Is THIS How You are SUPPOSED to Feel ? More TIRED ?

I have been using cpap for a over a month now and while I can see some improvements in my mood / outlook … I am waking up feeling very tired and then having a hard time getting going in the morning, seems like I am MORE tired than before I started treatment, this usually goes away during the day but it seems like it takes me a lot longer to get fully awake than before I started treatment -- my AHI has been around 4 - 4.6 and when waking up after 7-9 hours of sleep I feel like I could sleep for longer and am still tired when waking up , definitely not waking up feeling refreshed/ energized and ready to tackle the day .. any sugguestions? I did try increasing the pressure but it was uncomfortable ..

So, you started in 2013--but you got stuck with an Escape.
Then you got a different machine a couple of years later.
We have not heard from you since 2015, did you give up?
It appears you are "giving it another shot" now
Hang around--we will try to help you get it right this time.

You have recent notes here (besides this one) that will bring us up to date - can you post this in one of those please?

chunkyfrog wrote: ↑

Thu Nov 28, 2019 2:09 pm

So, you started in 2013--but you got stuck with an Escape.
Then you got a different machine a couple of years later.
We have not heard from you since 2015, did you give up?
It appears you are "giving it another shot" now
Hang around--we will try to help you get it right this time.

Your right, I tried a full mask and it just wasn't working.. but now I am using the nasal mask with more comfort but don't understand why I am waking up still feeling tired even thought once I get woke up ( takes longer ) I am in a better mood than before using cpap .

Did we talk about sleep inertia in your other thread? I don't remember. If we didn't...look it up.

Otherwise we go back to the usual stuff as to why we don't wake up bright eyed and busy tailed.
Hours of sleep?
Quality of sleep?
Medication side effects?
Other health issues that impact how we feel or sleep?

I have never ever woke up and could say I was bright eyed and bushy tailed. I have never ever been a morning person.
The best cpap therapy in the world isn't going to make me into something I never was in the first place.

I looked back at your recent thread, and I’d find it helpful to know more about your pressure increase: from what to what?

Also, are you still on the trail of a data-capable machine? That’d make it a lot easier for the experts to help you.

Although your AHI is below the “mild apnea” level, it still means your sleep may be disrupted on average 4 to 5 times an hour. No surprise if this leaves you tired during the day.

Could you keep your future posts in this thread? That way everyone can see the history, and that can help them give you the best advice.

I started using cpap 3 nights ago, mask over nose and mouth, with memory foam gasket. I also am waking up more tired than before cpap. I've succeeded in sleeping 4 hours with the mask, then another 3 without mask. I wear the mask for 2 hours at a time in the day to get used to it. I also have the DreamWear nasal mask (without the nose plugs) that I've been wearing today, and will try tonight.

Cpap is an adventure worthy of becoming a fantasy novel. I am delighted to find this support group. Onward in the adventure.

More information on me and my cpap process.
I've had an at home study, showing obstructive and central apnea; and in lab study with cpap resolving osa, and only a bit of csa at the end of the study.

Sleep doctor prescribed 11 weeks of at at home cpap on a loaner machine to see if it will completely resolve csa.
So I currently have no access to data the machine is collecting untill my dr appointment at the end of 11 weeks.

I was able to get 2 masks from my sleep center to try out: dteamWear nasal (no nose plugs) and the triangle mask with memory foam gasket. So glad I got both of these before thanksgiving office closure and a big snowstorm closing our neighborhood roads.

I've been wearing a mask for hours each day to prepare my face to accept the mask at nigjt. I've worn the triangle mask 3.5 to 4 hours a night, last night just 1 hr before it woke me with mask burps. Switched to DteamWear for 2.5 hrs then no mask for the last 1.5 hrs of sleep.
Both masks become annoying after several hours so I'm searching for solutions. The triangle mask did not burp the first night when straps were tightly fitted, but the memory foam gasket folded over pressing the silicone against face. So I loosened straps and now it burps often. DteamWear is comfortable with minor annoyances possibly solved, so I can try it again tonight.

I'm grateful for this support group. It takes a village, as they say.

Sunterior wrote: ↑

Sat Nov 30, 2019 11:03 am

More information on me and my cpap process.
I've had an at home study, showing obstructive and central apnea; and in lab study with cpap resolving osa, and only a bit of csa at the end of the study.

Sleep doctor prescribed 11 weeks of at at home cpap on a loaner machine to see if it will completely resolve csa.
So I currently have no access to data the machine is collecting untill my dr appointment at the end of 11 weeks.

I was able to get 2 masks from my sleep center to try out: dteamWear nasal (no nose plugs) and the triangle mask with memory foam gasket. So glad I got both of these before thanksgiving office closure and a big snowstorm closing our neighborhood roads.

I've been wearing a mask for hours each day to prepare my face to accept the mask at nigjt. I've worn the triangle mask 3.5 to 4 hours a night, last night just 1 hr before it woke me with mask burps. Switched to DteamWear for 2.5 hrs then no mask for the last 1.5 hrs of sleep.
Both masks become annoying after several hours so I'm searching for solutions. The triangle mask did not burp the first night when straps were tightly fitted, but the memory foam gasket folded over pressing the silicone against face. So I loosened straps and now it burps often. DteamWear is comfortable with minor annoyances possibly solved, so I can try it again tonight.

I'm grateful for this support group. It takes a village, as they say.

May I suggest that you start a new topic/thread of your own and then we can talk about things without muddying up someone else's thread?

I your own thread please tell us exactly which brand AND model machine you are using.
I am betting we can access your data from the machine if you want to look at it if there is a SD card in the machine.

Pugsy wrote: ↑

Fri Nov 29, 2019 6:27 pm

Did we talk about sleep inertia in your other thread? I don't remember. If we didn't...look it up.

Otherwise we go back to the usual stuff as to why we don't wake up bright eyed and busy tailed.
Hours of sleep?
Quality of sleep?
Medication side effects?
Other health issues that impact how we feel or sleep?

I have never ever woke up and could say I was bright eyed and bushy tailed. I have never ever been a morning person.
The best cpap therapy in the world isn't going to make me into something I never was in the first place.

We didn't talk about sleep inertia but I did look it up .. I guess looking back never have I woke up feeling amazing and full of energy lol .. I usually get about 7-9 on cpap . and normally don't wake up, no med or other health issues, other than this dev septum .. I can tell you that when my nose is more clear I always sleep better and have a lower AHI .. I need to try to get it fixed thats about it.. my AHI has been between 3.5 - 4.5 and others have mentioned that coujld be the cause of me waking up and still feeling very tired .. but whats confusing is I wake up feeling more tired VS if i DIDNT use the cpap .. once i get woke up im ok though ..

While we realistically can't expect over night miracles once we are using cpap we sure don't expect to feel worse.

I have no idea why you are feeling worse with cpap than without but without any real data we really can't offer much of anything in the form of ideas.

Your AHI is higher than I would like to see .....what kind of apnea events are making up that AHI might be something that would shed some light on things. Seeing the flow rate up close might also shed some light on your sleep quality.
Maybe you are having a lot of central apneas for some reason and more arousals that maybe you don't remember. We don't always remember an awakening.

Really, without any data, all we can do is say "maybe this or maybe that" and make guesses but guesses are really kinda worthless.

From what I see in your other threads your AHI has consistently been around 4-7 so far and the highest pressure I see you have tried pressures in 7.4 to 8.2 range. Most of us have lower minimum pressures but that is because our APAP machines increase automatically, your CPAP machine is set pressure so your pressure needs to be higher to account for lack of auto adjusting capability. I would try a pressure of 10 cm.

I see you were mostly using EPR set at 1 or turned off. EPR makes it easier to breath out making it much more comfortable. You mentioned having a deviated septum, that is going to make it more difficult to breath and higher EPR will likely help. I noticed you comment that your AHI was less when changing from 1 to 0, after also changing pressure down from 7.8 to 7.4/7.6. At 7.8 with 1 EPR your exhalation pressure would have been 6.8 cm, with 7.4 cm and no EPR your pressure stays constant at 7.4 cm. This is likely what caused worse AHI because your minimum pressure during exhalation plays a part in keeping airway open.

If you increase EPR by the same amount you increase pressure then your minimum/exhalation pressure will stay the same. At pressure of 10 cm if you use EPR at 3 your exhalation pressure will be 7, EPR of 2 your exhalation pressure will be 8. You can put the mask on and change settings while wearing it to notice the difference, it is fairly significant. I would try EPR of 3 but do what you feel is most comfortable, just be aware you may need a pressure increase for the EPR to be helpful AHI wise.

If you find it harder to fall asleep at 10 pressure try using ramp (if you aren't already). Set the ramp pressure to 7 and ramp time to auto (or a certain time if you know roughly how long it takes you to fall asleep). On auto it will start at 7 and transition up to 10 once you fall asleep. I personally prefer ramp turned off but it is something to try if you find it a bit harder to sleep with higher pressure.

I am getting adequate treatment from CPAP and still feel more tired after some nights just because I am still getting used to wearing the equipment. Like yourself I have noticed although I feel more tired in the morning I have more energy throughout the day which is a sign it is helping you. You should be wearing the mask every time you sleep or nap, if you don't use it(even just for part of the night etc) then you are very possibly undoing the benefits from using it the majority of the time. Even if it makes you more tired to wear the mask all the time eventually you will adjust and it will improve. Once you are used to the equipment and have figured out optimal settings you will likely start feeling better.

Geer1 wrote: ↑

Sat Nov 30, 2019 5:06 pm

I would try a pressure of 10 cm.

What if that AHI is 90 % central apneas?

Pugsy wrote: ↑

Sat Nov 30, 2019 8:21 pm

What if that AHI is 90 % central apneas?

During his original post years ago he was using pressures in 13-14 cm range and had AHI ~1.

Geer1 wrote: ↑

Sat Nov 30, 2019 10:44 pm

Pugsy wrote: ↑

Sat Nov 30, 2019 8:21 pm

What if that AHI is 90 % central apneas?

During his original post years ago he was using pressures in 13-14 cm range and had AHI ~1.

I understand your assumption about years ago but my question to you was "what if his events are central in nature and not obstructive". It wasn't "what was his AHI years ago". We are dealing in the present and not the past and we don't know what that AHI of 1 years ago was composed of.

Have you been following KatieW's recent thread....years ago she just had obstructive apneas easily managed with cpap but her health changed and now she is having a truckload of centrals?

Situations do sometimes change.

Though I do agree that in this situation about the only thing that could be tried is more pressure until if/when he ever gets a full data machine.

I would just add a note to watch the AHI closely though in case it increases instead of decreases and if it does then maybe more pressure isn't the way to go.
Cover all potential bases whenever possible because you never want to advise something that might make things worse without covering that potential risk. While it is unlikely to cause a problem....it's not impossible for more pressure to now cause a problem.