Newly diagnosed

[Rob108]

Hi, I am a newly diagnosed apnea sufferer. Had a full night sleep study where my numbers were:ahi 108.5/hour. My sleep efficiency was 47.5%. I had sleep staging of N1=49.3%, N2=50.7%, no N3 or REM. My SpO2 mean % = 88%, Minimum SpO2%= 71.6%.
I had a bad 1st titration attempt where I left after 2.5 hours because I felt like I was being drown. I've had surgery for a deviated septum, and have been a mouth breather for 40+years. Went back 2 days later for a "pap nap" where the tech listened to my concerns, fitted me with a full face mask, a day ramped the pressure. That went well so I was scheduled for a 2nd titration study in a week. I stayed all night this time. I waited 2 months to get set up with a cpap machine
Took home a Resmed S9 elite with humidifier & a quattro fx cpap mask (different from the one I wore to be titrated). I've been using it for 28days, at least 7 hours/night (full compliance)
Using this forum I learned how to access my daily stats. My ahi is 2.2 - 3.5 now and I have a smiley face mask leak. Haven't downloaded software yet cause I'm still being remotely monitored.
I go back to the dme /sleep doctor the end of next month.
I still am tired and have no energy but I'm attributing that to adrenaline withdrawal
Should I be seeing (or feeling) more results or do I have an enormous sleep debt looming. My initial sleep study was typical for me cause I can't remember when I last woke refreshed or had any dreams.
Hoping when results kick in some of my other health challenges benefit.

[Pugsy]

Welcome to the forum.

Yes, sometimes it takes some people quite some time before they begin to feel better or as good as the "numbers" on the machine seem to point to how they should feel. It's not solely the AHI that affects how we feel. There's so much more to it than just reducing the apnea events.

You can temporarily remove the modem to get to the SD card and use the software if you wish. Just put the SD card back and replace the modem when done. No one will be the wiser.

When someone says "why don't I feel better" there can be any number of factors involved.
The most common factors are hours of sleep and sleep fragmentation...so you say 7 hours average and that's really good but are you waking often during the night for any reason?
Also the meds we take can impact how we feel either by messing with our sleep or just how we feel the next day.
So do you take any meds?
Any other health issues? Pain?
Bed comfort. Mask comfort. Leaks that wake you up even though they aren't maybe huge leaks?
When was last complete physical? Did they check for the usual things like Thyroid and maybe some unusual things like hormone levels or vitamin D?

Finally sometimes it just takes some people longer than others and often the improvements are so gradual that we don't really notice them until maybe we have to do without the machine for night for some reason. Then we get a rude reminder of how bad things used to be.

So you have to use the mask and machine anyway but it hurts nothing to start doing some detective work to see if something else may be impacting how you feel.

There's lots of other things that can cause "tired and no energy". For me it is pain from some arthritis issues. It causes fragmented sleep for me and it doesn't matter how many hours of sleep I get if I wake up 20 to 30 times a night every time I move in bed. So I have had to work on those issues separately. I would feel like crap even without the OSA with that many awakenings.

[Rob108]

Thanks Pugsy,
I have plenty of other ailments. High blood pressure, Barretts esophagus, svt's, in addition to the "normal" aches & pains of being over 60
I take 5 different medicines for blood pressure, nexium for Barretts and have had 2ablations for the svt's.
I do think I'm being aroused by leaks near my eyes that are too small to mess up the smiley report.
I exercise at the ymca (silver sneakers program) but I'm still overweight
Been so long I can't remember what energy is like.

[STL Mark]

The silver sneakers program is excellent at my local ymca also. You are doing great things and you are sticking with them. Many quit. Pat your self on the back for doing a good job and think of the positive things you are doing. Regarding not having the energy level you desire, talk to your doctors. It may be that you have other issues that are a factor also. But they won't take you serious if you are not compliant on your CPAP therapy, so you will be a lucky one and they will put more effort into looking at other causes.

[Julie]

I would ask your MD to recheck your BP in the near future, because Cpap routinely lowers it in the majority of people, and if you can get off some of those meds I think you'll feel better as a result.

[Pugsy]

Going by the green or red smiley fact on the machine for leak evaluation is sometimes misleading.
Mr Frowny face doesn't show up until 25% or more of the night is spent in large leak territory. That's a lot of leaks. I once had a horribly leaky night when I was trying a new type of mask headgear. Woke up fairly often with the leaks. So I know my sleep was fragmented and when I looked at the leak line it was really ugly but I didn't spend enough time in over 24 L/min leak to trigger Mr Frowny.

So while I doubt leaks are totally to blame for your lack of energy, it is possible that they are playing a small factor in sleep quality.
You will know more when you get your software up and running.

[Rob108]

Yeah, last night one of the quick disconnect came unhooked (don't know how long) & I still had a smiley.

Julie ,
Had my bp checked this week at the cardiologist & it was still high 168/102. At first I thought not getting the adrenaline kick every 35 seconds all night from the apnea /Hypopnea episodes would lower my numbers especially with all the meds I take for that purpose. Not so far . I also monitor my bp twice daily with my own omron unit per my primary care doctor's request.

[StuUnderPressure]

Haven't downloaded software yet cause I'm still being remotely monitored.

In a ResMed S9 AutoSet, you CAN remove the SD card withOUT removing the Modem. I don't see why it would not be the same on the Elite.

Regardless, those modems very often do NOT record the entire compliance period and you will end up having to bring the SD card to them.

[STL Mark]

Personally I believe Rob108 is on the right track with not messing with the SD card while in the monitored compliance period. There is nothing that can be done with the data other than learning how use the program. The negatives are great if an error happens to the data (like unlocked cards in a mac), or the card is not returned to the machine, or the card is returned locked to the machine. One certainly would not want to adjust any settings during this period.

[StuUnderPressure]

Personally I believe Rob108 is on the right track with not messing with the SD card while in the monitored compliance period. There is nothing that can be done with the data other than learning how use the program. The negatives are great if an error happens to the data (like unlocked cards in a mac), or the card is not returned to the machine, or the card is returned locked to the machine. One certainly would not want to adjust any settings during this period.

Yes, an abundance of caution while in the Compliance Period is good advice.
And, I would not suggest that anyone in the compliance period do this.

But, the compliance is for hours used during the required compliance period.
They look at nothing else!

Even if the SD card was totally screwed up & had to be reformatted, the S9 Elite would write all of the information in the machine back to the card. That information in the machine has all of the compliance information in it.

AGAIN, I do NOT suggest that anyone else do this.
But, "I" would want to access my data from the very 1st day & be able to view it in the ResScan Software. But, I also would not change any settings (pressure, etc). But, I would change Ramp, EPR, etc. & any settings that allow me to see ALL of the data the machine produces.

As an alternative and at the very least, I would want the DME to "verify" my compliance as soon as I had met it. They often let it go on for more than the days they need just to make sure they have enough compliant days.

If I knew for sure that I had already met the compliance requirement, I would be contacting the DME for the verification they need to perform.

[Rob108]

I am in a complicated situation. I got my machine while being covered under an employer medical plan but am going to medicare coverage the 1st of august. I was told by the dme I needed to show compliance for both insurers. I can't afford more out of pocket expenses (last year's was $7500 and I'm closing in on that amount this year, $7500 is the max out of pocket /year on the employer plan).
That's why I had to wait almost 60days for official dme follow up.