Crisis of Faith...

Hi Folks,

Almost four months on CPAP, and I have been totally compliant and with good attitude and good spirits. But I am having a crisis of faith. I am tired. And I am frustrated that my apnea index is always around 2 - 3, and that I have lots of hypopneas. Between 8-12 an hour. Now I am not sure that the machine reads hypopneas well, so I am inclined to ignore that part. But my PB 240S doesn't give a whole lot of information other than hypopneas, apneas and snoring. My original AHI was 12 but the episodes of apnea were prolonged. Now I don't know how long my apneas are, even if there are fewer than before. And I don't know about leaks.

I switched to the CL2 about a month ago and have enjoyed it. Thought maybe I needed more pressure with it, so upped from pressure of 5 to 6 but my AI is the same. So I went back to 5.

It is a busy time of year so that also contributes to fatigue. I have started feeling the need for naps again in the afternoon and that had improved when I started CPAP. Also, I have been having many more headaches than early CPAP. Is it even connected?

I have mild OSA to begin with. I am frustrated. Maybe I don't need this CPAP???? But my instinct is that I do. Meanwhile, I keep on donning the mask at night. May go back to the Breeze for awhile and see.

Looking for support

AII

AII,
Maybe you shouldn't disregard the hypops. Since you were diagnoses with hypops to start with, the machine might certainly be reporting your's correctely.

How long did you stay on 6? Was it during last weeks miserable weather? Did you change both pressure and mask at the same time?

I sleep and feel worse when when there are more hypops reported by the machine (420E), and had more of those than apneas during the PSG.

Do it one thing at a time: either mask, or pressure.

O.

apneaicinisrael wrote:
It is a busy time of year so that also contributes to fatigue.

Could that be part of the problem Might it just be that you are stressed at this time, causing the headaches and tiredness you are experiencing I've no doubt people without OSA can experience similar symptoms too

In any case, please don't give up on your treatment. Even mild OSA is a serious condition. Remember the good times and let your good spirit get you through this temporary difficulty.

Good luck.

Many times raising the pressure will raise the number of Hypopneas - but you could try it again.

If all else fails, print out the reports and take them to your sleep doctor.

apneaicinisrael wrote: But I am having a crisis of faith. I am tired. And I am frustrated that my apnea index is always around 2 - 3, and that I have lots of hypopneas. Between 8-12 an hour.

Are you saying your AHI is always around 2 or 3? If you are, that is not bad. That is excellent.

My "AI" is 2-3, but that doesn't include the hypopneas at all. That is what is concerning me, really, that I am not taking the hypopneas into consideration. My DME, with whom I did a "home titration test" with an APAP when I started, also didn't pay much attention to the hypopneas. But they concern me.

If my "AHI" was really 2 -3 I , too, would be quite happy. And then I would honestly say that my fatigue is "extra-apneic"!

Thanks for the continued support and input - always, always welcome.

AII

AII~

Just a little more curiosity about your scenario......Are you getting enough hours of sleep per night? I mean at least 7-8? Do you have mouth leaks at all? I have been at this CPAP thing since January, and knew I wasn't a "mouth breather" per se. The Swift pillows force of the air almost blew my mouth open it was so powerful to me that I switched back to a regular nasal mask. My numbers looked awesome, my AHI was usually around 1 or 2, snores still sometimes high but overall the numbers looked great but still after 5 months of 100% compliance I really didn't feel ALOT better than pre-cpap days. I had resigned myself to the fact that I did not need to tape my mouth like other users, because only a few times would I wake up and feel air leaking thru my lips. But finally 3 weeks ago, after still being soooo tired I figured what the heck, I had tried everything else, and guess what? I am starting to feel REALLY good now. My numbers on the data over the past 3 weeks don't really look any different than before mouth taping, but I can DEFINATELY tell the difference. This is just my rationale here, no proven fact, but I think even though my numbers don't reflect much difference, I firmly believe everytime those pesky mouth leaks would occur, it would cause "micro arousals" in my sleep or sleep disturbances have you. Which in turn caused me to not have as restful sleep.

If you haven't tried mouth taping, try it. The first night was a little hard, but now, not a problem at all. Someone here suggested it ( I can't remember who) but to get some of the stickiness off to help with removal the next morning he/she stuck the tape to their forehead first. The next morning, I just SLOWLY remove little bit at a time, and no remaining residue or pain.

I am really starting to feel this working now. I can relate to your frustrations, because I was feeling like after 5 months to still feel so sleepy, I almost wanted to pitch the whole idea and give up.

Hang in there. Try the tape thing if you don't already.

Keep us posted

Suzy

snoozie_suzy wrote:I had resigned myself to the fact that I did not need to tape my mouth like other users, because only a few times would I wake up and feel air leaking thru my lips. But finally 3 weeks ago, after still being soooo tired I figured what the heck, I had tried everything else, and guess what? I am starting to feel REALLY good now. My numbers on the data over the past 3 weeks don't really look any different than before mouth taping, but I can DEFINATELY tell the difference. This is just my rationale here, no proven fact, but I think even though my numbers don't reflect much difference, I firmly believe everytime those pesky mouth leaks would occur, it would cause "micro arousals" in my sleep or sleep disturbances have you. Which in turn caused me to not have as restful sleep.

(bold emphasis mine.)

Excellent point, Suzy. Sleep disturbances are sleep distrubances, whatever the source. I hadn't thought about that possibility as a reason to aggressively control mouth leaks, but...very good point!

Thanks RG!

Like I said, no scientific data here to back up my presumption, but its a plausible idea. I had held off on taping for months, because I thought people that taped only needed to because their mouths were wide open with leaks. Plus my leak data didn't report any signifigant leaks, and the very few times I would wake up I wansn't even sure these small "hissing" sounds through my lips would even register on the "leak data" at all or even decrease the pressure that was keeping my airway open.

If you think about it though, before any of us here on this forum were diagnosed/discovered we had OSA, we were arroused many, many times a night from deep sleep to stage 1 or2 without even knowing we were being disturbed. So it stands to reason, that my sleep might be disturbed MANY more times than just the times I physically wake up with the lip hissing stuff. It could happen every twenty minutes, who knows, I just might not be fully waking to them.

Like I said previously, just my thoughts, can't really back it up with any hard facts.

Suzy

I’m glad I no longer have a mustache. What type of tape do you use? How about a chin strap? This might also come in handy if you don’t want to talk to your significant other.

Snooter

Snooter,

Right now I'm using the 2" wide 3M nylon surgical tape. Its probably the stickiest of the bunch, I might even try the paper kind, but I am lucky I guess because I don't have extra sensitive skin like others have posted on this board. It must be all those years of waxing my upper lip!

I am hoping that ApneacinIsrael (AII) will be able to give this a shot if not already doing so. I know it is infuriating sometimes to be 100% compliant, go through dozens of masks to find the right fit, get the pressure zoned in just right and have pretty decent numbers on their data each night, but not feel completely RESTED.

Suzy

Suzy, thanks for the understanding and the advise. I think you might be on to something. I was NEVER a mouth breather before, but I definately notice that I do get those little hissing leaks now. I don't drop my chin and roar, just the hiss from the corner of my mouth, but apparently it is enough to wake me (sometimes?), because I am aware of it. Hmmm. Mouth taping? And I thought I was one of the lucky ones. But I think I should consider it.

Thanks,
AII

AII~

You're very welcome for the advice. Its not often I am able to give any, seeing that only being a cpap-er for 6 months I don't have as much "mileage" as other users who have been at this for years. I don't know any info regarding your machine, but does raising your pressure more create MORE hypopneas? Because with my Auto, that doesn't happen, at least not in small incriments. If I go to high though, my snores increase and AHI raises. I was just wondering if your pressure could stand going to say, 7cm?

Also, do try the 7-8 hour sleep schedule if you can, that is another thing I have tried very hard to stick to the past month. And on weekends, even though I am able to sleep in later, I try not to sleep in much later than on weekdays, because come Sunday night it throws off my whole circadian rythym thing and sleep cycle.

Will be crossing my fingers, hoping you can get to the bottom of this soon. It is hard not getting results as fast as others are able to. At least that is how I felt sometimes when I logged on to this forum. Some people would report that they felt great after a month, and I'm thinking "I've been at this 5 months, I don't feel better."

I honestly did not think I fit the criteria either to tape my mouth, because I truly thought it was for the people whose mouths flung wide open during sleep, but for months I would wake up sometimes and feel hissing and my lips wouldn't even be open, just through the corner of my mouth. But the tape thing has proven to be a miracle. Not to say I still haven't had a lousy night here and there, but those seem to be more mind over matter, like when I've had a rough day at work, and psychologically I am awoken at night.

Good Luck, please keep us all posted on what happens.

Suzy

AII,

I've been fighting a similar battle trying to get my AHI down. Although in my case, I'm now really only trying to get my AI down. The data I see from my oximeter these days shows me that my HI, which runs around 3 now, is not affecting oxygen saturation. That wasn't always the case though. I've had plenty of "hypopneas" which did cause desaturations.

Over the nearly six months I've been plugging away at apnea treatment I've been able to make gradual improvements. One of the things I've found really helps me to decide whether a problem is real or not, and whether what I'm doing is helping or not, is monitoring with an oximeter. If I see oxygen desaturations, then there's a problem. You might see if your DME or physician can get you a recording oximeter to use for a few days, or even better, for a week or two. It would let you know, for instance, whether your hyopneas were causing a problem or not. They could just be indicative of your breathing pattern.

Also, one of the simple things I've found success with is Poligrip strips. It's a lot less scary than mouth taping, and it has helped me. Mouth breathing, for me at least, seemed to cause some apneas to register as hypopneas. I have no idea whether that might be part of your problem or not, but when I started using Poligrip strips to help keep my mouth shut at night, I no longer see the desaturations which coincide with hypopneas. In fact, I've been able to totally disregard my HI index which still runs around 3.0, but which no longer contributes to desaturations.

Hope this helps.

Regards,
Bill