didn't notice because I was just looking at the SleepyHead report which clearly says what machine you are using.
You probably couldn't find the choice for the AirSense 10 AutoSet and that's because it's down in the "R" section of the choices instead of being up with the "A" choices for the others.
So when you have time you might correct your equipment menu selections to avoid potential confusion.

Exactly that! all updated

[Freerider]

We can have a chat about masks later once we figure out if you were awake or asleep when those centrals got flagged.
You didn't happen to try the DreamWear FFM from Respironics did you?
Relatively new to the market
https://www.cpap.com/productpage/pr-dre ... k-headgear

I haven't tried that mask, look a bit similar to the Amara which I just couldn't get on with. I see the F30 is very similar too!

[Pugsy]

Yes, the DreamWear is similar to the Amara but not the same. I have played with both myself just to compare them.
If it ends up that we might want to try something for those centrals (if they are real) I will explain my thoughts and we can discuss your problems with the Amara View and maybe the slight difference will fix those problems. Cross that bridge later if we need to.
IMHO the DreamWear is a much improved version of the Amara View but just my opinion.

[Freerider]

Hi all,

Please see below my chart from last night, as requested I turned the machine off briefly when I woke. The last on/off x 3 was when I was awake for about an hour.

[Pugsy]

Can you omit the bottom masked pressure graph (we already have the regular pressure graph above) and slide the flow limitation graph into view in its place?
Also don't really need the snore graph. Omit it and resize so the other graphs are a bit larger.