Newbie after some help

Hi guys,

First of all just finding this website sounds like a god-send as I've been on CPAP
for 2 years and struggled with finding doctors who care to help. So thank you so much to everybody
on here helping people.

I had an AHI of 32 in my initial sleep study. upon starting CPAP it had dropped to around 5
My Sleep technician was never interested in changing any settings except for the ones that came standard on the machine.
He was not interested in removing the SD card when i asked him to look at the data closely.
I have since moved away and have struggled to find any doctor willing to look at my data , they only seem interested
in charging me another $1000 to partake in their sleep studies. Even a local resmed clinic took the machine, opened the machine settings and
said to me "wow ive never seen ramp turned off before, everything looks fine"

I still feel as bad, if not worse most days than prior to beginning treatment with a CPAP machine. daytime sleepiness, chronic fatigue etc.
I'm hoping somebody may be able to help me interpret my data and move forward feeling better.

I have uploaded some results prior to me fiddling around with settings myself. aswell as after where I noticed a drop in AHI but feeling worse
upon wakening and throughout the day.
Thank you so much in advance if you can even attempt to help me its much appreciated.

Prior to me messing around with some settings;

https://ibb.co/9Wt0pyd
https://ibb.co/pnnFCy9
https://ibb.co/6F2NsSZ

https://sleephq.com/public/940a80da-1ac ... 7184691e2d

https://sleephq.com/public/a9cf5bc3-5b3 ... 6b761caa92

https://sleephq.com/public/c0b779ec-6cc ... 8dfe3ac808




-----

After i tried changing some settings;

https://ibb.co/MVJsYLk
https://ibb.co/nkGvRhH



https://sleephq.com/public/ab4dcc13-633 ... 727c6c1257

https://sleephq.com/public/45b32a9a-ec5 ... 522f452ed3






I use a resmed autoset 10, resmed n30i nasal pillows/mask
I sleep for a good amount each night, and wake feeling completely unrested and suffer daytime sleepiness to the point it affects my work.

Thanks again.
Jake

How many hours of actual sleep are you getting?
Do you wake frequently during those hours of actual sleep? If you do wake often...any idea why?

Do you take any medications of any kind? If so, what?

Do you have any other physical or mental health issues going on? If so, what?

Thanks for the quick reply,

I don’t wake up at all during the night I sleep through. Maybe once or twice on a random occasion I may wake.
I aim for 8 hours sleep a night and am fairly consistent in trying to get that.

No medication at all, I drink alcohol on occasions maybe twice a month. and my AHI is usually lower on those days. (Could be just something weird I have noticed could be coincidence)

No physical issues, in good health otherwise.
Suffered depression from time to time. Anxiety also. But last 2 years during cpap they have been very mild.

Thank you for the extra information.

I don't have time right now to dig deep on those reports but will try to do that later today but some of the other members will likely chime in as well or they may have additional questions.

From a quick glance though...on the couple of reports that I did glance at....Nothing seems to be screaming "fix me and you will feel those good numbers".

My plate is over full today...probably be later this evening before I have the time to do some deeper digging on your reports.

A word about alcohol and lower AHI....actually fairly common and we don't really know why except sometimes when someone's diagnostic sleep study points to REM worse that the AHI is lower after consuming alcohol it's because we don't sleep nearly as good as we might think after consuming alcohol so we don't get much REM sleep and the AHI is lower because we don't get a lot of sleep when/where the OSA might be worse.
Read this.
https://www.sleepfoundation.org/nutriti ... -and-sleep
BUT I doubt alcohol is a big factor in your problems because you aren't all that frequent of a drinker.

Also...just because you don't remember awakenings doesn't mean they didn't happen. Just means you weren't awake long enough to form a memory. Obviously if you did remember them then we might have a culprit to look at with more interest.

Another question before I have to go....
Have you ever had days where you didn't feel tired or sleepy after a night of cpap use where you got 7 or 8 hours of sleep.....or has it been where you just have never ever felt the nice low numbers?
What is the lowest AHI you have ever had excluding the nights where alcohol was consumed?

Can you also post a screen shot of the OSCAR Statistics page and make sure you include the bottom area where you see "changes to device settings"?

Honestly, thank you for even trying, take your time I appreciate you even looking.

Lowest AHI I’ve ever had excluding alcohol was 1.5ish. (That’s a strange one about the alcohol and AHI too , good info )

Have I ever felt good on CPAP? Absolutely, it’s rarer than feeling bad though, a lot rarer. But definitely does happen. I think it’s so disheartening because sometimes I do feel great but majority of the time I’m tired . I wish I could figure out exactly where I’m going wrong

Some more backstory; (I didn’t think to mention this before)
I have obviously had sleep apnea for a long time, but I did not seek help for it as the initial reason I got diagnosed was through an ear nose and throat specialist who noticed I have overbite in my jaw and it could be a reason to me not feeling so good at the time, so long story short I went to a sleep specialist and did the study on that . So the jaws always had overbite. But prior to cpap how I remember feeling in a morning was energetic and springing out of bed. I’ve always worked long hours trouble free.

I feel as though sleep apnea and CPAP was diagnosed on accident, I clearly need it judging by the severe AHI during the study, but I can’t help feel I felt better prior to treatment. I have tried sleeping without the machine a handful of times over the last 2 years when I get fed up with the randomness of feeling okay. But I usually feel worse without the machine.

Now when I sleep with no machine I wake up gasping, usually with dry skin on my lips . It’s really strange as I never ever had that experience prior to CPAP.

statistics page

https://ibb.co/JssjtCV

Jake, do you know the breakdown of your AHI in your sleep study? (Obstructive apnea, central apnea, hypopnea.) And what kind of study was it: at home, or in a sleep lab?

I think as it happens you had the same settings in all the charts you posted. When you raised your minimum, or used a fixed pressure higher than 8.6, did the breakdown of your AHI change? I'd be especially interested to know whether you had fewer OAs and more CAs.

There's some clustering in your events. Occasionally this can reflect something about a person's sleep position. Do you sleep mostly on your sides? Sometimes on your back? Do you use a high pillow (or several pillows)? Do you sometimes tuck your chin down toward your chest?

Finally, during the day are you mostly sleepy, or do you often feel fatigued as well? Sleepiness includes an urge to sleep; fatigue is weariness or the sense that any exertion requires an act of will.

Thank you for the quick reply,

No I don’t sorry, it was a at home style study. I could have the paperwork somewhere for it still I’ll have a look later this evening.

I can post more charts at times when I’ve changed settings if that helps. I’m off the PC now but definitely will check in with that later on.

Mostly on my side I sleep. I have a very firm pillow, normal height I would say. The firm pillow helps me with the mask. Rather than sink into a soft pillow. Prior to cpap I used to sleep face down. And breathe through my mouth. I would say that I do tuck my chin down to my chest at times.


Definitely fatigued aswell. That’s a really good explanation of sleepiness vs fatigued too. Thanks!

I would say more so fatigued than sleepy .

Thank you

Jake...so I assume male. How old are you?

When is the last time you had your testosterone levels checked?

When is the last time you had your vitamin D levels checked?

When is the last time you had the routine labs done that are normally part of a routine physical? Like, thyroid function, CBC, etc? Testosterone or Vitamin levels aren't usually a part of the routine labs.

When you have time please fill in the equipment part of your profile. Please use the text format...icony/images aren't much help because the images are very small and not always easy to figure out exactly what the image depicts.

Have you ever had a work up for the fatigue itself?

Gotta get back to my chores.....ugh...tax time and I have put off way too long. I always have to pay so I never do early what I can put off to the last minute.

Oh...quick question about the home sleep study.....did it involve your wearing some sort of chest or abdominal belt.
What other gear did you wear? Finger tip gadget? Nasal cannula in the nostril? Anything else?

Looks to me like you minimum pressure is too low.
Look at those "ski jumps" in the pressure chart. The machine keeps dropping the pressure to where you start snoring, and then, zooms up again.

Your statistics page also show that you did better (AHI -wise) with higher pressure but in both cases (green and light green, you remained there for only a short time. Why?

It's possible that those drops into pressure that lets you snore are disrupting your sleep.

I second Pugsy's questions about medical tests you may have had. In addition, I'd recommend that you ask for tests that would reveal anemia or autoimmune disease.

When you talk with your doctor, it'd be good to explain as clearly as you can that you're mostly fatigued rather than sleepy. Examples can sometimes help. "I used to enjoy a long walk in the park once a day, but now I get worn out just driving to the store." "Sometimes I need to pee but just feel too wiped to get up and go to the bathroom." Or whatever. It could be especially useful to the doctor if you can say whether exercise makes you feel better or makes you feel more fatigued.

See whether you can avoid chin-tucking. Some people have good results from wearing a soft cervical collar at night to keep their necks aligned. Of course anything that makes sleep worse for you is not helpful!

Thanks again for all the replies.

Yes pugsy, Male, 28.

I dont think i have had testosterone checked. ill add it to the list.
same with vitamin D.

I get routine labs done frequently, I have been numerous times to the doctors about feeling generally fatigued and unwell . all okay except slightly high cholestrol which is now back to normal. changed butter out of diet.
I will fill the equiptment part of my profile in after i send this post, thank you.

not sure as to what you mean by a workup for fatigue. I saw a doctor last week about it and she sent me for some auto immune disease tests . ugh tax is the worst!

The home sleep study i worse a chest belt(I think from memory) alot of electrodes on my chest hooked to a pack on my waste. a finger tip gadget yes, and yes a tube connected to my nose that sat just
inside my nostrils .



------

Ozij thanks for the reply, I cant remember why i changed the pressure back down, i think from memory i experienced extreme bloating and gas as if i was swallowing air when i had it on cpap mode high pressure.
Thank you very much ill try upping the base pressure and see what changed, up until this point ive been shooting in the dark and not collecting any data myself except for if i wake up worse i change things back. i under
stand this is not the way to do it so i will have to make small changes and see how they go over a period before i decide if its better or worse.

---------

Funny enough Miss Emerita i did go for auto immune disease blood tests the day of writing this thread. as you can imagine im at my whits end feeling like this, as i have turned to an internet forum for help also XD
but no tests for anemia, although all my iron studies have been fine (maybe anemia was in my iron studies i am unsure)
I really do find it hard to talk to the doctors here. i have seen approximately 20 different doctors over the last 2 years. our medical system in australia is great, but you get rushed in and out and i feel the certain level of care
i remember from a child is not present anymore. being able to differentiate between fatigue feeling and sleepiness thanks to you will be a great help. I have had glandular fever in the past also which i thought could have been
this aswell but the doctor wasnt convinced. Cervical collar? Ill look into it for sure. appreciate it! Thanks again for all the help.

--------------

what i will add is that i was up late last night, stressed about this issue, and got less sleep than compared to usual. and i feel 20x better today than i have felt for the last two weeks. i will attach my oscar data for last night for you guys to see
if anything was different. (i did change some settings last night too but im not sure they really affected how i slept. i turned humidity off and set a manual tube temp aswell as raised the max pressure)
today i am energetic and feel great physically and mentally, actually feel pretty rested aswell.

https://ibb.co/7yBnGvN


This is why i get confused haha.


Thanks again for all your help guys

https://sleephq.com/public/f5af3a67-133 ... 8154eb82a3


This is the sleephq data from last night, incase it shows further insights compared to oscar. thanks