FF mask, Auto A-Flex and still exhausted.....

Well, it has been 3+ months now and i am waiting for that first night's rest where I feel refreshed in the am.

Went from CPAP to Auto C-flex to Auto A-Flex and Nasal to pillows to FF Quattro and I still can't get out of bed in the morning.

I know about sleep deficit....but this is like paying back Ft. Knox.......

I feel like my throat is affected but if I have a FF mask.....wouldn't that cut down of the effects of trying to snore?

Maybe I need a Psychiatrist instead of a Neurologist...

Elliot

what was your titration found pressure?
what did the machine report as the 90% pressure?

What is the range and AFlex setting you are using?

I would:

-bump up the Auto:Min pressure
-make sure Auto:Max is not limiting the pressure from increasing, if you don't have any problems in the past of runaways, bump the Max up +5 from the 90% pressure.
-try AFlex=2 if you are not already there.


OSA may NOT be why you are tired.

You would have to drag out your PSG's and read them carefully, if you have any PLM, PLMD's, RLS or Spontaneous arousals seen on that report, those items can contribute to daytime fatigue more than OSA does.

SO you treat the OSA with CPAP, it takes care of those items, but you still have those others that are interrupting your sleep architecture.

If you have other disorders like chronic back pain, arthritis, GERD, Post nasal drip etc., those may be contributing to interrupted sleep. Many times medication you are taking for hypertension can also make you fatigued.

They are now finding that taking an antidepressant can contribute by killing your metabolism.

Thank you SD for replying.....I believe I am guilty as charged on many of the counts.

My titration was found to be 8.....after 2 months the doctor bumped it to 10.....I am seeing 12 as my daily number.

I have the A-Flex set as 9-15.

the daytime fatigue AND fighting any sleep at the wheel has improved. What is not better is the dreadful AM when I have trouble getting up and feeling refreshed.

The last time I can remember feeling good in the morning was the am after my Second Sleep test.....not the first.....and that was a nasal mask set at 8...

regards

Elliot

personally, I don't believe in that sleep-debt theory, if that were the case I'd been foreclosed on long ago.

I feel if your OSA AHI is 12 or under that you are effectively treated or treated as well as a "normal" person would be. In other words, that AHI isn't high enough to contribute to the walking dead fatigue during the day.

If we all felt great during the day NONE of us would be here. I don't care if I don't sleep at night, of course I care if I have to spend the day napping away or that I'm so tired and unmotivated to do anything, then I care.

I think a majority of us are guilty of simply not getting the sleep duration we need, teenagers are the only ones that get enough sleep it seems, and they are screwed up from staying up all night. But mention a party they need to go to and they are suddenly up full of energy and gone not tired at all.

I would bump up your Auto:Min to 10 or 11 and put the AFlex at 2 if you are at #1, use the feature if you can it will help. I haven't studied it carefully, but my guess is you have to be at #2 or #3 to get any real benefit from the 2cm PS built into AFlex. So if you have to, bump it up and use a higher AFlex setting to compensate for the higher Min pressure. I would even use Auto:Ramp if you need it for falling asleep, set that timer to 30 minutes and Ramp pressure to 8.5 or 9.0.

Then you should start off at 10.0cm, when you hit the Ramp it will drop to that lower pressure (pressure you are using now) until you get to sleep then it increases up to take care of those residual events.

Try it, I bet your AHI falls, if you are using a FF mask and 10 cm before, you probably need 11 cm with the FF mask.

Doesn't take much to convince me you get better therapy with a nasal mask.

Have you tried one of your nasal masks since going with Aflex?

Don't know what it is, but that machine does magic with my leak rate, I checked it last night, my 7-day leak rate was 1.4L/m and my 30-day leak rate was 1.7L/m. I don't know if the Aflex sees my Soyala nasal as a OptiLife mask or what, but the leak rate keeps falling. My AHI has fallen also to less than 3, for me that is pretty good.

I'm still tired during the day but I also only get about 3-4 hours sleep on most nights, just due to bad habits I guess. I can't sleep when its this hot, lately here it has been over 103F, its almost midnight and its still 81F, I hate running the air all night, my bill will be $600-700. I can't even stand the dog sleeping against me.

I have this problem, if and when I ever get 8 hours sleep, I'm so recharged that I cannot get to sleep the next night.

Good point (it's happened to me!) - be sure you are giving yourself enough hours of sleep, and not blaming problems on OSA, but simply not enough sleep.

It is 4:50 as I write this after waking up to the tight FF mask squeezing my head.....3 1/2 hours sleep.

Time to change the mask......I think the pillows with a chin strap gives me better sleep.....not sure why.

I did change the settings to 10-17 Aflex=2 Although it was set on 3 previously.

The machine and mask felt "noisier"....different.

Elliot

From what you just said, it sounds like your mask is way too tight. Loosen it up and it'll feel and seal better.

Get more sleep.

Den

I've been on CPAP since 1995 so you think I'd be an expert but I'm not. I was just living with poor quality sleep for many years, and probably some brain cell die-off to boot. Because of this forum I just recently started using the Encore Pro software to moniter my sleep. I have also become alot more savvy about all things related to sleep apnea, and still learning. Heed the advice of these people and trust your own instincts. I know it is difficult when you have to function without sleep, I did it for years using caffeine. Last fall I started having migraine headaches so I decided to go off the caffeine. I had to become more proactive in my health recovery. I've changed my diet and still working on the CPAP thing. Last night I was able to get my AHI down to 3.5.
I'm not even sure if that is good or not but I feel better.

Just hang in there and keep asking for help.


Victoria