Started CPAP - now I am more tired...

It is difficult to tell from your graphs, but if your blow up of the oximeter graph is showing both O2 (green) and pulse (blue) your big desaturation is an artifact.

A problem event shows up as a spike in pulse rate accompanying the desaturation.

A lack of oxygen in the body triggers a "fight or flight" response and this spikes pulse rate.

Latest data... I can't really tell if I am getting better or not...

I felt sleepy waking up this morning despite having slept for nearly 10 hours... I don't feel sleepy now though.

ugghhh... now the fatigue/tiredness is kicking in again... I never had this before CPAP... it's getting hard to think this is worth it. My sleep study without CPAP showed 8 events per hour and 63 events in rem... but my avg o2 was 94-95 and my lowest was 89 (for a single minute). So if the whole apnea problem is my body sensing o2 going low (or I guess more accurately co2 going high) and causing micro arousals... if my o2 was never going that low then I shouldn't have really been having many micro arousals... maybe the cpap is causing even more...

hard to know what to do... stick with it, and see if I adjust and sleep well with the cpap.... give myself a few days off from the cpap and see how I feel?

I guess maybe I should call to make followup with my doc...

glyphix wrote:ugghhh... now the fatigue/tiredness is kicking in again... I never had this before CPAP... it's getting hard to think this is worth it. My sleep study without CPAP showed 8 events per hour and 63 events in rem... but my avg o2 was 94-95 and my lowest was 89 (for a single minute). So if the whole apnea problem is my body sensing o2 going low (or I guess more accurately co2 going high) and causing micro arousals... if my o2 was never going that low then I shouldn't have really been having many micro arousals... maybe the cpap is causing even more...

hard to know what to do... stick with it, and see if I adjust and sleep well with the cpap.... give myself a few days off from the cpap and see how I feel?

I guess maybe I should call to make followup with my doc...

Not hard to imagine why. If I had that many events, I'd feel like crap, too.

You need some different settings.
If you're going to use a range of pressures, I think you need to open up the maximum pressure by several centimeters. From what I understood of the older APAPs, it needs at least three centimeters of pressure to consider responses. Yours only has enough room to allow the pressure "bumps", which I believe may be disrupting to sleep.
And, if you're willing to use straight pressure, you're going to need more of that, too.
Remember, the main things that will cause an APAP to increase pressures are Flow Limitations and/or Snores.


Den

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STICK WITH IT......I would raise the top pressure to at least 15...maybe all the way to 20 just to see how high the machine needs to go to stop your events. Right now it wants to go higher, but you have limited it to a top of 9.5.

I raised max to 15... though it didn't go higher than 9.8. AHI was 2.43 though! Which seems better... feel OK right now... though I did have coffee this morning because of an early meeting and I don't normally drink caffine.

Anyway... todays graphs...

EDIT.... stats say max press 9.8... but graph shows a tiny spike to 10.42.

It says I leak too much... For mask leaks do I just tighten? it seems like the mast has a big hole in it anyway where air is constantly escaping (and seems meant to escape)... how does machine tell difference between that and leaks around my face?

glyphix wrote:I raised max to 15... though it didn't go higher than 9.8. AHI was 2.43 though! Which seems better... feel OK right now... though I did have coffee this morning because of an early meeting and I don't normally drink caffine.

Anyway... todays graphs...

EDIT.... stats say max press 9.8... but graph shows a tiny spike to 10.42.

It says I leak too much... For mask leaks do I just tighten? it seems like the mast has a big hole in it anyway where air is constantly escaping (and seems meant to escape)... how does machine tell difference between that and leaks around my face?

Well, that's a whole lot different (better) from the ones you previously posted.
Can you handle raising your minimum pressure a bit? Maybe by a .5 to 1.0 cm increase?
You're having few Flow Limitations or Snores for the machine to increase pressures. And, very few apneas. Most of your "events" seem to be hypopneas.

If the events aren't there to drive up pressures, it shouldn't go higher than where it needs to go.

In theory, if the minimum is high enough to squash the snores and flow limitations, it shouldn't have those events to raise pressures. Then, we can see what's left for other events.
I've seen some reports that (seemingly) no amount of pressure eliminates the flow limitations and may actually make them worse, but that may not happen in your case. I think you're heading in the right direction at this point.


Den

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I don't know how much those 1.5 cm. pressure "probes" are affecting your sleep, but they may be something to watch, in case they are.

And, you may need to snug up your mask headgear a bit if it gets too leaky.


Den

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Thanks! I tried upping the min a bit. Here are results.

glyphix wrote:Thanks! I tried upping the min a bit. Here are results.

Well, lets start off with the "How do you feel?" question........
I see some differences and improvements.
It appears you slept for about an hour longer.
You appeared to have fewer Large Leaks.
Even though your AHI was a little higher, there were some variations in most of your numbers.

If it's OK with you, I'd suggest continuing with these settings for a few more nights. One night doesn't make a "trend".


Den

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Thanks! Felt a bit tired this morning, but not overly fatigued in general so I guess all in all on the better half atleast. Will stick with these settings for a while and see how it goes.

glyphix wrote:Thanks! Felt a bit tired this morning, but not overly fatigued in general so I guess all in all on the better half atleast. Will stick with these settings for a while and see how it goes.

Actually, a setting of (about) 9 cm. looks like it might be a pretty good fixed pressure. If, as you progress with this over the next few nights, and the pressures don't take sizable jumps, you might consider gradually dropping your maximum pressure until it equals the minimum. If that eliminates the pressure "bumps", you could find whether it improves your sleep quality.

But, it'll take some nights of looking at reports to see what works.


Den

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Don't hate me I am NOT giving up on CPAP... but by early last evening I was all tired and fatigued again, nearly falling asleep trying to read something... While I excersied I yawned like 15 times, when I normally never yawned before CPAP.

I decided I needed a few days without CPAP, so I could see what my baseline is again. (WRT tiredness/fatigue)... I want to make sure that It's not all in my head and that without the CPAP I really don't have the fatigue symptoms. In the meantime I am still monitoring my o2 sat all night with oximeter. Then I will go back to CPAP and work on finding settings that make things better instead of worse. (Maybe I'm one of those who needs constant pressure, but needed it higher, etc). But I felt I was getting lost and needed to get my pre-CPAP bearings again to know what i should feel like at minimum. And so I can start keeping a better log of how I feel to go along with my daily readings for me (and my doc at the end of the month) to look at.

I tried importing my oximetry data into sleepy head... I see it warns IF you are syncing with CPAP to import that first... I have no CPAP data so I went ahead and just set the start date/time since my device does not keep that info... but then no data shows in sleepy head... I was expecting atleast the o2 and pulse rows... Will sleepy head just not show anything unless there is CPAP data? Does anyone know?
EDIT: I figured it out... normally when I import oximetry data and associate with CPAP I select the previous day even though the start time is really 1am or so. When importing ox data without CPAP I needed to select the REAL day that it was 1am for, not the previous day

I am curious if people think this is a valid o2 drop or not... there is clearly a few second gap in readings just before the first drop... which often results I know in my o2 sensor reading lower o2 than real for 15 seconds... but it does read lower o2 for a full minute... then there is another 30-45 second event.... neither of these times is it accompanied by a serious increase pulse...

This is my only "o2" event of the night. Apart from a 15 second one following a 30 second gap in readings that I am already sure is just a glitch.

glyphix wrote:I am curious if people think this is a valid o2 drop or not... there is clearly a few second gap in readings just before the first drop... which often results I know in my o2 sensor reading lower o2 than real for 15 seconds... but it does read lower o2 for a full minute... then there is another 30-45 second event.... neither of these times is it accompanied by a serious increase pulse...

This is my only "o2" event of the night. Apart from a 15 second one following a 30 second gap in readings that I am already sure is just a glitch.

I don't know, but it was only for a very brief period......and not "seriously" low.


Den

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