My First Data Post - Good AHI But Poor Cognitive Function

[miltown]

After lurking on this incredible site for a while, i decided to share a few days of data. After being diagnosed with moderate OSA, I began CPAP therapy over 2 months ago. I've taken to the mask quite well and have a good AHI but my cognitive function is still poor. I constantly have this horrible, disconnected, dreamlike brain fog which effects my personal and professional life greatly.

Below are three recent nights of data. At first, i thought everything looked good. Then i noticed the 'average leak' hovering at 24. What's the difference between the 'large leak' and average leak?

[MaxDarkside]

Give it time. "Cog and Fog" for me are the last things to improve and after 9 months, I still have a ways to go. Cognitively, I have moments of sharpness amongst mediocrity and occasional impairment. By noon I'm good.

[Pugsy]

Large leak is where the leak is so bad that the machine may not be able to deal with the events properly...either allow events to slip past the defenses or maybe not be able to accurately flag any events that might occur.

We are never told exactly where large leak territory is. Respironics machines report total leak which is the intentional/vent leak rate plus any excess (unwanted) leak rate. So you won't ever get a zero leak number because the vent is always included. From past experience large leak territory is somewhere above 75 L/min. If you hit large leak the dark green band at the top would have a light green band during large leak and your leak line will be a lot higher than it is. It is pretty obvious when that happens. You leak line is showing minimal to none leaks right now and points to leaks being very well controlled. Of course if the leaks (even tiny) are disturbing your sleep then that is a different problem but from this report leaks aren't an issue at all.

On paper....your therapy is optimal. You have read the drill...sometimes it just takes time for us to see the improvements we wish to see. While giving it time, since you have to use the machine anyway, use the time to investigate any other reasons why you don't feel like you are feeling as good as the reports say you should feel.
If there are other issues unrelated to OSA that are causing some less than desirable symptoms remember that the cpap machine only fixes apnea related issues. It doesn't fix other problems which might affect how a person will feel. There are lots of things that can and will affect how we feel the next day.
Meds, insomnia, pain, fragmented sleep, general health issues, bed comfort, mask fit and comfort, hormone levels, and the list goes on and on. Isolating and fixing any of those possible issues is much harder work than just slapping the mask on.

[jnk]

Give it time. "Cog and Fog" for me are the last things to improve and after 9 months, I still have a ways to go. Cognitively, I have moments of sharpness amongst mediocrity and occasional impairment. By noon I'm good.

Nice post. Even though it appears to have been made entirely ante meridiem.

[robysue]

Below are three recent nights of data. At first, i thought everything looked good. Then i noticed the 'average leak' hovering at 24. What's the difference between the 'large leak' and average leak?

Your leak lines are superb.

Your profile shows you are using a Swift FX pillows mask. Here's the leak chart for that mask:

At your pressure of 9cm, the expected leak is 30 L/min (plus or minus about 5 or 6 L/min)---i.e. the expected leak rate for a particular individual can range from about 25 L/min to about 35 L/min. Your leaks are running just below that range, but sometimes that happens. The main thing is your leak line is nice and flat and not well over the expected leak rate.

For more information on interpreting leaks in Encore, see A primer on looking at System One Leak lines

As for the brain fog, sometimes it just takes time and more time.

Do you think you are sleeping well in the sense of sleeping soundly with few or no wakes during the night? If so, just give it more time.

[miltown]

Thanks for the replies! Such a wealth of knowledge some of you have.

Pugsy you bring up a great point about other possible health issues. That's exactly what i was thinking recently...if i adapt to CPAP well, am 100% compliant and the data is optimal then perhaps i need to look into other areas as well.

Robysue - i should have indicated this earlier but no (see - brain fog - i forgot )- i don't always feel like i sleep soundly through the night. Actually i rarely feel that way since starting therapy. I will usually wake up anywhere from 4 to 10 times. 10 times would obviously be a bad night. I wake, adjust mask or pillow and then roll over to a different side.

[MaxDarkside]

Nice post. Even though it appears to have been made entirely ante meridiem.

No, I'm not anti-merriment (LOL). Hehehe... OK, now it's past noon. On the "Cogometer" I'm running a 5 on a scale of 0-10

Pugsy you bring up a great point about other possible health issues. That's exactly what i was thinking recently...if i adapt to CPAP well, am 100% compliant and the data is optimal then perhaps i need to look into other areas as well.

Ya, eliminate this cause, give your body time to adjust/repair (may take numerous months for "Cog n Fog" to rise to a new normal) and then look at the residual maladies, go after the next "big one" that is treatable.

[Pugsy]

Fragmented sleep itself (no matter what the reason) will sure give us some less than desirable symptoms the next day.
So those frequent awakenings will mess with the normal restorative sleep cycles. If you can isolate a possible cause for the awakenings and try to limit them then you would stand a better chance of feeling the improvements that you think the reports should be showing.