Wow!

One other thing to consider CollegeGirl is PLMD. Even though you don't have RLS it would be possible to have PLMD with the attendant arm or leg jerks during the night and they could be waking you mildly such that you don't remember it in the morning. Or they could be taking you out of REM sleep with its more restorative sleep patterns.

One other thing to consider is Acid Reflux or GERD. I have an acid reflux problem and was very surprized to learn that it can make cpap therapy ineffective. The acid reflux is not severe enough to cause me discomfort most nights, but it could be enough to cause my soft tissue to swell an become difficult to splint open with cpap. That helped explained why sometimes I felt like I wasn't getting the full benifit of cpap.

I notice you have a cpap Auto. I have recently purchased a biPAP auto and have been using it for a while now. I noticed a huge drop in my alertness and found myself backsliding to the point of requiring caffeine to function. I had a very hard time determining what caused it because I changed masks at the same time, i was also sick or had other outside factors affecting my ability to sleep during that time.

I think I might have tracked my issue down and it surprises me. I took my machine out of auto mode and put it to set values that do not vary. I noticed a difference in how I felt the very next day. I felt great again the second night (last night) and think I might have nailed my issue. I need to get a larger sample to make sure it isn't a fluke or something, but it does look promising. I remember others mentioning getting a better nights sleep in non-auto mode as well.

I had really good numbers in encore pro as well, I supect that when the machine changes pressure I end up waking up enough to disrupt my sleep even though the apnea's are sucessfully prevented. That is a totally unproven guess, but it does make sense to me. I intend to give it some more time and then post about whatever I end up discovering.

WillCunningham,

I also found that using an APAP is terrible for me. I don't feel rested at the best of times with my CPAP but I did a 3-week trial with an APAP and I felt as bad as way back when I didn't have a CPAP at all. I even went to the see the sleep doctor at the clinic and he said that probably the pressure changes wake me up without my realizing it.

Now, in 2 years when I'm allowed to replace my CPAP, I have every intention of replacing it with an APAP. However, I plan to use it in CPAP mode except for if I need to check for changes (ie weight changes, medication changes, etc) to see if pressure needs changes.

France

APAP, might be terrible for you if it,s not set up to work correctly, and some aren't, or if you don't have the software and know how to use it correctly.

As you say if your one of the few that has it set correctly and it doesn't work for you you can turn it off. The options are there. Jim

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CPAPopedia Keywords Contained In This Post (Click For Definition): APAP

I think had it setup correctly, I had my range set to 12-22. I left the PS at 8. I could have experimented more with it, perhaps shrinking the range and playing with the PS settings. I would imagine that making those changes might help. I don't want to experiment with it right now though, at least not till I get back to a fully rested state. My encore numbers were great, I just startetd getting more and more tired as time went on indicating some other kind of problem. I don't want to claim success till I get a few more good nights sleep, but France's experiance and the past couple of nights make me think I am on the right track for my problem. I figured it was something CollegeGirl might want to consider since her profile lists an Auto machine.

I plan to use it more like France, in straight biPAP mode using auto mode occasionally to check for changing pressure needs. It has already proved to be very valuable because it set my 90% high at 18.5cm where my original perscription was for 17cm. I am definately pro-auto, especially given that it can be used in non-auto mode as well.

WillCunningham wrote:One other thing to consider is Acid Reflux or GERD. I have an acid reflux problem and was very surprized to learn that it can make cpap therapy ineffective. The acid reflux is not severe enough to cause me discomfort most nights, but it could be enough to cause my soft tissue to swell an become difficult to splint open with cpap. That helped explained why sometimes I felt like I wasn't getting the full benifit of cpap.

1]auto[/url]

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They can fix the Acid Reflux and stop it cold!

Ask your doctor about a laparoscopic fundoplication.

I had mine done at Mayo in Arizona. Absolutely wonderful!!

Now I can eat anything and never give a thought to reflux.

Wow, what great responses. Thanks, everyone! Let me take them one at a time:

France, I forgot to respond to you in my last post, but give it at least a few months to help with your tiredness before you start looking for other causes. Your body has to have a chance to catch up on your sleep debt before you really start feeling rested. Good luck, and keep at it!

Leaveye, I eat healthily and am very active (I spend ~2 hours per day in some sort of physical exercise), but thanks to a virtually dead metabolism I lose no weight. Dieting only makes me gain weight. (I can't tell you how many people don't even know that 95% of diets fail, and most of those dieters not only put that weight back on, but gain more. I not only have this issue, but, when I diet, my metabolism goes into "lock-down" mode, and I not only don't lose, I start gaining. This is what happens to someone who was put on a diet at age two and not allowed to quit dieting until age 16). So I'm sort of stuck where I am weight-wise for now. Even my doctor agrees, and, let me tell you, getting a doctor to admit defeat with weight-loss is not easy. Still, my blood pressure, cholesterol, blood sugar, etc. are all well within normal ranges, and other than the apnea (that I've had since childhood) and asthma (also since childhood), I'm quite healthy. In short... this is not a viable solution for me right now, but I'm glad it worked for you!

Paul, would PLMD not have shown up in my initial sleep study? If not, maybe that's something to look into.

Will, I only get heartburn once every few months during waking hours. Could it still be causing problems while I'm sleeping without any other symptoms?
If so, I'll have to check into it.

As to the auto, a couple of months after I received it I tried setting it to various "straight" CPAP pressures for a while. No improvement. I've also fiddled around with it in Auto mode, raising the minimum pressure and lowering the maximum. I've tried just about every combination you can think of. I've also tried adjusting CFLEX settings. I'm glad you've solved your mystery, though!

CollegeGirl wrote:I only get heartburn once every few months during waking hours. Could it still be causing problems while I'm sleeping without any other symptoms?
If so, I'll have to check into it.

Sure could. There's such a thing as "silent GERD."

http://www.medscape.com/viewarticle/516189

http://www.entnet.org/healthinfo/topics/GERD.cfm

Thanks, RG. I'll check into it!