increased pressure, now chasing leaks

So, I increased my minimum pressure to 9 several weeks ago. I have been sleeping much better. I feel better every morning than I did before. So no doubt about it I am getting better sleep. I still feel tired, though, and still feel like I am not getting enough quality sleep, even though I am sleeping around 10 hours a night. The first few nights with the higher minimum pressure, I could tell my mask was leaking a lot. I tightened the straps considerably, and then I started noticing my mouth was getting very dry. I started taping my mouth shut at night. That helps too, but I suspect I am still having mask leaks. I don't really know what to make of the Leak Rate chart. Any advice? I think I am going to try a mask that covers my nose and mouth.

Your leaks are minimal in terms of excess leaks.

You just need to understand how Respironics reports leaks to understand the graphs.

Respironics reports total leak...that's the top line on the leak graph...total leaks is the mask's expected intentional leak/vent rate plus any excess leak.
The bottom leak line is a close approximation to excess leak only.
Your pressure is varying a little so the vent rate part of the leak will also vary a little. More pressure equals more vent rate.
The only time you might have had a little excess leak on the graph above was that little blip around 23:30. I suspect a tiny bit of mask movement happened. Nothing huge and unless you woke up from such a tiny leak it isn't enough to hurt anything.
Large excess leak will be flagged by the machine and until you see total leak numbers over 90 L/min the machine can easily compensate for the small leaks.

So unless tiny leaks are waking you up and disturbing your sleep...leaks aren't your problem causing you to not feel as good as you want to feel.

Do you take any medications? If so what?
Sometimes fatigue is an unwanted side effect to our meds.

Interesting to me is that your Sleepyhead chart looks "perfect" but you still don't feel good. Your pressure is set to 9 and it only went as high as 10 - so it seems that you found your optimum pressure given that your AHI is 0.7, you didn't have any "events", only one session of 10 hrs of sleep. You didn't get up to use the bathroom or anything, just a solid night's sleep.

I'm not one of the "experts" here, but that's how I interpret it. My charts are never as clean as yours, my AHI is higher, pressure goes higher, never a calm night. So I wonder what's going on with you? How is your health overall? Is 10 hours of sleep too much? I would feel blah if I slept for 10 hours, way too long for me. More is not better for me, I wake up feeling like I have a hangover. Is that normal night's sleep for you?

Chris8243 wrote: ↑

Mon Jun 17, 2019 6:57 am

Interesting to me is that your Sleepyhead chart looks "perfect" but you still don't feel good.

Chris8243 wrote: ↑

Mon Jun 17, 2019 6:57 am

So I wonder what's going on with you?

There's the rub.
The cold hard fact of life is there is a lot more to feeling the good numbers than just getting them.
Getting good numbers is the easy part. Feeling them is a whole different story sometimes.
There's a lot more to getting good restorative sleep quality than just eliminating sleep apnea events or airway breathing issues.

I always look at medication side effects as well as other health conditions when people say they don't feel the good numbers.
Rule out easy and common first. Sometimes there simply isn't an answer but sometimes there is.

Pugsy wrote: ↑

Mon Jun 17, 2019 7:17 am

Chris8243 wrote: ↑

Mon Jun 17, 2019 6:57 am

Interesting to me is that your Sleepyhead chart looks "perfect" but you still don't feel good.

Chris8243 wrote: ↑

Mon Jun 17, 2019 6:57 am

So I wonder what's going on with you?

There's the rub.
The cold hard fact of life is there is a lot more to feeling the good numbers than just getting them.
Getting good numbers is the easy part. Feeling them is a whole different story sometimes.
There's a lot more to getting good restorative sleep quality than just eliminating sleep apnea events or airway breathing issues.

I always look at medication side effects as well as other health conditions when people say they don't feel the good numbers.
Rule out easy and common first. Sometimes there simply isn't an answer but sometimes there is.

So complicated! Now I'm wondering about my medication. I envy people like my husband who falls right to sleep & wakes up happy. I've never been happy in the morning in my entire life! So hard to wake up. When we first got married that was a shock: his mood in the morning. I guess no one in my family are "morning people" so that was strange. And I get mad at him when he falls right to sleep.

Chris8243 wrote: ↑

Mon Jun 17, 2019 7:56 am

I've never been happy in the morning in my entire life! So hard to wake up.

Some people are "morning" people and some people aren't. I never was a morning person my whole life...never have been.
I think a lot of people expect cpap therapy to turn them into a "morning" person and that's an unrealistic expectation when they were never a morning person to start with. That's a mighty big miracle for the cpap machine to pull off.
Doesn't stop me from wishing that it would happen because my husband is like yours...a morning person but it is what it is and he knew I was a grumpy old bitch for the first few hours in the morning when he married me. We rarely ever plan anything that would involve me moving or doing much first thing in the morning. It's just not a good thing to do. Slow painful death for those that screw with me in the mornings.

I do what I can to give myself every chance of it though....but I don't beat myself up over it when it just isn't going to happen for whatever reason. I am what I am and who I am....

I did discover that my BP meds may be impacting my energy levels somewhat. Probably not the only culprit but fatigue and insomnia are known side effects. Pain itself is fatiguing...so my old arthritis probably isn't helping either. I think that often it's a combination of multiple factors affecting why we don't feel as good as we want to or the numbers say we should.

Do the best you can but don't beat yourself up too much if you feel you come up short...sometimes it just happens through no fault of our own.
Sometimes we just have to live with medication side effects or the fact we are just a grumpy old bitch in the mornings because that's what we have always been.

I have been taking valerian root and melatonin at bedtime. Perhaps the effects of those are lingering through the next day. It's a good idea and one I hadn't thought of. I will try a few nights without and see what my results are. I agree that 10 hours is too much. My best nights are the ones where I fall asleep before 9 PM and wake up before 6 AM. I just don't have very many of those. Maybe one a month. I don't expect every night to be like that, but I do want to improve what I can improve.

jbsims wrote: ↑

Mon Jun 17, 2019 11:23 am

I have been taking valerian root and melatonin at bedtime. Perhaps the effects of those are lingering through the next day. It's a good idea and one I hadn't thought of. I will try a few nights without and see what my results are.

Maybe stop just one, not both at the same time?

jbsims wrote: ↑

Mon Jun 17, 2019 11:23 am

I agree that 10 hours is too much. My best nights are the ones where I fall asleep before 9 PM and wake up before 6 AM. I just don't have very many of those. Maybe one a month. I don't expect every night to be like that, but I do want to improve what I can improve.

Advice from my sleep doc to improve "sleep hygiene" and help break the cycle of insomnia is to set an alarm for the same time every day, 7 days a week. No sleeping in, even on the nights when you feel like you've barely slept. He said to take a shower & get dressed right away, no hanging around in PJs.

Choose the time you to to bed & the time you want to wake up & stick with it. It has helped me. I'm better at getting up at the same time then going to bed at the same time. Some days I'm exhausted and go to bed early, most days I stay up too late.

jbsims wrote: ↑

Mon Jun 17, 2019 11:23 am

I have been taking valerian root and melatonin at bedtime. Perhaps the effects of those are lingering through the next day. It's a good idea and one I hadn't thought of. I will try a few nights without and see what my results are. I agree that 10 hours is too much. My best nights are the ones where I fall asleep before 9 PM and wake up before 6 AM. I just don't have very many of those. Maybe one a month. I don't expect every night to be like that, but I do want to improve what I can improve.

Neither Valerian Root nor Melatonin have shown benefit for sleep quality or quantity. Valerian Root is safe to take if you like it, but not melatonin. There's no reason besides combatting jet lag that anyone should be using melatonin supplements. The absolute truth is, there is no such thing as sleep medication. Only sedative medication, which is not safe. The best way to combat insomnia is to follow these tips:
1. Same wake and sleep time every day
2. No light exposure for 1-2 hours before bed. (Even a few minutes of brushing your teeth with the bathroom light on will drastically reduce your melatonin level). I keep a small warm-hued reading light on my waistband while I get ready for bed (Low light is not safe for elderly, as they may trip in the dar)
3. Temperature control. Make sure you are warm during the day and cool at night. This is extra hard to achieve this time of year because our workplaces are often cooled more than our homes. Wear a sweater during the day if you have to.
4. Cognitive Behavioral Therapy for Insomnia

There are many smaller tips I could give, but these are the big 4. Realize that tips 1-3 are just ensuring that your daily routine matches that of prehistoric life. In other words, in nearly every case, insomnia is NOT a disorder. We are not meant to sleep under the conditions of modern life.

Stay positive, good luck