On CPAP two months and not feeling improvement

Pineapples4Life · Post by **Pineapples4Life** » Sat Sep 30, 2023 12:09 pm

I've been religiously using my CPAP for the past two months, in spite of my depression with being diagnosed with severe obstructive sleep apnea. I was told by the sleep doctor that it would greatly help with my chronic fatigue and coping with daily pain due to my autoimmune condition. Instead, the fatigue has not improved and I am in worse pain. My settings are at 6-14 auto, Flex 3, and ramp and humidity as tolerated (I cannot tolerate either of them, so they are turned off). When I am falling asleep, I feel like the machine is cutting my inspiration short, like I am breathing in and suddenly cannot breathe in the rest of the way because the flow of air pauses. My numbers according to DreamMapper and Wellue are good, and the doctor thinks I am doing great. I don't feel great. I feel like I am half awake/half asleep all night. I'm lucky to get one hour of deep sleep, and am having hardly any REM sleep. I wake up with deep lines in my face from the silicon headgear, likely due to the position that I must sleep. Due to pain in my SI joints, hips, and shoulders, I cannot sleep on my back or straight on my side. I sleep somewhere between my side and tummy, which leaves lines in my face for many hours almost every day due to the pressure of sleeping on the headgear that is covered with fleece. I cannot quite get into the perfect position (pretty much face down) to get comfortable and I am having a lot of muscle tension/spasms in my neck since starting CPAP. The headgear is definitely not too tight or too small (the sleep tech looked for me), as I can easily slide 2-3 fingers beneath both sides at the same time. The sleep tech changed my settings to a continuous pressure of 9 which gave me debilitating headaches, so I changed it back to the original settings a week later. I don't know what to do to improve my sleeping situation. Since my pain is chronic, doctors will not prescribe opioids for relief. I have downloaded information using Oscar, but it's overwhelming for me to look at. I'm hoping that someone knowledgeable can give me insight or suggestions to make this work for me. I feel like a trainwreck.

ozij · Post by **ozij** » Sun Oct 01, 2023 5:42 am

Pineapples4Life wrote: ↑
Sat Sep 30, 2023 12:09 pm
I feel like the machine is cutting my inspiration short, like I am breathing in and suddenly cannot breathe in the rest of the way because the flow of air pauses.

If this is how you keep feeling, it's possible that Respironics' "Flex" algorithm is simply not good for you. "Flex" is Respironics' implementation of pressure relief -- some people can't tolerate it. Can you turn the Flex off, or down?

ResMed's pressure relief implementation is different,

Not much more anyone here can do to help you without OSCAR data.

Pineapples4Life · Post by **Pineapples4Life** » Sun Oct 01, 2023 9:02 am

I can turn the flex down/off, but does that mean I will have to work harder when I exhale?
I posted Oscar data, but maybe the wrong thing. I don't quite understand all of it.

ozij · Post by **ozij** » Sun Oct 01, 2023 9:22 am

You posted oxygenation data from Wellue. Not breathing data from your CPAP. OSCAR is an open source program that collects data from your CPAP.

OSCAR https://www.sleepfiles.com/OSCAR/

Pineapples4Life wrote: ↑
Sun Oct 01, 2023 9:02 am
I can turn the flex down/off, but does that mean I will have to work harder when I exhale?

You'll have to try.
Do you have trouble exhaling?

Miss Emerita · Post by **Miss Emerita** » Sun Oct 01, 2023 11:04 am

I can see that you posted data from Oscar, but it would be a huge help if you'd do it this way:

Take a single screen shot that includes all of the following:

Left panel
Events graph
Pressure graph
Leak graph
Snore graph.

Don't include anything else. You can move the graphs around by grabbing them in their label areas, and you can squash them a little by grabbing the gray bars that separate them.

Pineapples4Life · Post by **Pineapples4Life** » Tue Oct 03, 2023 4:15 pm

I removed the flex and was able to exhale without difficulty. Last night, I tried raising the lower end of my pressure range from 6 to 7. It seemed uncomfortable at times. I did not miraculously wake up feeling like a new, energetic being.

Thanks for the mini training session so I could build my own report. I'm attaching it.

ChicagoGranny · Post by **ChicagoGranny** » Tue Oct 03, 2023 4:31 pm

Please include the Flow graph in future posts ---->https://www.apneaboard.com/wiki/index.p ... _your_Post

Miss Emerita · Post by **Miss Emerita** » Tue Oct 03, 2023 6:56 pm

Thank you, CG! How could I have left out flow rate!

Pineapples4Life · Post by **Pineapples4Life** » Tue Oct 03, 2023 7:12 pm

I added the flow graph. Thanks!

ozij · Post by **ozij** » Tue Oct 03, 2023 9:10 pm

Pineapples4Life wrote: ↑
Tue Oct 03, 2023 4:15 pm
I removed the flex and was able to exhale without difficulty.

Did removing the Flex change your feeling of interrupted inhale?
Last night, I tried raising the lower end of my pressure range from 6 to 7. It seemed uncomfortable at times. I did not miraculously wake up feeling like a new, energetic being.
[/quote]
Keep your minimum at 7 for a few nights - some of us (many...) need time to get used to different pressure settings.
The charts you posted are Friday's charts, and still have your minimum pressure a 6.
Can you post a chart of your sleep at the higher minimum?

chunkyfrog · Post by **chunkyfrog** » Tue Oct 03, 2023 10:35 pm

I know two months seems like a long time, but some of us need double that
before we feel improvement--I did, and I was surprised, as it was gradual.

Pineapples4Life · Post by **Pineapples4Life** » Wed Oct 04, 2023 8:07 am

I'm attaching two nights' data. Oct 2 was the night that I managed to sleep with the minimum pressure at 7.
Last night, Oct 3, I had to decrease it back to 6. Air was entering the back of my throat and traveling between my cheek and gums towards the front of my mouth. I had to choose between opening my lips to let it out or swallowing it, which would be awful considering I'm headed to gallbladder surgery this morning. When I paused the machine (after about 30 minutes) it showed an AHI of 22!

ozij · Post by **ozij** » Wed Oct 04, 2023 9:13 am

Good luck with your surgery.

AHI number for short periods in which you weren't even asleep can be safely ignored.

On CPAP two months and not feeling improvement

On CPAP two months and not feeling improvement

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