I need some help please

palerider wrote:

araris wrote:I have updated the information. Yes I use sleepyhead. I can post images on here later
My cpap is not showing up even though I have selected it.
I use a remstar auto cpap with c flex

actually, according to the picture you posted, you have a "PR system one REMstar 60 series plus cpap machine with c-flex"

araris wrote:

palerider wrote:

araris wrote:I have updated the information. Yes I use sleepyhead. I can post images on here later
My cpap is not showing up even though I have selected it.
I use a remstar auto cpap with c flex

actually, according to the picture you posted, you have a "PR system one REMstar 60 series plus cpap machine with c-flex"

I know that the machine is an auto cpap... I could be wrong. I was going with what the machine says on it. I know its a system one with c-flex, and I know that it will go into apap phase for 30 days before turning into a cpap. Sorry I am uneducated in this.

robysue wrote:

araris wrote:I was diagnosed with sleep apnea two and a half years ago.

Any idea of how bad the untreated sleep apnea was on the diagnostic study? Even a term like "severe" or "moderate" or "mild" enough.

My dr. said I had a mild case of sleep apnea. he said I stopped breathing ten times an hour, but whenever I entered REM sleep I would have 28-33 apnic events. He set my pressure at 10 originally.

My initial pressure setting was 10 but after trying cpap and having stabbing gas pain I quit it and tried the oral appliance route. I gave up with the oral appliance this pay December.

Why did you give up on the oral appliance? Was it clearly ineffective? Or was it causing problems with your teeth or triggering pain?

The oral appliance was not making my feel any better and it hurt my teeth. I was and still am dead tired all day. I have since found out the I have Mono antibodies which my dr says will make me more prone to daytime sleepiness and fatigue. I also am a little low in vitamin D. 29 on a scale of 30-100. I started vitamin D supps about two months ago. Vitamin B levels are on the high end.
I have been tested for low Testosterone. my GP tested my at 320 which is low and wanted me to start on hrt. I then went to a endo a month later and she tested my and I was at 498 and in the normal range. I personally think my test is low again though becuase I have been experiencing some "other" issues

I have been consistently using a cpap since December 6th 2013, so not quite a year.

Really it's more like you've been papping for a bit more than 1/2 of a year.

True

This new machine tested me for a month and determined I needed a pressure setting of 8.

What machine are you using?

The software in your signature is for a Puritan Bennett Sandman machine, but I was unaware that the Sandman had even a limited auto mode for the machine to determine what pressure you need.

In other words, your description of the machine is for either PR System One Series 50 CPAP Pro with AutoIQ or the newer PR System One Series 60 CPAP Pro. And the GoogleDocs data you shared seems to be from SleepyHead not Sandman.

I am using Sleepyhead. I don't see that as an option to select. I accidentally left it on that

Even though I have been compliant with the new machine for seven months now I still feel extremely tired. Over the pay seven months I have had days where my ahi is under 2 and I have felt amazing. I have even had four days in a row where my ahi is under two but more often than not my ahi is around 4-5 and more recently it's been a little over 5. There is no rhyme or reason to it. I can wake up and it'll be anywhere from 1 to 5.

AHIs to tend to bounce around a bit for some people. But an upward trend that lasts for several weeks or months is something to think about.

I have played with my pressure settings and moved them up to see if my ahi would improve but to no avail.

Dial winging is often less efficient that we want to believe, particularly if you make a lot of frequent pressure changes without knowing what exactly it is that you are trying to fix.

I guess I shouldn't be winging it... I'm just so tired of being tired all the time and having no energy. I used to have abs and was known as the fit guy...Now I''m emabarrassed to take my shirt off. I'm trying to see if another pressure would give my a better AHI, since anytime I am under 2, I feel great. It's just rare that I ma there
'

Question: After changing the pressure, how long do you typically leave the new pressure in place before you change it again?

I have mostly stayed at a presssure of 8. of my 191 days on cpap 114 of those were on 8. 30 days were on the apap setting of 5-18. 19 days at 9. and I just reset the apap again with an 8-12/
Question: Have you also been frequently changing the comfort settings? Comfort settings are the things like C-Flex+, the humidifier setting, and the temperature setting if you are using a heated hose.

I don not mess with the cflex or the humidifer or the heated hose

Before my diagnosis of sleep apnea I was extremely fit. 6 feet 170 lbs. Now I'm about 210. I just started exercising again and eating better two months ago. I stopped exercising and eating well shortly before my original diagnosis off sleep apnea. I'm so tired all day long. My Dr. put me on modafinil about a year ago but now I need more of it to not feel tired.

The modafinil script was written when you were using the oral appliance??

Yes.

As you continue to exercise and eat better, you may start feeling better. There's more to feeling energetic than just getting good quality sleep.

Also, my dr. Never looks at my sleep data, should he? He just tells me that as long as I am under five he's happy.

This is not uncommon. *sigh*

But if there is something in the data that you are particularly concerned about, you may want to bring in a hard copy of the data with you to an appointment with the sleep doc and show it to him and tell him what parts are concerning to you.

It's there anything I can do to improve my ahi. I would love to be able to keep it under 2 constantly

It is a process. But with some work, it's not an unreasonable expectation that you should be able to keep your AHI below 2.5 most of the time.

araris wrote: I'm averaging over six [hours of sleep] a night. I would like to sleep more but many times I wake up and stare at the ceiling. I have studied good sleep hygiene and I try to go to bed at roughly the same time every night. The problem is that I will have bouts of insomnia around four times a month and it throws off my sleeping pattern.

Several questions about your sleep patterns and your insomina:

I always have interrupted sleep. that last time I slept through the night I was a kid. My sleep dr. told me that everyone sleeps different so he is not concerned with my waking up all the time.

Question: When you say you have "bouts of insomnia around four times a month", what do you mean? How long is each "bout"? How often do you have 3-4 days in a row of what feels like insomnia?
I will have insomnia for three or four days and then go back to normal which for me is waking up several times a night. I afraid to get up as I may not be able to go back to sleep.

Question: Are there identifiable trigges for your insomnia? In other words, does stress play a role in how bad the insomnia is?
No triggers that I am aware of.

Question: How would you describe the insomnia? Is it bedtime (sleep onset) insomnia where you can't seem to fall asleep in a reasonable amount of time? Is it sleep maintenance insomnia where you keep repeatedly waking up throughout the night? Is it wake too early insomnia where you wake up early than you want to and can't seem to get back to sleep for the whole rest of the night?
I can always fall asleep immediately. the problem is staying asleep. Once I wake up, I'm always fearful of not being able to fall back to sleep. sometimes I can immediately and sometimes I can't.

Question: Other than trying to tighten up on sleep hygiene, have you ever done anything to try to treat the insomnia? If so, what have you done and how well did it work (or not work)? Have you ever talked to a doctor about the insomina as a separate issue from the sleep apnea?
No I have never taken any drugs. Im afraid of becoming addicted to anything.

araris wrote:https://drive.google.com/folderview?id= ... sp=sharing

As you can see I have played with my settings to see if another pressure would be better for more

There's nothing in the data you posted that screams: FIX ME by dial winging. The one night of detailed data shows a lot of restlessness after the wake at 2:20. The centrals scored during the short session centered around 2:40 are likely sleep-wake-junk (SWJ); it's not clear you ever got soundly back to sleep at that point. Hence the apneas and hypopneas scored during that session are probably not real. The string of events at the beginning of the last session are probably sleep onset or SWJ as well.

In other words, if this data is typical, you need to focus on trying to minimize the amount of time you are AWAKE during your desired sleep period.

Any suggestions as to how? It's hard for my to stay asleep.

Also, would a better machine: vpap, apap, or just a better machine help me feel more rested?
Let me know If you need anything else?

To paraphrase Sludge, you first need to know what the problem you are trying to fix is.

If your AHI is consistently below 5 and you are getting six hours of sleep and you report several bouts of insomnia each month, the problem with your sleep may not be undertreated sleep apnea. It may simply be bad sleep caused by the insomnia. And working on fixing the insomnia may do more good for you in the long run than dial winging and changing machines. In other words, as long as the insomnia is an issue, dial winging and changing machines might not actually change a thing in how you are feeling.

palerider wrote:

araris wrote:

palerider wrote:

araris wrote:I have updated the information. Yes I use sleepyhead. I can post images on here later
My cpap is not showing up even though I have selected it.
I use a remstar auto cpap with c flex

actually, according to the picture you posted, you have a "PR system one REMstar 60 series plus cpap machine with c-flex"

I know that the machine is an auto cpap... I could be wrong. I was going with what the machine says on it. I know its a system one with c-flex, and I know that it will go into apap phase for 30 days before turning into a cpap. Sorry I am uneducated in this.

I am trying to tell you what kind of machine you have, and what to go select on the equipment list for the forum to avoid future confusion.

assuming, of course, that you posted a picture of your machine.

Pugsy wrote:If you are using SleepyHead and getting an AHI number your machine cannot be the PR System One 60 Series Plus Cpap with CFlex...that is model would be model number 260.

It sounds like you have the PR System One 60 Series Pro CPAP with CFlex (I think the equipment menu choice omits the CFlex part and is confusing but all the cpaps have CFlex so it doesn't matter) and that would be model number 460.
If unsure as to exact model (and to avoid further confusion) just look on the bottom of the blower unit for a little sticker with the model number on it. It's a 3 digit number which may have DS or REF in front of the numbers.

araris wrote: I did. I'll change it now