Sleeping Less: Still Tired, Now Xyrem

[Guest DD]

I've been using the CPAP for about six weeks. Before the cpap I averaged 7 hours. For the entire first month using cpap I averaged about 5 hours of sleep.

My doc suggested that I take a STARTING dose of Xyrem (a sleep medication for fibromyalgia) and I'm almost up to 6 hours of sleep.

The doc wants me to continue increasing the Xyrem but I'm starting to get side effects so that will probably mean that I'll have to either stop taking it or at least not to increase the dose.

I'm in a quandry and I'm tired.

[NeedinZs]

Hi DD,
Is you problem getting to sleep, or staying asleep?

Give some more details on your machine, mask, problems.... I'm sure you'll get some usefull information from others on here.

[Guest]

Hi DD,
Is you problem getting to sleep, or staying asleep?

Give some more details on your machine, mask, problems.... I'm sure you'll get some usefull information from others on here.

Ok, will do. My index was 38, doc said moderately severe OSA. Machine is Resmed Vantage with humidifier and Nasal Aire II. It's been difficult but after a month I saw my doc and he said I'm very compliant and my numbers are down. He said I was doing well. I said I was only sleeping five hours and was tired.

My main question is that I don't understand why I'm sleeping FIVE rather than my usual SEVEN hours AND I'm tired. Makes NO sense. The machines are supposed to help us, right?

[j.a.taylor]

My main question is that I don't understand why I'm sleeping FIVE rather than my usual SEVEN hours AND I'm tired. Makes NO sense. The machines are supposed to help us, right?

D.D.,

What is the quality of that 5+ hours of sleep?

You may have thought you were sleeping 7 hours before, but you may have been unaware of intermittent periods of wakefulness.

[Guest]

My main question is that I don't understand why I'm sleeping FIVE rather than my usual SEVEN hours AND I'm tired. Makes NO sense. The machines are supposed to help us, right?

D.D.,

What is the quality of that 5+ hours of sleep?

You may have thought you were sleeping 7 hours before, but you may have been unaware of intermittent periods of wakefulness.

Before cpap I thought I slept 7 hours straight, but I had the 38/hour incidents of apnea/hypoapneas. The machine has indicated below five incidents, often less than three, but I'm still tired after five hours. What is strange is why I'm sleeping fewer hours.

I'm guessing now, but before the machine I kept my arm straight as if I were touching the headboad with a pillow on top and I slept on the corner of the pillow with my head facing downward. I'm a mouth breather so maybe that position opened my airways enough for me to get 7 hours. I may not have had apneas. OR maybe I need a mask type of head gear because I'm a mouth breather.

Anyhow, my sleep doc suggested I increase the sleep med, which I did for 3 days, but side effects are becoming more pronounced.

This is all very frustrating! I'm hoping to gain motivation to continue. It's getting more difficult at times.

[Wulfman...]

Hi DD,
Is you problem getting to sleep, or staying asleep?

Give some more details on your machine, mask, problems.... I'm sure you'll get some usefull information from others on here.

Ok, will do. My index was 38, doc said moderately severe OSA. Machine is Resmed Vantage with humidifier and Nasal Aire II. It's been difficult but after a month I saw my doc and he said I'm very compliant and my numbers are down. He said I was doing well. I said I was only sleeping five hours and was tired.

My main question is that I don't understand why I'm sleeping FIVE rather than my usual SEVEN hours AND I'm tired. Makes NO sense. The machines are supposed to help us, right?

Ever wake up with a dry mouth? (I would guess...."Yes")

What pressure or range of pressures is your machine set to?


Den

[Guest DD]

Ever wake up with a dry mouth? (I would guess...."Yes")

What pressure or range of pressures is your machine set to?
Den

[?

I almost forgot to answer the 2 questions asked. My pressure is 6-9 (last night it went to 8 and a fraction, the highest it's been. The HIA reached 6 and a fraction, higher than it's ever been. I'm guessing it may be because I'm trying to keep the gear on my head so I stay mostly in one position which is not normal for me.

Prior to the machine I don't recall waking with a dry mouth. After the cpap no dry mouth. The leakage is always below .5 (point five).

That's why I don't understand why I'm only sleeping 5 hours when I always slept 7. Again, my hunch is because I'm a mouth breather trying not to use my mouth.

<insert Twilight Zone theme here>

Thanks for your help.


_________________

[Wulfman...]

Could very well be that the pressure changes are waking you. You might try it in straight pressure mode (CPAP) at 8 or 9 and see how that feels. In straight pressure you could also use the EPR feature.
The thing about tweaking or fine-tuning your therapy in single pressure mode is that at least the pressure and leakage should be a "known" or constant amount.

Den

[Guest]

I thought the leakage was caused by actual leaks from the nasal connection to the main tube that goes to the machine. Isn't .2 to .4 fairly steady? I think it may happen as a result of my movement just prior to settling into bed when the nose piece may leak air for a few brief seconds while adjusting the pillow. Is the machine that sensitive?

Your second point about a straight CPAP pressure sounds interesting but I can't change the settings on my Resmed Vantage S8. What's EPR? Is that the same as ramping (which I never use).

Could very well be that the pressure changes are waking you. You might try it in straight pressure mode (CPAP) at 8 or 9 and see how that feels. In straight pressure you could also use the EPR feature.
The thing about tweaking or fine-tuning your therapy in single pressure mode is that at least the pressure and leakage should be a "known" or constant amount.

Den

[Guest DD]

P.S.
I don't wake up (consciously) when I'm using the CPAP. I just don't sleep enough. Five isn't enough. I miss sleeping my usual seven hours.

Could very well be that the pressure changes are waking you. You might try it in straight pressure mode (CPAP) at 8 or 9 and see how that feels. In straight pressure you could also use the EPR feature.
The thing about tweaking or fine-tuning your therapy in single pressure mode is that at least the pressure and leakage should be a "known" or constant amount.

Den

[Wulfman...]

Can't change the settings?
Now you can. (see below and copy them to a file in your computer)
Make sure you go through all of the existing settings and write them down (before making any changes) in case you'd have to (or if you decide to) change them back.

EPR is "Exhale Pressure Relief".....decreases the pressure as you exhale. On the Vantage, it's not available in Auto mode, but is available in single pressure mode (CPAP). Settings are 0, 1, 2 and 3......the higher number giving the MOST relief......lower number the least. Depends on your pressure.....lower pressures usually don't need as much relief.....higher pressures probably do. If set to zero, it's off.

RAMP is different. It's designed to increase the pressure from a starting point to where your set pressure is. (kind of like training wheels on a bicycle) It can be turned off or can be set for a certain amount of time. (many/most of us don't use it after we get used to the pressure)

Den



1. Accessing the Clinical Menu

Turn on the device and wait until the standby (RAMP/SETTLING) screen appears on the LCD.
At this stage you can adjust the ramp/settling time.

Press the DOWN and RIGHT keys simultaneously for 3 seconds to access the clinical menu.


2. Changing Options and Settings.

Press the LEFT (menu) key to access the SETTINGS menu screen.

Use the UP and DOWN keys to scroll through the RESULTS, OPTIONS and SERVICING menu screens.

From a menu screen, use the LEFT (enter) key to access the parameters in that menu.

Use the UP and DOWN keys to scroll through menu parameters.

Use the LEFT key to view or change each parameter setting as required.

Press the RIGHT (exit) key until you return to the standby (RAMP/SETTLING) screen.

[Wulfman...]

P.S.
I don't wake up (consciously) when I'm using the CPAP. I just don't sleep enough. Five isn't enough. I miss sleeping my usual seven hours.

Could very well be that the pressure changes are waking you. You might try it in straight pressure mode (CPAP) at 8 or 9 and see how that feels. In straight pressure you could also use the EPR feature.
The thing about tweaking or fine-tuning your therapy in single pressure mode is that at least the pressure and leakage should be a "known" or constant amount.

Den

Been there, too.....in the beginning.
There's been two things that usually limit my sleep.....bladder capacity and the alarm clock.
When I was starting on therapy, I also had a lot of projects going on at work and some nights was barely getting 4 hours. I gradually increased my average over a period of time. Through the "learning curve", I made some changes in my bedtime habits to increase it. It's still not unusual for me to get up during the night for a "trip down the hall", but I usually have enough time to get back to sleep for another hour or two or three befor the alarm goes off. With time, it gets easier to go back to sleep. Five hours of "good" sleep is many times better than seven of apnea-disturbed sleep. You might try going to bed earlier.

Den

[Wulfman...]

Another thought that I meant to put in the last one.

There may be something in your sleep architecture that's going on at about the 5-hour mark. As an example, you may be in REM or deep sleep stages 3 or 4 and having events which may bump your pressure. Something like THAT might wake you up. There's supposed to be about a 90 - 120 minute cycle of sleep stages that we go through and repeat throughout the night. My thought was that there may be something happening at about that time mark that's waking you up. The list of possibilities is quite long and is individualistiic. Single pressure may help narrow the list.


Den

[Guest DD]

I copied the settings info down and then looked into the machine but couldn't find where I could change it from to straight pressure mode OR the EPR mode. Maybe my concentration is off --- it's late.

Could very well be that the pressure changes are waking you. You might try it in straight pressure mode (CPAP) at 8 or 9 and see how that feels. In straight pressure you could also use the EPR feature.
The thing about tweaking or fine-tuning your therapy in single pressure mode is that at least the pressure and leakage should be a "known" or constant amount.

Den

[Wulfman...]

I copied the settings info down and then looked into the machine but couldn't find where I could change it from to straight pressure mode OR the EPR mode. Maybe my concentration is off --- it's late.

Could very well be that the pressure changes are waking you. You might try it in straight pressure mode (CPAP) at 8 or 9 and see how that feels. In straight pressure you could also use the EPR feature.
The thing about tweaking or fine-tuning your therapy in single pressure mode is that at least the pressure and leakage should be a "known" or constant amount.

Den

I don't have one of those machines, nor have I ever gotten into the setup on one, but folks have posted information on the forum.

Here's another set that I've copied.
I would assume that you select between CPAP or APAP mode and then put in a single pressure number or a range of pressure as listed below.

Den

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ResMed S8 Series
To get into the provider setup mode in a ResMed S8 CPAP machine - such as the S8 Compact, S8 Elite or S8 AutoSet Vantage - follow these steps:

1. press the right and down arrows simultaneously for about 3 seconds until the word "clinical" appears
2. select Menu

Use the left and right arrows to cycle through the settings and use the up and down arrows to make adjustments. Below is a list of settings you can cycle through on an S8 AutoSet Vantage automatic CPAP machine. There are four groups of settings which have adjustments and data within them.

* Settings
o CPAP Mode
o Minimum CPAP Pressure
o Maximum CPAP Pressure
o Maximum Settling / Ramp
o Mask Type
o Tube Length
o Humidifier
o Smart Start
o Leak Alert
* Results
o Efficacy Data
o Usage Data
* Options
o Smart Data
o Reminders
o Factory Defaults
o Erase Data
o Date
o Time
o Menu Type
o Language
* Servicing
o Run Hours
o Serial Number
o PCV Number
o SW Number
o BR Number