1.5 years in and really fatigued again

I've been using my autopap nightly for about 1.5 years now. I started with nasal pillows only and that helped for awhile but I switched to the mirage liberty last fall because I was starting to get tired again. The Liberty has been pretty good but the past month has left me feeling dead tired and extremely fatigued during the day; almost like I was before I started using CPAP. I did have one awesome night last Thursday night where on Friday I wasn't tired one bit, but that's the only good day in quite awhile. Here are some graphs and maybe someone can help me make sense of them to see what was different about that one good night compared to a regular night and the last night I used my autopap. I'm also going to get checked out by my regular doc to see if there is something else going on that is making me really tired. Any tips that I could get would be greatly appreciated.

Good Night Stats


Good Night Graph


Typical Night Stats


Typical Night Graphs


Last Night Stats


Last night graphs

The things that jump out at me are "pressure changes", "leaks" and "not nearly enough sleep time".

The pressure changes in particular......can bump you out of your needed sleep stages......as your breathing changes the machine thinks it needs to increase pressure......and puts the person into lighter sleep stages......if not actually awakening the person......and leaving the person feeling unrested (or "fatigued").

Suggestions: Find a narrower pressure range or single pressure (which may also help flatten the leak line) and get more sleep.


Den

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Your leaks are pretty strong - how long have you had your mask and are you cleaning it (or using wipes) routinely? It can make a big difference in how the silicone works. Have you gained weight lately (even a few lbs make quite a difference sometimes)?

Are you on new meds? Alcohol? Different shift hours?

And have you had bloodwork (+ thyroid) lately?

I think, given that it's a respironics machine, that the leaks, while not perfect, aren't too bad. given that the upper line represents total leak, not just excess, which the bottom indicates... most of the time, they're pretty good.

other than that, nothing really says "FIX ME" to me... anyway, maybe a higher minimum pressure, so the machine doesn't take as long to respond to issues, and maybe even head them off in the first place.

So, it looks like your mask is almost a year old? Or have you changed the seal a few times during that period? Maybe a new mask seal, if not. I agree, a higher minimum might be helpful. Definitely keep that doctor's appointment and see if he/she has any ideas.

Actually the leak line is fine. SleepyHead makes mountains out of mole hills when we are zoomed in this close.
Some of the increase you see in total leak is because the pressure has also increased. That top line is total leak and that includes the intentional leak/vent rate and we all know that will increase with pressure increases. It is expected that the total leak line will increase with the increase in pressure so not all of that is excess leak.
The worst it ever got to was a brief spike to almost 50 L/min and while it looks like a mountain of a leak it really isn't.
If we were using Encore it wouldn't be nearly so impressive.
Large leak territory is up somewhere around 80 to 90 L/min with this machine and your mask at your pressures...you never got close.
So unless the leaks are disturbing your sleep...they aren't impacting therapy itself. You are well within the limits for the machine to be able to compensate.

Pugsy wrote: So unless the leaks are disturbing your sleep...they aren't impacting therapy itself. You are well within the limits for the machine to be able to compensate.

Yeah, I was thinking the leaks might have been disturbing his sleep - if that's the case a new mask seal might take care of it (or mask liners if he isn't using those).

I'll try to up my pressure a bit. I replace my mask every 3 months, nasal pillows about every 3 weeks and mouth cushion once per month. I use small nasal pillows and a large mouth cushion. I don't have any liners so maybe that would be a good thing to buy. I never sleep through the night and wake up after 5 to 6 hours. Usually I can go back to sleep after taking my mask off.

Tesseract wrote:I'll try to up my pressure a bit. I replace my mask every 3 months, nasal pillows about every 3 weeks and mouth cushion once per month. I use small nasal pillows and a large mouth cushion. I don't have any liners so maybe that would be a good thing to buy. I never sleep through the night and wake up after 5 to 6 hours. Usually I can go back to sleep after taking my mask off.

I would say that's one of your problems. That and not sleeping long enough WITH it.


Den

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