Still tired after all these years...

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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robysue
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Re: Still tired after all these years...

Post by robysue » Sat Mar 15, 2014 3:54 pm

Sandra_ON wrote:Have you or the doc or the DME looked at the data on the SD card???? And do you have a follow up scheduled?

Yes, I go to the RT monthly and he checks my card. I started at a pressure of 9, he put me up to 10 and then back to 9 as I was experiencing breathing problems and heaviness in my chest. Everything else looks fine.
Have you seen the AHI data and the leak data for yourself? Or are you just taking the word for the tech at the DME who's telling you nothing more than, "things look fine"???

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Machine: DreamStation BiPAP® Auto Machine
Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear
Additional Comments: PR System DreamStation and Humidifier. Max IPAP = 9, Min EPAP=4, Rise time setting = 3, minPS = 3, maxPS=5

Sandra_ON
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Re: Still tired after all these years...

Post by Sandra_ON » Sat Mar 15, 2014 5:16 pm

Have you seen the AHI data and the leak data for yourself? Or are you just taking the word for the tech at the DME who's telling you nothing more than, "things look fine"???

I stand over his shoulder when he's reading my card. I see the sleep doctor in May and then I get my own machine. I have a free one right now (since Jan). He points out what's happening and brings things to my attention.

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coffee
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Re: Still tired after all these years...

Post by coffee » Mon Apr 07, 2014 8:04 pm

Thanks for all of the suggestions and assistance!

I'm now set up to read the data from my sleep machine via encore basic.

This is the summary for the past eight months:

BiPAP autoSV Summary
Average Peak IPAP Pressure - 11.4 cmH2O
Average Percent of Night in Periodic Breathing - 0.9%
Average Time in Large Leak Per Day - 35 mins. 40 secs.
Average Breath Rate - 13.8 bpm
Average Tidal Volume - 433.4 ml
Average AHI - 4.0
Average Peak Flow - 25.2 lpm
Current Backup Rate - Auto

My sleep doctor claims that an AHI of around 5 is "normal".
She feels that data similar to this is proof the PAP therapy is working.

Anyone see room for improvement in these numbers?

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robysue
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Re: Still tired after all these years...

Post by robysue » Mon Apr 07, 2014 9:26 pm

coffee,

While an AHI around 5 is right at the cutoff between "normal" and "very mild apnea" on a diagnostic sleep test, many of us feel better if our long term AHI is lower than 4 or 5. So figuring out how to get the AHI down closer to 2 or 3 might make a difference.

Other things I notice in the data you post:
This is the summary for the past eight months:

BiPAP autoSV Summary
Average Peak IPAP Pressure - 11.4 cmH2O
Average Percent of Night in Periodic Breathing - 0.9%
Average Time in Large Leak Per Day - 35 mins. 40 secs.
While an average of 35 minutes of large leak time doesn't sound like that much, it could be indicate that for much of the night you are leaking at rates that are high enough to disturb your sleep, but not high enough to be flagged as a large leak. To give you a comparison: I've been using a System One BiPAP for 3+ years now. And I've had no more than 3 or 4 official large leaks in all that time. And none of them lasted more than 5 or 6 minutes.

If I were you, I'd strongly consider downloading Encore from the links in the Private area part of the forum and I'd look at the at the data myself every day for a while.

It could be that your daily AHI is varying substantially from night to night, but the long term average is about 4.0. And if your AHI is often higher than 4, that might (partially) explain why you're not yet doing any better.

I'd also look at the leak line every night for a while. Again, while you are averaging only about 30 minutes in large leaks per day, it could be that on some nights your leaks are a lot worse than that. And on other nights, you could have pretty important leaking that doesn't quite meet the (unknown) definition for Large Leak on the System One machines. And leaks can disrupt sleep even if we don't remember them waking us up.

It's also worth talking to the docs who prescribed the high blood pressure med(s); some of them can interfere with getting high quality sleep. It's also worth talking to both your sleep doc and the PCP about getting tested for all the usual suspects other than OSA/CSA that cause significant daytime sleepiness and daytime fatigue.

_________________
Machine: DreamStation BiPAP® Auto Machine
Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear
Additional Comments: PR System DreamStation and Humidifier. Max IPAP = 9, Min EPAP=4, Rise time setting = 3, minPS = 3, maxPS=5