What am I doing wrong?

[Windmill]

Hello all,

I am hoping the experts here have some suggestions for me, I have been on cpap for 1 month now. The first week or two seemed to be okay, I thought I was feeling better. The last couple of weeks I am having way more trouble than usual going to sleep and staying asleep. I have to take meds to get to sleep and they are taking longer and longer to work. I feel that I'm not getting a good nights rest. I have been experimenting with the EPR, going from 3 down to 0. I seem to get the best numbers with the EPR at 1 with a ramp of 10 minutes. Numbers being: leak varies from 0 (one night only) to .08, AHI from 0 to 1.6, AI 0 to .2, HI 0 to 1.4 over a 5 night period, with EPR set at 1.
Last night I set the EPR to 0 and had a leak of .22, AI 0 and AHI 1.1 and HI 1.1. I have had one night in the past month when all my numbers were 0. My current pressure is 7, is it possible that an increase in pressure would help to bring the AHI down to 0 consistently? I wake up a lot with the feeling that there is air hissing out around my nostrils and try to adjust my mask, which always seems to happen when I lay on my side. I feel like this is contributing to the awakings. I do tend to toss and turn a lot from pain in my hip.
I hope you can make this all out....I feel like I am rambling...

Thanks for any suggestions.

P.S. I just checked my numbers for the month, which I assume is an average. Leak .06, AHI.9, AI 0, HI .9

[DBoone]

Your numbers are really good. Seems like you've got it dialed in pretty well already.

[Pugsy]

I am green with envy in regards to your numbers.

Sleep architecture (getting to sleep, limiting arousals, etc) is also very important in how we feel. If we can't get past those hurdles it really makes it hard for good numbers to mean much.

What are you taking to get to sleep? How long have you been taking it? Any other medications that you take which may or may not influence sleep patterns? Pain can and does cause arousals so that issue needs to be dealt with in some fashion. I probably cannot offer much specific advice as I am sort of in the same boat you are in but I ask these questions so that those experienced CPAP users will have a better understanding where you are at.

[Windmill]

I take Ativan 1mg. and gravol to get to sleep. In the past before CPAP I used it occasionally 2 to 3 times per week, .5mg. I have tried some herbal remedies, melatonin, and benedryl, they don't keep me asleep and some don't work at all. I also have to take a beta-blocker and cholesterol meds. Don't know if they affect sleep or not. I take Tylenol for the pain. I try to stay away from anti-inflamitories as I have had 2 heart attacks and was told I shouldn't take them.

[drubin007]

numbers like that are nothing to be upset with...

I wish I could have numbers half as good as you. I am about 6 weeks into cpap and have yet to come close to your digits.

still playing with my settings trying to find the perfect medium like everyone else in here

[Hawthorne]

People with sleep apnea, even treated, should not expect 0 AHI every night. We do, after all, have sleep apnea.

We can get the AHI way down and, sometimes, get a 0 AHI, but your numbers are great, in my opinion!

[frustratedmary]

I'm having interrupted sleep still on cpap Ive been on for 7 weeks and have not had a decent nights sleep yet. I'm on a beta blocker also. I wonder if there is a connection.

[Windmill]

Hi...I wonder if there is a connection there too...I have an appointment with the sleep Dr. this Thursday so will ask the question as well as doing some more research on the beta blocker that I am taking. I know of a lot of other side effects that can come from them but never paid attention to sleep as one. My biggest issue right now is not being able to go to sleep or stay asleep so I really hate going to bed...same as when I went for the sleep study in the first place.

[alnhwrd]

I agree that your numbers are great. You should be very happy with them. My guess would be that you are catching/caught up on some sleep debt so your body isn't as tired, hence you aren't getting to sleep or staying asleep. I would suggest paying attention to your sleep hygiene and see if that helps. No caffeine after noon (maybe none?), don't eat before bed, get some exercise every day but none within five hours of bedtime. No alcohol before bed. Set up a routine before going to bed and stick to it. Go to bed every night at the same time, and get up at the same time. Good Luck!

[Windmill]

Me again, I have checked out the beta blockers..."Beta blockers decrease nocturnal melatonin release, perhaps partly accounting for sleep disturbance caused by some agents", as per Wikipedia. As well checked my specific drug and it says difficulty sleeping is a common problem as well as anxiety and nervousness, all things we don't need when we are trying to get used to CPAP! I will have to read more and see if taking some melatonin on a regular basis would help. I was on a beta blocker 3 and a half years ago for about a year and a half, was having sleep issues then but was doing very well so the Dr. said I could stop taking them. Remembering back my sleep did get better off them, but I had another attack so now they want me on the beta blocker permanently. At this point all I want is to be able to go to sleep and let CPAP do the rest.

[2flamingos]

If only we could all have your numbers! I have been on pap since Novemner 08 and have come close to that only a handful of times... You have nothing to complain or be concerned about there.

As for your research on Beta BLockers, I would suggest trying other sites as well. Wickipedia results are user entered and edited, and are usually based on individual experience and/or antedotal observations. IT does provide some helpful info to get a start, I jsut would not rely on it as my sole source.

Good luck and hang in there. Oh yea, and congrats on getting an appointment with your sleep doc - many of us have not seen ours since - oh, FOREVER.