Do I find another doc...?

You've gotten alot of mixed answers here, and I will apologize for the last couple of posts that seem more argumentative amongst the parties rather than helpful to you.
I would work very slowly on the self titration...giving yourself 3 or 4 nights on each change. One thing you need to remember is that you have probably had sleep apnea for years, so the damage it has done to your body is not going to change overnight...and most likely you will not feel better overnight. It is going to take your body some time to recover from the effects of sleep apnea...so even though your numbers look fairly good, you are not going to feel better immediately. Occassionally, some do feel better immediately, but if all truth be told, most of us took months to feel restored, and that is not abnormal. You are getting better sleep now, and gradually you will feel better. it may not happen all at once, but one day you will just realize that you feel better again.
Hang in there. If you don't notice an improvement with how you are feeling in 3 months time, then by all means, go back to your sleep doctor, and be more insistent about a new sleep study. And if she won't give you one, then look for a new doctor...but first, give it some time, and make very small gradual adjustments.
Good luck, and I do hope you start feeling better soon!!

Well for what it's worth, you could go in for another PSG, but while you're waiting I would go with the suggestion to self-titrate in CPAP mode.

I also am a very sensitive sleeper and the APAP mode doesn't really help so I run in CPAP mode.

I also found that while in APAP mode my best pressure is around 7.5, I still sleep best at 10.5cm in CPAP mode. This was discovered through several months of first running in APAP mode (which ended up being pretty useless, optimal pressure was always the minimum pressure setting), and then running in CPAP mode starting with 7.5 and bumping up by 0.5cm once a week, until I noticed that I felt better in the morning. Thus I found 10.5cm. It doesn't stop all my events (AHI usually between 1 and 2) but any higher and I get more central apnea's.

I never had that big AHAH moment either. I just notice that now if I sleep WITHOUT CPAP I am a wreck the next day, so it must be working I never realized just how bad I felt pre-CPAP until I had something to compare it with after CPAP. My morning congestion was improved, I no longer had a horrible dry mouth when I woke up, puffy eyes and dark circles were gone, my lungs didn't feel like they were in a vise grip when i woke up, I wasn't a total biatch the next day, I could wake up easier on my own, didn't feel the need to clobber my partner with the alarm clock when he woke me up for work, etc...

.... some people just experience a gradual improvement... mine took a couple of years, to be honest, plus the treatment for hypothyroidism and cutting back from work and commuting. Sometimes it's not ONLY OSA that needs to be treated, so keep that in mind too.

Given I didn't sleep well last night with the added pressure -- I think I'll leave it at this setting until I get used to it and then keep bumping it up for the titration. Seems 1cm up I notice quite a bit. But then again it may have been anxiousness from making the change. If tonight doesn't go a bit better I'll go back to the trick I used before which is using the APAP while awake and working to get used to it.

khemicals wrote:Given I didn't sleep well last night with the added pressure -- I think I'll leave it at this setting until I get used to it and then keep bumping it up for the titration. Seems 1cm up I notice quite a bit. But then again it may have been anxiousness from making the change. If tonight doesn't go a bit better I'll go back to the trick I used before which is using the APAP while awake and working to get used to it.

What setting are you using?


Den

Could you use the EPR feature say maybe set at 2 to see if that gives you some relief?

All of this and no mention of whether you ever requested and got a copy of not just the doctor's dictated results (1-2 pages each) but also a copy of the full scored data summary report w/condensed graphs (5+ pages each) for every in-lab sleep evaluation (especially) and in-lab titration you've had done??

That full scored data summary report w/condensed graphs from your most recent in-lab sleep evaluation (w/o PAP) may well have some answers or even THE answer. I don't know how many in-lab sleep evaluations and titrations you have had).

Slinky wrote:All of this and no mention of whether you ever requested and got a copy of not just the doctor's dictated results (1-2 pages each) but also a copy of the full scored data summary report w/condensed graphs (5+ pages each) for every in-lab sleep evaluation (especially) and in-lab titration you've had done??

I have the written results (no graphs or anything) from my first and only sleep study. No titration was done at the sleep study as apparently I wasn't a good candidate for some unknown reason to have the titration done same night. I haven't been back to get a titration done since I got such horrid sleep without the gear 8 months ago that I asked to go straight to APAP so I could get used to the gear.

preemiern wrote:Could you use the EPR feature say maybe set at 2 to see if that gives you some relief?

I have EPR set to 1 iirc, my initial post mentioned it and I haven't tweaked that since 1 was fine before I don't want to change too many settings at the same time.

Wulfman wrote: What setting are you using?

12cm CPAP mode, everything else as stated before.