Low AHI but I still feel terrible

[tommy_t3]

Hey everyone. I finally got my AHI down to a good level by messing with the pressure settings, but I still feel terrible.
I don't feel rested at all. I don't see any red flags in my results, but maybe I am missing something.
Does anyone see anything in these results that could be a problem?




Thanks for the help!

[zonker]

Hey everyone. I finally got my AHI down to a good level by messing with the pressure settings, but I still feel terrible.
I don't feel rested at all. I don't see any red flags in my results, but maybe I am missing something.
Does anyone see anything in these results that could be a problem?




Thanks for the help!

welcome aboard! unfortunately, what you consider "good" isn't considered such by most of us. we feel MUCH better with an ahi of around 1. and i'm pretty sure you'd feel better too.

since you already know how to do your own settings, i'd suggest bumping your minimum up. and i don't know why you have your max at 12. you may want to bump that up to the full 20, though to be honest, i didn't look too closely at your charts.

good luck!

ETA- never mind about higher max, i just looked and didn't see it going over 12.

[tommy_t3]

Thanks Zonker.

I'll bump it up to 9 and see what happens.

Does it look like I have a leak issue?

[Pugsy]

You don't have a leak issue unless some small leaks are waking you up despite that SleepyHead statistic showing 8% over the red line threshold.

Main thing is that statistic is based on a ResMed red line number of 24 L/min and that's not what Respironics machines use.
They actually report leaks differently and because of the difference SleepyHead often will report time over red line when there isn't any.

Look on the Events graph....see the LL line? That's large leak per the machine itself and I don't see any LL flags.

So let's fix it and change the red line threshold to something more in line with what a Respironics machine would have.
Respironics doesn't have a fixed red line...it varies with the mask used and the pressure used but we can get close by changing to a nice conservative threshold number.
Go to Preferences/CPAP tab and change the 24 L/min number to around 60 or 70 L/min which is more in line with where the threshold is for a Respironics machine. Actually even that is probably ultra conservative but gotta pick something or simply turn off that statistic.
People seem to want to see that statistic though...so your choice.
That statistic is strictly a SleepyHead calculation and not reported as such by the machines. The problem for Respironics users is that SleepyHead defaults to the ResMed red line and that line isn't accurate for Respironics machine users.

As far as not feeling improvement...what exactly do you mean by "still feel terrible".
Fatigue? Excessive sleepiness during the day? Exactly what symptoms are you having that you wished you didn't? My "terrible" might not be the same as your "terrible". Be specific.

Also...do you wake often during the night?
And do you take any medications of any kind? If so, what?
Any other physical or mental health issues going on that might impact how you feel or sleep?

[palerider]

Hey everyone. I finally got my AHI down to a good level by messing with the pressure settings, but I still feel terrible.
I don't feel rested at all. I don't see any red flags in my results, but maybe I am missing something.
Does anyone see anything in these results that could be a problem?




Thanks for the help!

Good, generally, is under 2. Bit more minimum pressure.

Also, please get rid of the snore and resp rate charts, make the others larger and less squished please.

[zonker]

Thanks Zonker.

I'll bump it up to 9 and see what happens.

Does it look like I have a leak issue?

you are certainly welcome. the experts are here and i'll defer to them.

make sure to get your charts set up as pugsy and palerider ask you. they need to see certain parts of your sleepyhead charts so they know what specific advice to give you.

continued good luck!

[tommy_t3]

Thanks everyone. I made the changes Pugsy requested.

By feeling terrible, I mean that I am still extremely tired in the morning and lethargic through the day. I also look like I haven't slept in weeks which probably doesn't help the mental aspect of it. Last night was much better than before so I am making progress.
I am not taking any medications, prescription or OTC. 5'8" and 150 lbs. No health issues aside from sleep apnea.
I wake up frequently in the middle of the night. Last night was not as bad as usual. I am guessing that I woke up 5-7 times last night. The good thing is that I am not using the restroom as much. Most of the times I woke up last night was to take off the mask and scratch my nose which probably shows as pressure losses through the night.

Last night, I tightened the mask so tight that my nose has a red mark and I still managed to wake up to air hissing out the top near my right cheek. I may have been turned slightly on my side at the time, I can't remember. I was able to make an adjustment and the leak stopped.

I also adjusted the chart as requested and the numbers should reflect the new L/min settings. As you can see, last night I dropped down to 2.41 with the min pressure at 9. I am going to step it to 10 tonight.

Thanks for your time!

[Pugsy]

Frequent wake ups for any reason will trash sleep quality and we won't be able to feel the good numbers if we get them.
It's normal to wake up some during the night (like at the end of a REM cycle) but most of the time we just roll over and go back to sleep and aren't awake long enough to formulate a memory of the awakening nor awake long enough to mess with the normal progression of the sleep cycles. When we can remember 5 to 10 wakes ups per night then it's a fairly safe bet that we had more than that counting the ones we don't remember.

Sometimes it's fairly easy to know why the wake ups occur....like a leak or mask comfort issue and then we work on that problem.
Other times it isn't so easy to know why we woke up...and it isn't always related to a sleep apnea event of some sort.
We first have to identify the cause of the wake up (if at all possible) to have any chance of fixing it so we don't have so many wake ups.

For leaks...big or little...that wake you up...maybe consider a mask liner or simply a different mask.
No mask should be leaving huge red scars on the face from having it so tight...it's either the wrong size, improperly fitted or simply the wrong mask for a person's face.

[zonker]

tommy, when you get around to it, could you please go to the control and put your equipment in? once you do that, your equipment will show up at the bottom of each of your posts.

i mention it because i was going to advise that you go to you tube and search for your mask + fitting videos. as pugsy has said, yours is too tight. i know it seems like the tighter you make it, the less it will leak. but that's not the case.

[tommy_t3]

Thanks for the advice. I watched a couple videos last night and they didn't really help. I woke up with leaks a few times again. I have purchased some Rezzzmed liners. I'll update this when I get them.

Thanks again!

[D.H.]

To the OP:

Why are you wearing a full face mask? While some really do need it, many don't. Nasal masks tend to fit better and leak less.

[zonker]

Thanks for the advice. I watched a couple videos last night and they didn't really help. I woke up with leaks a few times again. I have purchased some Rezzzmed liners. I'll update this when I get them.

Thanks again!

you are welcome. will be interested in how the liners work out for you,

oh and thanks for filling out the equipment profile.

[tommy_t3]

To the OP:

Why are you wearing a full face mask? While some really do need it, many don't. Nasal masks tend to fit better and leak less.

The guy who fit me said that 90% of people need a full face mask. To say the place I got my machine from is incompetent is an understatement, so I would not be surprised if they just made that up.


You're welcome Zonkers. Thanks for pointing it out

[Okie bipap]

The guy who fit me said that 90% of people need a full face mask. To say the place I got my machine from is incompetent is an understatement, so I would not be surprised if they just made that up.

Many DMEs will tell you what ever they need to say in order to make the maximum amount of profit. They will push the items with the most profit, regardless of what you think you want, or need.

[Dorian]

Just my opinion on mask tightness... my Wisp mask is adjusted so its actually kind of loose, the headgear mostly just holds it in place and the mask just seals without being pulled much at all. I've tried a bunch of other masks and some of them had to be very tight to seal. So, keep experimenting.