Looking for a new Doctor

After 2 years I am still not feeling completely on top of the world.While I do feel a lot better than I used to but I still feel there is lots of room for improvement. I called the DME and asked for the results from my card. I do not understand any of it but I have it here to print out and take to a new Dr. I just called MY primary care Dr and am asking her to get me the help I need. I know my level of sleep is better. I even get down to dreams lately. My biggest complaint is that I never sleep more than 5-6 hours. So I do not feel I am getting sufficient sleep. Waiting for her office to get back to me.

Laura

OceanGoingGal wrote:I called the DME and asked for the results from my card. I do not understand any of it but I have it here to print out and take to a new Dr.

Here's a topic that has a screenshot of the only part of the report from Encore Pro or Encore Viewer I look at (begins on page 4 of a downloaded report):
viewtopic.php?p=417959#p417959

That discussion was with someone who was using a BiPAP Auto machine, not a straight CPAP machine like you are using, Laura. In the report from a straight CPAP machine like yours, there are only two areas of the Daily Details graph I'd even glance at...what the AHI was, and the leak rate. Those particular graphs start on page 4 of the report. I don't even glance at the first three pages of an Encore Pro (or Encore Viewer) report.

Generally speaking (there are always exceptions! ) with your Respironics machine what you want to see on each graph of "Daily Details" is:

AHI below 5.0

Leak rate no higher than 40 unless you are having to use an extremely high pressure, like pressure of 16 or more.

If your CPAP treatment looks like it's going well AHI-wise and leak-wise, then I'd be thinking about looking into other possible health issues that don't have anything to do with OSA. It's always possible that a person's CPAP treatment is going great, but other health problems can be making the person continue to feel tired, worn out, sleepy, exhausted, etc.

Hope you find a good new doctor and start feeling better and better!

I still have not talked to the Dr. She never got back to me today. The nurse had said they uually assign sleep apnea to a pulmonologist. I had this illness a very long time before I was able to seek treatment. I had no insurance so I did what we without insurance do,I went without. I finally got insurance and went straight to a Dr to get the care I needed and had neglected for years. As it turned out that was the only time I ever did consult this Dr. I was not happy with her as my PCP. I now have a PCP that I trust and really like.
Cpap pressure 11.0
Average Obstructed Airway Apnea Index 0.8
Average Hypoapnea Index 0.9
Average Vibratory Snore Index 0.4
Aveerage Leak 44.0
What all this means escapes my feeble mind.

Laura

The AI (apnea index) and HI (hypopnea index) numbers look good to me. Those numbers are for how many apneas and hypopneas (averaged out "per hour") are sneaking through despite treatment. You're having less than one on average per hour. That's great!!

Both the AI and HI numbers are extremely low ("low" is good! ), so it seems that your prescribed pressure of 11 is serving you well -- keeping your airway nicely open while you sleep.

Average Vibratory Snore Index 0.4 -- that's so low as to be insignificant. Might be an occasional "snore" happening, or might just be an externally caused vibration in the hose or mask that got registered as a "snore" that wasn't even really a snore.

That average leak rate of 44 (at no more pressure than 11) is probably a bit high. Not terrible, but it's high enough to be an indication that getting better control over leaks might be worth trying to do. You're wearing a nasal mask (covers the nose only) so without taping your mouth and then looking at another Encore Pro overnight data download to see if the leak rate improves dramatically, there's no way to know whether the leaks are coming from around the mask cushion, or... from occasional mouth-breathing during your sleep.

If you ruled out the possibility of mouth breathing during sleep, and if you are extremely comfortable using the mask you have, I'd not worry unduly about trying to reduce the leak rate. If you're not crazy about your mask, however, you might want to try another mask to see if the leak rate improves. ResMed nasal masks are generally less likely to spring leaks around their cushion than Respironics masks, imho.

Even if you don't do a thing to try to improve on the leak rate, it looks to me like your CPAP therapy is going well. But I ain't no doctor.

I'd keep using CPAP and start looking for other health reasons completely unrelated to OSA for still not feeling great.

Some people only need to sleep for 5 or 6 hours while some people need 9 hours of sleep. If you feel refreshed, you are good to go. If you still feel fatigued or your sleep is not refreshing, you may need a pressure change or new equipment.

RG
Thanks for the post.
I will ask "She Who Must be Obeyed" read it to me my eyes are still a little swollen.

Rested Gal, Thanks for the information. I am really confused as to why I am unable to sleep longer when everything seems to be going good. My therapy has helped in many ways. No hangover feeling every morning. Also I no longer have bouts of struggling to keep my eyes open. I do feel fatigued by mid afternoon and need a short nap. 20 minutes or so seems to do me well. I have changed my bed times to see if I could benefit from staying up later. No difference, I still only average 5-6 hours no matter what time I turn in. I refuse to take any meds for this. I hate meds for any reason and as it is I have 2 meds for blood pressure and one to control my sugar. I am struggling now to control both of these in a natural way so I can get off the damn chemicals. I know it can be done as my nephew is free of his diabetes meds altogether. Until I went on those meds, in the last year I never took anything stronger than aspirin and never under any circumstances would I take acetaminophen. I guess I can chalk a lot of this up to aging and learn to live with it.

Laura

I had called my PCP to get an appointment for another Dr regarding my OSA. Today a Neurologist called and set up an appointment for me. So now we go down another road toward recovery. We shall see where this road leads me, probably to the poor house after I pay all the co-pays.

Laura