Beginning to feel bad again

This is wierd...

I have a Respironics Bipap Auto, but am running it in straight Bipap mode because I seem to get the best results this way. I am using the Swift Nasal Pillows Mask. I have been on Bipap for 3 months and am beginning to see the benefits slipping away...even though I am getting between 7-8 hours sleep a night and my Encore Pro data looks very good. My AHI is consistently between 3-5 and it would be lower if I ignore the data over times when I am awake.

If anything I have lost about 5 lbs, but nothing substantial. (Diet and exercise much improved since pre Bipap). I am 5'11' 185lbs.

I have read in posts on this board that when people begin feeling bad after awhile on cpap that it usually means a pressure increase is a common solution. My pressures are 8/12. I was titrated at 7/11, but bumped it up in my 1st month because I was snoring and this improved my ahi and eliminated my snoring.

If the Encore Pro data looks so good, how come I am not feeling well? I just have that "hungover" feeling and am more tired than I remember since I began Bipap. I have mild headaches again and am waking a couple times a night for restroom break. I am not so tired that I have the uncontrollable urge to nap, but I do have that foggy "polluted" feeling again and am hitting a wall late afternoon.

Is there anything else that could be going on even though my data looks good in Encore Pro? Mask is comfortable and mask leak data looks great and I have no mouth leaks because I tape my mouth shut.

The only other piece of info is that my neck has begun to bother me and my head pillows aren't as comfortable, or I am having a harder time getting comfortable with my pillows (this could somewhat explain the headaches I am experiencing).

Another factor to note is that over the last month I have just gone back to work after losing my job in May (OSA related). I have been working from home and am somewhat stressed starting my own business...this could be a contributing factor, but again, my stats look good and it looks like my Apnea events are under control. Just cannot understand why I am not feeling better than I am.

Oh, one other thing...I have been using Ambien. I first started at 5mg to get me "over the hump" to help me get to sleep on Bipap. I have scaled back to 1.25mg/nt. Very small dose. Still helps me fall asleep. I probably should totally quit as I probably don't need it anymore. Could such a small dosage of Ambien be playing a factor in this?

Anyone have any thoughts on this? THANKS AS ALWAYs!!!

Hi,
My friend just got off a small dose of Ambien. She had felt the exact same way, hungover, sleepy during the day, etc.
She feels much, much better now. The Ambien was the culprit.
I'm voting for the Ambien and the stress being the cause.
Just this week I had the same problem (see post named "suffering".)
I changed my APAP to 9-16. It had been 4-14.
I feel tons better now. The only thing is...my data looked bad, and yours is fine.
I'll let some of the others that know more chime in here, but good luck to you, and I hope you get some help soon.

Hi mesaboog,

This is just a guess, but I think you nailed the problem when you wrote this:

"Another factor to note is that over the last month I have just gone back to work after losing my job in May (OSA related). I have been working from home and am somewhat stressed starting my own business...this could be a contributing factor, but again, my stats look good and it looks like my Apnea events are under control. Just cannot understand why I am not feeling better than I am."

Sounds like your bipap treatment is going well, but stress (understandable!) in your life is getting your sleep out of whack. Cortical arousals (brain arousals kind'a like micro wakeups, but not "awake enough" for you to be aware of them) might be knocking you out of more restful stages of sleep. Having no relation at all to respiratory events, which seem to be well controlled with your treatment.

Perhaps when things get going well in the business you're starting, your brain will simmer down, so to speak, while you sleep. That doesn't help in the meantime, though.

On the off chance that you do need more pressure despite your good data, it wouldn't hurt to bump your bipap up another notch again. If that doesn't help after a few nights, just turn it back down again. But I'm betting it is life in general that's wearing you down at the moment.

Another thought... stress could be exacerbating underlying health issues, if you have (or have had) any.

I had a very similar experiance. I switched to the bipap auto and found myself backsliding and feeling very unrested. The data all looked good for me as well.

I am assuming that in my case the changing pressures in auto mode might have been enough to bring me out of the deep sleep stages, while still prevent apneas. Going to straight bipap mode seems like the silver bullet for me, since I made the switch I feel my energy returning and am waking up feeling rested again.

I suspect RG is right and your problem is probably related to all the changes in your life recently. Stress can do horrible things to a person.

I know how frustrating it can be having a backslide though and wish I had some suggestions for you. You are already in straight bipap mode so that won't be able to help you. I wonder if perhaps shrinking the range of the ipap and epap might help? I don't have any reason to think it would other than my apparent pressure variance sensitivity. I also wonder if you might do well to spend a night or two in auto mode to let it re-titrate you and see if your needs have changed for some other reason.

Good Luck!