Having trouble on high pressure, still tired, please help!!

[sickwithapnea17]

I've been diagnosed with SA for over a year now and have been on bipap but the 18/14 auto is uncomfortable and makes my lungs work and I'm still tired and have no energy. I was on a 10cm cpap setting and that was much more comfortable- I can't fall asleep at 18/14 so I use a 45 minute ramp but still I take the mask off in the middle of the night. I also have high blood sugar and may have gotten diabetes.
For years I've been waking up with my heart pounding and rapid breathing, but I wasn't tired until recently- I could still work and study. I also had the high blood sugar recently. I was looking into tonsil surgery with laser procedure. I heard of one that removes the excess tissue in addition to the tonsils and adenoids.

Thanks very much!

[sickwithapnea17]

I don't think my desktop has a card reader and I can't afford to buy one now. If I send the card to the doctor will they give me a report? Does a labtop read cards?

[Pugsy]

What machine do you use? What type of data card is in the machine?
Large data smart card that looks like credit card? Those need a special card reader.
Small data card ..SD card (like those in cameras)...if the computer has a slot for the SD card nothing else is needed and yes many laptops have this slot. If no slot then card reader adapter is needed to plug into USB port and it is not expensive $10 at walmart or less online.

[JDS74]

I've been diagnosed with SA for over a year now and have been on bipap but the 18/14 auto is uncomfortable and makes my lungs work and I'm still tired and have no energy. I was on a 10cm cpap setting and that was much more comfortable- I can't fall asleep at 18/14 so I use a 45 minute ramp but still I take the mask off in the middle of the night. I also have high blood sugar and may have gotten diabetes.

Did you have a second sleep study or titration that lead to the change in therapy?

Do you have or can get your sleep study reports? It will be very helpful to compare the first one that got you the CPAP and 10 cm H2O therapy with the second one that got you to BiPap and 18/14 therapy.

The important numbers to compare are the Obstructive Apneas between to two studies.
Also look at the O2 saturations/desaturations so see how that is going.
The studies may show that, like me and others on this message board, you have complex sleep apnea. The studies will show,in adddition to the Obstructive Apneas, Central Apneas and that may account for your being still tired in the morning.
It happens that pressures for successful treatment of Obstructive Sleep Apnea leads to the development of Central Sleep Apnea as well.

CPAP and BiPap machines don't treat Complex Sleep Apnea very well but careful titration can help.

You might want to think about either getting your own Pulse Oximeter so you can see your oxygen levels during the night or asking your sleep doc to loan you one for a two to three day at home study. The CMS50 ones available on-line do a good job.

Your reaction to the higher pressures may suggest that a slower approach to them is needed. Talk to your doc to see if you can set your machine to lower numbers for a while and then gradually move them back to the 18/14 as you get used to the higher pressures. Changing from a straight 10 cm to 18/14 BiPap is a big jump and it sometimes takes a while to get used to the higher pressures.

If you can produce your own reports, it will be easier to see how this approach is working.
To echo one of the earlier posters to this thread, please click on User Control Panel and then select your equipment and use TEXT as the display mode. That way the correct software to help you can be suggested.

[Pugsy]

That way the correct software to help you can be suggested.

OP has the software. I think we are waiting for SD adapter for computer. Not sure though.
Pretty sure the machine is PR S1.

[sickwithapnea17]

thanks so much!!! I just suddenly started to be tired about 2 years ago. I don't know if it was correct to jump me from 8cm CPAP to 18/14 philips auto bipap but the bipap study says that I am getting 0 OSAs and only central apneas now. Also it says my O2 was dropping down to 73% for a short time, but I've seen so many doctors and exercised and went on low carb but still having trouble getting sleep. The O2 on 5 liters/minute does help and make a difference for me

The high pressure seems to make me tired because it makes my lungs work hard. What kind of sleep apnea do they use a bilevel setting of 10/4 for because that seems better and more comfortable?
My machine is also stuck on 2cm pressure differences so a 18/14 is really 16/14 for some reason
thanks so much! I'm still suffering for years from this terrible disease and chronic fatigue. I also may be developing diabetes and have high blood sugar

[sickwithapnea17]

oh and for years sometimes I would wake up rested and fine but I would have this I think it was chest congestion and rapid breathing but at least I was rested and now I can't get rest?

[sickwithapnea17]

thanks so much for the posts! OK I got the encore data from 4/21-9/6 and the most severe problem is clear airway apnea which is as high as 9 and then the hypopnea RERA indices which max at about 2 so I don't know what to do about the CA?
oh and the higher pressures on the report reduce the CA to under 2 but at about 15/12 average not 18/14
ugh I got food poisoning again from bad spinach....
so the cas are probably centrals? I really feel better it seems on bilevel 10/4 than 18/14 auto but maybe I need an ASV since I am sometimes having up to 9 cas on the graph
the O2 machine really helps set to 5.0 liters
the other bad problems I have are memory loss and trouble concentrating even a little....somedays I take one class and I don't even have energy to do anything else that day

[cflame1]

you really need to speak with your sleep doc (and if you don't have one... get one!)

messing around with pressures when you're throwing what are potentially centrals is not a good thing.

[gasp]

I also recommend you have a physical with your physician and let the doctor know about your rapid heartbeat and congestion. You need to have serious health issues ruled out while you address your apena therapy. It is possible that issues such as asthma, COPD, heart disease can cause the symptoms you describe. Treat these symptoms seriously and seek medical attention for those symptoms if for nothing else to know you don't have any serious health issues. Then the sleep doctor will also know and assume the apnea therapy pressure etc., is the cause of your symptoms.

[archangle]

Sick, please fill in your profile with your machine and other equipment type. There's a link below this post.

[sickwithapnea17]

I woke up again with the mask off and I tried sleeping for a few hours without bipap and I was nauseous all day and tired and had ADD even though I got a lot of sleep. I guess I am just dependent on bipap now forever. I have memory problems still also
even though the card in my bipap seems to say my clear airway apneas are only 9 sometimes I don't feel rested every night.

[cflame1]

I woke up again with the mask off and I tried sleeping for a few hours without bipap and I was nauseous all day and tired and had ADD even though I got a lot of sleep. I guess I am just dependent on bipap now forever. I have memory problems still also
even though the card in my bipap seems to say my clear airway apneas are only 9 sometimes I don't feel rested every night.

Like I said above swa17... go and see your doctor... get them to explain the 9 CA's to you. Get them to do something about it.

[sickwithapnea17]

the same thing happened I took the mask off at night and woke up on 18/14 without sleeping more than a few hours and I still can't fall asleep right away on 18/14, I have to set the ramp to start on 4.0
maybe I need to go wtih 16/12?
well I've seen several pulmonologists at this one office and they just ignore me and tell me to keep the settings the same usually- my doctor isn't a sleep doctor
but I'm happy with them since I got the O2 machine
maybe a sleep doctor can adjust my settings so that I get better sleep

[sickwithapnea17]

anyway I'm asking here because my doc don't give me any info!