1 year in, same brainfog, would appreciate help

[Finnian]

Hello.  I had years of brainfog that I ignored, got blood tests and physicals that found nothing, finally saw a sleep doc and he found 70+ apnea events.  Got my CPAP and the first night I woke up feeling amazing, like there was a tube of oxygen straight from my nose to my lungs.  That petered out after the first week, and a year later it feels like I'm maybe 30% better.  I average 1.8 events so think this should be working better.  Still tons of brainfog, inability to concentrate, no interest in things.  I have terrible sleep habits but I sleep fine once I get to sleep, though lately I've started waking up like 7AM and can't get back to sleep once awake.  I'm super braindead in the afternoon, but not in a way that I want to take a nap.  Just a zombie that does nothing.

I'm overweight and get zero exercise, 240lbs 5'8", and the sleep doc tells me the only thing to do is to lose weight and that'll make breathing better, but it's real hard to do when I feel like this.  I also got a lot of anxiety problems, which I'm working on.  No medications. Half of me thinks this is all on me to get in shape, but I hope there's an issue with the machine.

There have been times when I have woken up feeling tons better.  A couple times I was on a weeklong cruise with just zero anxiety, sleeping comfortably, and after 5 days I felt like myself again.  I got nose surgery to open up the airways and when I got home from the surgery I felt amazing, I was laughing and chatting with friends, and wonder if it's them knocking me out meaning I got 4 hours of amazing rest, or if it was the breathing tube meaning I got lots of oxygen.

My machine was setup wrong for a lot of the year.  When I first looked it had a 2-pressure range, like 12min to 14max so I thought it was supposed to be 2 apart.  I would randomly change it wondering if I needed less or more, but always 2 apart, so like 6-8 one night, 18-20 the next, etc.  When I found this forum I set it from 5-20 and it felt like things got 30% better.  I upped it because it started feeling too low, or it would always go up to 8 anyways.

USA
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: DreamWaer Nasal CPAP Mask with Headgear

Would appreciate any hints or help.  Thanks!

broberso 5-19.png (107.38 KiB) Viewed 2129 times

broberso 5-20.png (108.97 KiB) Viewed 2129 times

broberso 5-21.png (110.88 KiB) Viewed 2129 times

[more02]

lets see 2 minute flow rate charts of OA and CA

[Julie]

To "More" - I'm sure you want to be helpful, but as a newbie, maybe need to wait a while before continuing to post, or posting what you have, which is not necessarily helpful and could be misleading.

[zonker]

Hello.  I had years of brainfog that I ignored, got blood tests and physicals that found nothing, finally saw a sleep doc and he found 70+ apnea events. 

welcome to the zoo! i'm sorry you are having such a rough time of it. by coming here, you are bound to get some good advice.

my first advice would be to raise that minimum pressure to at least 11. and give it a few nights to settle in. if you look at your pressure graph, you can see you get above 10 a few times. setting it at 11 gives your machine a better chance at holding open your airway, which is what cpap therapy is all about.

as to weight loss, yeah, it can certainly help, but it's no cure or anything. i'm not one to give advice about losing weight. i'm a bit overweight myself and i can't seem to get serious about losing it.

more forum members will be along shortly to give you advice. being saturday, most of them are busy with other pursuits.


good luck!

[Miss Emerita]

Welcome, Finnian. You have a lot going for you: an excellent machine, lowish AHI, Oscar, and this forum. Plus you have seen improvements along the way. All that is good.

But clearly your waking life is not what you want it to be, with brain fog and apathy plaguing you. You are right to want to take action so that you will feel like yourself again, as you have from time to time.

You have put your finger on some essential steps toward improvement. They are not magic, overnight cures. Taking some exercise and losing weight are at the top of the list, and improvement your sleep "hygiene" is right behind. But I know this is easier said than done.

So can you promise yourself to start somewhere? How about getting outdoors in the morning? To start with, just walk around outdoors for 10 minutes -- is that something you could do? Being outdoors in the sun will also help a little on getting sounder sleep at nights.

And if you snack a lot, can you try not buying the high-calorie snacks so they're not there to tempt you, and instead get pretzels, grapes, carrot sticks, cherry tomatoes -- stuff like that? Look at the calorie information on some dips; some of them aren't bad and might make the vegetable snacks more appealing.

Sleep "hygiene." I notice on your charts a bedtime ranging from 12:20 to 1:30 a.m. If you wake up at 7 a.m. and can't get back to sleep, could you try going to bed no later than midnight every night? It would be a good experiment to see whether you wake up even earlier when you do that or instead still wake up around 7, but having had more sleep. I would try the experiment for a couple of weeks before trying to assess the results.

How are you on the blue-light screen time? If there's a lot of it in your evenings, can you get off your screens (including TV) by 11 p.m., just to start with? Anything you might read on paper? Any forms of solitaire you might play with a card deck? (I know my age is showing here!)

About your settings: You have some busyness in your flow limitation graph -- nothing horrible but still maybe something to address. I recommend changing your EPR from 1 to 2, while raising your minimum pressure from 10 to 11. Try that for a few nights and post a chart so the experts here (not me) can take a look. I can think of some additional changes that might be a good idea, but one step at a time.

[Finnian]

Thanks. I've set the minimum to 11 and EPR up to 2. I'll try that out for a while. I guess I picked up a wrong idea that I wanted the minimum to be lower than what I need, so it wasn't interfering when I didn't need help.

I agree Miss Emerita and appreciate the caring. I'd got some self-care issues that therapy is helping with, but it's tough to do a lot of the things you list. I'll try to take it seriously and as good advice. I do tend to do a lot of screen time even at bedtime, because it's hard to have the brainpower to read. I'll do my best to give it a try and check back in.

I'll do some more graphs after a few days. Here are the OAs and CAs zoomed in if it shows anything.

broberso OA 5-21.png (99.27 KiB) Viewed 2086 times

broberso CA-2 5-21.png (99.78 KiB) Viewed 2086 times

broberso CA 5-21.png (99.39 KiB) Viewed 2086 times

[Miss Emerita]

Finnian, before the two CAs it looks as though you had a brief arousal with some deep inhalation and exhalation. Sometimes that will wash out enough CO2 to reduce your urge to breathe. Then during the pause (CA), the CO2 builds back up until you start breathing again. If the arousal is you getting bumped out of a sleep stage prematurely, then that is not helping your sleep. But if it isn't, then a handful of these every night is nothing to worry about.

[pitman]

I see you have zero leaks which makes me think about my experience when I used a pillows mask for over a year and had the same symptoms you mention. I then discovered I am a mouth breather and switched to a full face mask. The FF produces better results for me. I'm not sure if this would help but at least consider. Maybe others will comment on this.

[Finnian]

Hmm, I tried to get a full face mask last time I saw the sleep doc, but the guy talked me out of it. Claimed it can push your jaw back, resulting in even more problems. I should have demanded it, but just wasn't in the mental state to argue properly. My mouth isn't ever dried out, which I thought would be a problem if you were a mouth breather? Does it not flag as a leak if you are losing air out of your mouth? I do get leaks if I use the cushion type, but the pillow style just seals up to my nose and never moves.

Is there a place people buy masks off-insurance? I should go through mine, but it's a pain.

Thanks again for the tips and help everyone. I'm glad to be working on it.

[Julie]

You seriously need a new doctor - I imagine he thought you were talking about a dental device (that does push your jaw back), but FF masks don't.

[weiss27md]

I've used secondwindcpap to buy my 2 masks with no insurance. If you're having mouth leaks correct tongue posture or a soft cervical collar could help. Do you consume caffeine? If you have anxiety and poor sleep I would ween off caffeine, or at least don't have any after lunch. For weight loss try intermittent fasting. You don't have to change what you eat, just when. The best way to do it is eat breakfast and lunch and skip dinner. It's best not to eat near bedtime anyways, especially if you are having sleeping issues. Eat less carbs, no more liquid sugar like sodas, no more candy. My AHI is low like yours but I also suffer terribly. I think it's apart of my autoimmune disease plus caffeine consumption.

[jimbud]

My mouth isn't ever dried out, which I thought would be a problem if you were a mouth breather? Does it not flag as a leak if you are losing air out of your mouth? I do get leaks if I use the cushion type, but the pillow style just seals up to my nose and never moves.

Yes, you would have a dry mouth if you were a serious mouth breather.

Yes, your leak graph would show leaks if you were mouth breathing.

Leaks are not your problem.

JPB

[Finnian]

Was gonna do an update, but checked the SD slot on my machine and turns out I forgot to put it in for the past 5 days of trying the new settings. Whoops. Will put up some graphs in a few days.

I definitely feel better with the higher pressure. No morning headaches. Probably 30% more energy/happiness.

The weekend was weird as I slept in until noon, felt nice, though when I start working my schedule gets really off. Still having braindead time in the afternoon. I'm having success in not having screen time in bed, trying to read 20-30mins at bedtime, etc. I think another week or two with the new settings may be really good and help me solidify some better sleep hygeine.

Thanks for the help! A little progress is giving me some hope that I'll get the energy to start exercising and diet, and things will get much better.

[Miss Emerita]

I'm so happy to hear you're seeing improvement! I hope you will soon be in an UPWARD spiral.

It's funny, before I posted to you about using your screens, I brushed up on the topic on line and wound up buying some yellow-tinted lenses that clip onto my glasses, because I recently started watching TV in the evening. It's early days still, but the last two nights weren't great for me (pain issues), and in the mornings I was expecting to be stupid and grumpy all day, but then it turned out I actually felt OK. I'll be curious whether this keeps up.

[Norma45]

Finnian, I am going to add some non cpap things to check out, similar to some of what others have said.

Have you tried light therapy in the mornings (bright white light, for some blue lights work – look specifically for therapy lights). Bright sunlight tells our body when morning is, so that we get sleep in the evenings. For most 20-30 min works best, for others they need longer.

Ditto on trying no blue light in the evenings. Have you tried no blue light screens, or even going as far as wearing amber glasses and no lights on in the home that contain blue light. If you need that screen time, check out the apps/settings that lower blue light and even lower the brightness of the screen.

Both of the above used together can make you feel sleepy earlier in the evening.

I use the parent control limits to help control evening screen time - I have to ask for each additional 15 minutes which makes me think twice about should I turn it off to go to sleep.

Are you relaxed at night or feel some tension in your body? You might need magnesium or something else to relax your muscles. When my muscles are not relaxed, I have trouble dropping into sleep.

Don't settle for feeling like krud, there are a lot of things to try that can make a difference.