having problems with fatigue

[shell174]

Hi everyone,

I've been on CPAP therapy for over a year now. My AHI is 6 and my pressure is 7. I have the Fisher & Paykel 604 machine not data capable. I'm using the ResMed Quattro FX mask.

The problem I've been having is fatigue. I also have hypothyroidism and an autoimmune disease. Well, I've got my thyroid hormones corrected and the fatigue is still there.

I feel very frustrated my CPAP therapy. I know I have mild apnea. I've tried a couple of masks, but with my machine there is no way to tell if my mask is leaking.

Anyone have any advice. I'm feeling frustrated.

Thanks in advance,
Michelle

[Pugsy]

Off hand without knowing if the AHI of 6 is from maybe too little pressure or leaks I would suspect the AHI number.

6 isn't all that bad but some people need as little as AHI of 2 to really see the difference in energy levels.
I felt really crappy at AHI of 5-7 and noticed much more energy at AHI less than 2.

Just a thought. Of course their are other factors that could be affecting things but the first thing that I would suspect that might need some work is the AHI of 6.

[Wulfman]

Hi everyone,

I've been on CPAP therapy for over a year now. My AHI is 6 and my pressure is 7. I have the Fisher & Paykel 604 machine not data capable. I'm using the ResMed Quattro FX mask.

The problem I've been having is fatigue. I also have hypothyroidism and an autoimmune disease. Well, I've got my thyroid hormones corrected and the fatigue is still there.

I feel very frustrated my CPAP therapy. I know I have mild apnea. I've tried a couple of masks, but with my machine there is no way to tell if my mask is leaking.

Anyone have any advice. I'm feeling frustrated.

Thanks in advance,
Michelle

I presume that AHI of 6 was from your sleep study and pre-therapy.......

My advice is to get a machine that has data capabilities and the software to see what's happening with your therapy.

Wouldn't that seem like a "logical" step to take?


Den

[Pugsy]

I agree with what Den says. I hit the submit button just as I thought the same thing.

Is it possible for you to get a new machine? If so, that would be the optimal way to go with data capable machine and software.

If not possible either talk to the doctor about this and/or consider a very small increase in pressure and hope that leaks are under control. Flying blind without data but sometimes better than not flying... In your initial sleep study was there any mention of central events? If so, talk to the doctor before messing with pressure.

[Guest]

I was able to get an APAP machine today for a week as a loaner. I used it for an hour for a nap and it is showing AHI of 5 and a leak rate of 60.

The auto pap will titrate the right pressure, is that correct?

[Pugsy]

I was able to get an APAP machine today for a week as a loaner. I used it for an hour for a nap and it is showing AHI of 5 and a leak rate of 60.

The auto pap will titrate the right pressure, is that correct?

Which machine? Brand name.
Makes a huge difference when looking at that leak rate.
What settings on the Auto machine? Your cpap pressure isn't all that high but if it is set wide open 4 to 20, it might not have enough time to get to your usual 7 cm and ward off the events.

Which machine also makes a difference on which software to get.

[Guest]

Which machine? Brand name.
Makes a huge difference when looking at that leak rate.
What settings on the Auto machine? Your cpap pressure isn't all that high but if it is set wide open 4 to 20, it might not have enough time to get to your usual 7 cm and ward off the events.

Which machine also makes a difference on which software to get.

It's a Fisher & Paykel SleepStyle 200 APAP. I looked up the leak rate and it said that 60 leaks or below is acceptable.

They set the machine at 5 up to 20 for the pressure.

[Pugsy]

F & P, not easy to get the software. I do think their leak rates allow for a generous leak and still be okay. Don't know how they figure it but I think it is total leak. Maybe someone using this machine can clarify about the leak.

I assume this is trial from the DME. Use it and see what they come up with after the trial period. The hour long nap and AHI of 5 is really not much different than your AHI of 6 with the other machine.
One hour is short time though.

[Guest]

I assume this is trial from the DME. Use it and see what they come up with after the trial period. The hour long nap and AHI of 5 is really not much different than your AHI of 6 with the other machine.

Thanks for responding. The AHI of 6 was my result from sleep study. Unfortunately, I have a CPAP that is not data capable.

[Pugsy]

Thanks for responding. The AHI of 6 was my result from sleep study. Unfortunately, I have a CPAP that is not data capable

AHI of 6 during the initial sleep study or AHI of 6 is what they came up with at the titration part of the study?
Were there other issues like low oxygen levels or other respiratory or sleep disturbances?

[Guest]

[quote][Were there other issues like low oxygen levels or other respiratory or sleep disturbances?
/quote]

I mainly have my apneas during REM sleep. I had about 20 apneas during an hour of REM sleep.

[Pugsy]

I mainly have my apneas during REM sleep. I had about 20 apneas during an hour of REM sleep.

Let's see what a full night of data will bring. One hour nap doesn't allow for much REM if any. I too am worse in REM.
About 12 events per hour in non REM sleep but over 50 /hr in REM. I found that even with an AHI of 5 when I looked at the reports the bulk of my events were occurring in 3 or 4 clusters during the night, during a time frame that loosely coincided with REM sleep. With an AHI of 5 I felt awful. When I raised the minimum pressure just a bit I found the APAP could better address those REM events and it brought my AHI down below 3 and I could tell a difference.

Wish you could have got a machine where you could use the software but after a week the DME can download the data and see if the pressure wants to go up higher to try to address those events. The minimum of 5 may not be enough to allow the machine to have enough time to address those events. If your titration study was like mine, I didn't get much REM so my worst part of the night wasn't really ever address and I came out with an 8 cm pressure recommendation. Once I changed the minimum to 10 I could see marked improvement in both the AHI and how I felt.

I am not suggesting that your situation is like mine or even that you need a higher pressure but it sure could be a possibility.

Also bear in mind that even with the best of numbers if we have other issues that affect the restorative powers of our sleep that we might still have those issues if they are not related to OSA. So we can get "good" numbers and therapy yet still feel like crap. I have a very bad back and neck. Lots of pain. Lots of tossing and turning. Lots of wake ups from pain. That fragmented sleep also impacted how I felt over all. So sometimes it is a combination of things that affect how we feel.

Give the APAP the week and watch the numbers to see how it goes.

[3HQ2ML]

After 4 days on the Auto Cpap, I felt alive again. The first night I had lots of REM sleep. I took the loaner back and they adjusted my pressure from 7 to 9.5. The problem now is that I'm starting to feel crappy again back on my machine.

They tested the pressure on my machine and everything is fine. My mask leaks were acceptable. The RT did tell me that my pressure did go up to 11 sometimes on the Auto CPAP.

Anyone have any idea why I would feel so much better on the Auto CPAP?

I guess I need to make another appointment with my sleep doctor. I just want to feel good again.
Thanks in advance,
Michelle

[Pugsy]

Michelle,
Without knowing what machine you are using, all the settings and data, we can't offer much of anything.
Software reports?

I get the impression the APAP was used as titration tool and they now gave you something else??? If so what?

[LX4KP]

They gave me a loaner Auto Pap F & P 200. The first night on it I had 3 AHI per hour. The second night I had 2 AHI's per hour. I was down to 1 AHI per hour on the last two nights I had the machine.

I don't have the readouts from the loaner machine. The RT said that my pressure went up to 11 on the Autopap. He ran a report and it said that my pressure should be at 10.

The RT set the pressure on my F & P 600 cpap machine at 9.5. I can't tell if I'm having AHI because I don't have a data capable machine. I'm sorry I'm not that knowledgeable about sleep apnea, mostly because I don't get any feedback from my machine.

I pretty much have all my apneas during REM sleep.

So, I've been using my cpap at the new pressure of 9.5 and I'm back to feeling crappy again. Seriously, I feel depressed.

Does anyone know why I feel so much better on the Autopap than my CPAP. Obviously, I'm having less apneas on the Autopap.

I thought once I got my pressure increased, I would feel better.