Fellow Pap'pers,
I need your expert advise. I have been on apap therapy since February and feeling much much better, until last month . I had joined an exercise class, was losing weight and feeling on top of the world. But something has happened. I have lost my energy, no longer go to class, have gained my weight back plus, and can't hardly go a day with out a nap. I have noticed that over the last month my pressure on my auto has slowly increased. It is set at 9-16 and has been holding around 9.5 at 90% of the night. It has started to creep up, started holding at 10 then 11 and is now 12 most of the nights. My numbers are still great, usually and AHI of 1.0 or less. I have very few apneas, mostly hypops. Could the auto just not be catching the hypops? I also was diagnosed with PLMD at 57 arousals an hour. Am taking Nerurontin for that. Possibly my PLMD is what is waking me and causing the fatigue and I may need my dosage increased? I saw my sleep doc about 2 months ago and he did not schedule a follow up, said I was doing great, had plenty of knowledge to monitor myself and to call his office if I needed anything. I suppose I will need another PSG to check the PLMD but really don't want one nor do I think my insurance will pay for one since my AHI is so low.
Any advice, guesses, suggestions, words of wisdom, or criticisms are appreciated.
Gilda
Increasing pressure + not feeling rested.
3 posts
• Page 1 of 1
Increasing pressure + not feeling rested.
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rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
Gilda, it could very well be the PLM disturbing your sleep. That would definitely be something to check out with your doctor...perhaps your medication for that needs to be adjusted.
About your 90th percentile number. When you see "11" as the 90th % number, are you thinking that means the machine had to use a pressure of 11 on you 90% of the night?
Because, if that's what you're thinking, I don't believe that's what the "90th %" number means. I think it means the machine had to use a pressure of 11 AND pressures BELOW 11 ninety percent of the time during the night. Doesn't mean it used a pressure of 11 ninety per cent of the time...although that's possible, too.
Look down at the table chart called Summary of Daily Details where it shows how many minutes of actual time you spent at each pressure. Look at "Minutes at Pressure" or "% of Night" to see which pressures the machine was using for you MOST of the night.
You might see something like this:
On that chart, you'll see that while the column for pressure of 12 is the 90% pressure for that night, the machine used 12 for 29.5 minutes total. Much more time was spent down at lower pressures.
Of course that wasn't even a steady half hour at 12. On the pressure graph (which I didn't include, to save space) it varied to 12 and to 13 for brief periods throughout the almost five and a half hours that I slept during that session. The pressure range was set for 8 - 15, btw.
The majority of the night was spent down at the lower pressures of 8, 9, and 10. Nothing anywhere near 90% of the time was spent up at the "90th % pressure of "12".
So, I wouldn't concern myself with what the 90th percent pressure number is. That number is important to doctors when they have sent a person home with an autopap for just a trial "auto-titrating" temporary period.
If the doctor is planning to prescribe a single pressure for putting the person on straight cpap later, he'll look at the number shown as the 90% average from the trial period and prescribe that number for a single pressure straight cpap machine.
For you, or me, or anyone using autopap as our permanent treatment machine set for a range, and are spending most of the night below "that number", the 90% number holds no special significance, imho.
About your 90th percentile number. When you see "11" as the 90th % number, are you thinking that means the machine had to use a pressure of 11 on you 90% of the night?
Because, if that's what you're thinking, I don't believe that's what the "90th %" number means. I think it means the machine had to use a pressure of 11 AND pressures BELOW 11 ninety percent of the time during the night. Doesn't mean it used a pressure of 11 ninety per cent of the time...although that's possible, too.
Look down at the table chart called Summary of Daily Details where it shows how many minutes of actual time you spent at each pressure. Look at "Minutes at Pressure" or "% of Night" to see which pressures the machine was using for you MOST of the night.
You might see something like this:
On that chart, you'll see that while the column for pressure of 12 is the 90% pressure for that night, the machine used 12 for 29.5 minutes total. Much more time was spent down at lower pressures.
Of course that wasn't even a steady half hour at 12. On the pressure graph (which I didn't include, to save space) it varied to 12 and to 13 for brief periods throughout the almost five and a half hours that I slept during that session. The pressure range was set for 8 - 15, btw.
The majority of the night was spent down at the lower pressures of 8, 9, and 10. Nothing anywhere near 90% of the time was spent up at the "90th % pressure of "12".
So, I wouldn't concern myself with what the 90th percent pressure number is. That number is important to doctors when they have sent a person home with an autopap for just a trial "auto-titrating" temporary period.
If the doctor is planning to prescribe a single pressure for putting the person on straight cpap later, he'll look at the number shown as the 90% average from the trial period and prescribe that number for a single pressure straight cpap machine.
For you, or me, or anyone using autopap as our permanent treatment machine set for a range, and are spending most of the night below "that number", the 90% number holds no special significance, imho.
How long were you exercising each day ? How long have you been exercising ?
Many people new to exercise get so enthuseastic , especially after seeing good results , that they overtrain. Cortisol levels are high . Fatigue, sleep disruption, even depression. Take a weekor two off and slowly begin again. Don't forget to EAT .
Or it could be something else .
When I lost weight and exercised my pressure actually went UP .
:twis ted:
Many people new to exercise get so enthuseastic , especially after seeing good results , that they overtrain. Cortisol levels are high . Fatigue, sleep disruption, even depression. Take a weekor two off and slowly begin again. Don't forget to EAT .
Or it could be something else .
When I lost weight and exercised my pressure actually went UP .
:twis ted:
3 posts
• Page 1 of 1