Feeling like I should be doing better...

[Ogre]

Been on CPAP for coming up on a year. Made the switch to APAP back in April and got a different pillow and saw some improvement. Still dealing with bad dry mouth some mornings and not feeling as good as I hoped. I can't export my data but I wrote down my numbers from the last month. Can anyone tell me if I'm missing something? I think these numbers look ok but I'm not quiet proficient in interpreting them yet.

AutoCPAP Mean pressure - 11.1
AutoCPAP Peak Average pressure - 12.5
Average device pressure <=90% - 12.6
Average time in apnea per day - 10 seconds
Average time large leak per day - 16 minutes 39 seconds
Average AHI - 1.5

[echo]

Hi ogre,

While your reported AHI looks good, there might be room for improvement (mainly judging from the large leak info, but even that is not enough info).

First, What are your APAP settings/range?

Second, the leaks might need some work and might be the cause of some of your troubles. Do you have the software and graphs so you can get more detailed info on those leaks? Don't forget if leaks are excessive the reported AHI may be misleading.

Any particular reason why you switched to APAP? Also, what was your pressure setting when you were on CPAP?

[Ogre]

I have it set for 9-20. I do get the graphs, but like I said, I can't export that data for some reason. Even tried to cut and paste it but it wouldn't let me do that either. I made the switch because my prescribed pressure was for 9 but after a couple weeks I felt like I was going backwards again. I up'd the pressure by .5 every week until I hit 11 on my old CPAP and although things were better I felt it could have been even better. So I made the switch to APAP so I could get the data and to see what the machine "thought" I should be at. Since April these are the numbers I've gotten, not much change in them at all. About the same time I got a new pillow that had some neck support and it made a big difference as well.

[echo]

Oops, missed that you said that in the first post. I am by no means no expert on your software but I think you should try to figure it out and post some graphs so we can see what's going on. If you can "print" from the software then you can try printing to a program like PrimoPDF, which will generate PDF files. You can find it online for free. You print to it like a printer, and it generates a PDF for you, which you can then link to here. You can also try searching in cpaptalk (see upper left corner of the main page) for words like "print" and "encore" etc. You might also try doing a "print screen", pasting the capture in a paint program or something like Irfanview, saving it as an image file, and then post the image here.

If you need help please ask, as someone will for sure be familiar with your software and be able to help you.

As far as pressures go, it's quite reasonable that your ideal pressure is not the same as your titrated pressure. However I would want to rule out leaks definitively before digging further.

Do you have a good "hose management" system to avoid that the hose tugs on your mask?

Don't forget that there can also be other causes for not feeling 100% on cpap... poor sleep hygiene, other health problems like diabetes, hypothyroidism, etc.

BTW do you have access to a pulse oximeter?

[Julie]

Hi, I wonder if you've ever tried a different pressure spread, like 9 and 15, because as it is now (9-20) the open-ended ceiling is not to your advantage as 20 is unnecessarily high. It would be interesting to see what happens if you lower it (most of us are set around 8 - 12, as 10 seems to be a common denominator.

[Ogre]

Julie, I'll give that a shot tonight too. I wondered if that would matter as well. I had it set for 20 right from the start because I wasn't sure how high it would go. I suppose after the first couple months after seeing the average where it was I could have set it lower. Probably just never thought about it to be honest.

[echo]

Hi ogre, I just read some of your previous posts. You sure had a difficult past, and I hope things are working out better for you now. I can understand if you're frustrated with your therapy because it's not completely delivering the solution you hoped for... BUT I am sure we can help you optimize your therapy given all the data. So I'm glad to see you posting here looking for solutions!

I also wanted to ask, are you doing better? What are your complaints? What would you like to see improved? Daytime sleepiness, fatigue, ...? In the previous post you mentioned that you felt like you were slipping back again. I had that many times, and it wasn't until I found the right combination of mask and pressure that I really started to feel better. My pressure is way different from my titration too, and I need to use straight cpap because I cannot handle the changing pressure of the apap. The final cherry on the cake so to speak was getting treated for hypothyroidism. So my suggestions stem from my personal experience... but also based on the trends we see here on the forum. Some people just do better with cpap, not apap (that will be my next suggestion for you) and some do have other medical issues that also cause fatigue.

But ok back to your data, I hope you can post the graphs...

[Ogre]

Echo,
Yeah, it has been a long road. But to be honest, since the pillow change and the switch to APAP things have been much better. Not anywhere near the fatigue I've had in the past and I've had some bad nights but if my numbers weren't so level I'd be a little more worried. My main complaints right now are the dry mouth and a little fatigue. Maybe I'm just being greedy as far as the fatigue goes and maybe I've gotten as much as I can get. But I wasn't quiet sure on how my numbers really were in the grand scheme of things so I thought I'd post them out here and see what the great people in this forum thought. The one number that did stick out to me was the leaks, I did think that was high but I thought everything else was ok but did seem to remember that if one of my numbers was off it could give false readings on some of the other numbers.