one month on cpap and more tired than before

[tammyv]

I have used my cpap for one month now and I am more tired and crabby than before.
I dont know what is going on or why? A few times I have also woke up and felt like I was choking.
Any ideas?

[wil]

More information would be very helpful... What is your setting like? Equipment (sorry... I can't identify the pictures too well...)?

Tell us more about your sleep... do you continue to wake up often? Do you have access to your sleep data? AHI? Do you wake up sore?

Would love to try to help, but can't tell much from what you wrote...

[tammyv]

My setting is a 10 and sometimes i wake up and night more often not.Machine says my AHI is 1.8 and sometimes I wake up sore I do have RA and fibormyagia(spelling?)

[pam933]

I'm in a similar situation - I've been on CPAP for 1 1/2 months and I feel worse than when I started. I finally went back to the sleep doc yesterday (but I went to a new doc because I didn't like the first one) and he was encouraging. Of course, none of this might apply to you, but I'll just let you know what he said to give you some ideas:

-I've been switching back and forth between nasal pillows and a nasal mask because of congestion and he said that there tends to be more compliance with nasal pillows and put me on Flonase to help with the congestion (I've been totally compliant since I got my machine but I like the pillows better anyway so that was fine with me)
-he said to put a small amount of vasoline on the inside of my nostrils to help with the seal and for them getting sore near the middle
-he said that at the end of my sleep study my carbon dioxide was elevated so he did a blood test to check on that, he said if that turns out to still be high then I might need to switch to biPAP
-he said that some meds I'm taking for other things might be interfering with the quality of sleep I'm getting, so I'm going to talk to my other doctors and see if I can change to meds that won't affect my quality of sleep
-I told him that I'd been waking up a lot during the night due to itchy or cold nose (which using the nasal pillows should help), or rainout (I just got a heated hose so that should help), or to adjust the mask (he said if that kept happening I could come into the sleep lab at the hospital and try on some masks and try them out for free to see if I found one that stayed on better)
-And he said that if all this doesn't work I might need to try APAP (I think just to see what pressure I end up with but I can't remember)
-And I told him that I didn't want to keep coming in because I have a $60 copay- which surprised him - but he said that we could proably do all the follow-ups over the phone, which I really appreciated

So you're not along in having trouble with this. Hopefully we will feel better soon!

[TerryB]

Hi Tammy,
Let me give you some pointers.
They may be a part of your problems, they may not.
Only more exchange of information will help you narrow down what you need to do.
I started out with a nasal mask ( the type which fits over your nose ) and found that I got a sore nose and leaks were a problem.
Within a month, my provider had given me a nasal pillow style (two soft funnels fit in your nostrils ).
Leaks were still a problem which I identified with the software and card reader I bought on line.
I eventually found that I could eliminate mouth leaks by using Poligrip denture adhesive strips.
These days I use:
A fixed pressure of 15 CM which I verify from time to time with my autopap machine.
A swift FX nasal pillow mask.
A chin strap to keep my mouth closed.
Adhesive strips to keep my lips shut.
Ear plugs so I won't listen to myself breathe or be awakened by outside noises.
I take one of my BP pills at bedtime and I take an OTC sleeping med every night too.
I go to bed on a pretty firm schedule so that I wake up on time every morning in time to go to work.
I get almost exactly 8 hours every night and am awake and ready to go to work at a consistant time.


I know there is a lot there, nut you may notice something which rings a bell, that you'll profit from dealing with.

Good Luck.

TerryB

[Julie]

If you're congested, try turning your humidifier down - it often causes congestion. You can even turn it off (I never use it) because it's not part of "therapy" as such, just a convenience for comfort.

[Wolfhound668]

Hi Tammy,

I'm pretty much in the same boat right now. I've been back on cpap for a little over a month and am still dragging through the day.

Funny, I sent my card in to be read a few days ago. The person over at the lab called me up yesterday and said my numbers were great (my AHI is averaging 1.7 for the month). She figured I must be feeling fine by now. Boy she seemed surprised when I told her I wasn't feeling any better.

Part of my problem is that I'm still not used to the mask (I still wake up when I roll over to make adjustments). I'm also still trying to work out my humidity level. Either too dry and I get a sore throat and sinuses or too humid and I wake up at 3am congested. Not much room in-between. Darn Chicago weather isn't helping any.

Keep fighting the good fight. We'll figure it out one of these days.

[TheTwinsMom1]

I am coming up on my second month using CPAP, I will tell you that by the one month mark I asked this same exact question. I was also told that sometimes it takes time. For me I am just starting to feel rested in the morning and not crave a nap every day. Hopefully you will start feeling better soon also.

[cobra4x4]

There are many threads on this exact subject ...
A search would have yielded a number of posts telling you that this is a normal occurence for most people as your body adjusts.

This feeling worse on cpap usually lasts a few weeks (could be longer depending on the individual) while your body undergoes changes. Your no longer being deprived of much needed oxygen while asleep and of coarse your now getting quality sleep (maybe not for a complete night). You will find eventually that you will be waking much earlier than your used to (I'm still getting used to that, it just seems weird to me to wake at 5am).

I'm sure there will be other adjustment phases that I have not yet gone through, however the important thing as many have said is to keep up with the therapy even though there will be a few bumps in the road.

As for humidity you will most likely need to adjust the settings as the seasons/weather change, that also depends on where you live (humid place, dry place or in between), I live on the west coast of Canada and found I needed to decrease the setting from 2 to 0 as the temperature has increased.

[ww]

Leaks cause a lot of therapy to not work properly, particularly mouth leaks with nasal masks. You need to be able to review your data to improve your therapy over time. We all suffer from trying to get a perfect leak line. This is an earlier post using a Nasal Aire mask: viewtopic/t39186/viewtopic.php?f=1&t=33 ... 56#p282156 ..

I finally bought a ResMed S9 with H5i and Heated Hose and that has allowed my AHI to get down to less than 0.5AHI. See the comment made by 6Pt Star in the above referenced thread. Good Luck in peeling the onion to get your therapy working better!!!

[kteague]

Yes, what you're experiencing is common, though the reasons why vary from person to person. Just getting used to the new sensations can take a while. About the choking sensation, opening the mouth and have the air rush around the back of the throat all wildly could account for that sensation. Or, if your pressure is ineffective, it could have been an apnea. But even when the pressure is adequate, a few events usually remain. I hesitate to just tell people to give it time, although that may be the best answer for them. Instead, I'll say #1 Make sure any mask or mouth leaks are resolved, #2 Get a mask that is not painful, uncomfortable or chronically leaky. This board contains many tips for tweaking particular masks. #3 Confirm per data that the pressure is therapeutic.

If you continue to have problems, do evaluate your any meds for sleep side effects. And be specific about your symptoms, as in what time they usually happen - shortly after falling asleep, off and on all night, after several hours sleep, etc. Do you wake up occasionally briefly, stay wake for long periods, etc? All this can hold clues. Also, did you sleep study make any mention of limb movements?

Keep plugging away. One month is probably a very small percentage of the time you had untreated sleep apnea, as well as just a small investment into your future years of sleep. You have every reason to expect things to improve soon.

[tammyv]

Thanks for ALL the great advice as normal. I am sending in my card today to see what they say at the cpap store.
I will let you know if any changes come about.. Tammy..

[PattyC]

I am feeling the same way as the OP but I don't take any medications. I have had one night where I got 6.75 hours of sleep (one wake up but I actually put the mask BACK on instead of leaving it off for the rest of the night) and I felt so great! I didn't yell at my children! Amazing! It has taken me a couple of months but I can now fall asleep with the mask on. I also got the EPR turned on on my machine. Why isn't this just an automatic setting? Now that I have it on, I don't feel like I am frighting the pressure. Wow! Anyways, the reason for my post in this thread is to discuss the leg movements. My sleep study did indicate like 26 limb movements per hour. My doc didn't think we should address that when I got my machine. Could this possibly be part of why I am so sore in the morning? My AHI (when I have the mask on) is below 2.0 now.

[kteague]

PattyC - Having limb movements reported on a sleep study can be significant - or insignificant. Can you be more specific about what the diagnostic and titration reports said about the limb movements? Did they cause arousal? Was there a reduction or increase between the two studies? Sometimes those with sleep apnea move around a lot when the body is struggling with breathing. In those cases, getting the cpap therapy working well takes care of the movements. Others' limb movements may be due to Restless Leg Syndrome (RLS) or Periodic Limb Movement Disorder (PLMD), and can persist after using cpap, and can in some cause the legs to feel sore. Is there anyone who observes you sleeping that can tell you about how much you move (or don't move) around while sleeping?

[Wulfman]

I have used my cpap for one month now and I am more tired and crabby than before.
I dont know what is going on or why? A few times I have also woke up and felt like I was choking.
Any ideas?

Since you show a nasal mask in your profile, my guess would be that you're leaking air out your mouth while you're sleeping......thereby nullifying your therapy.


Den