Still a newbie with some questions ...

I started on CPAP - ResMed S9 Elite at the end of February and was doing really well for the first few months - I noticed a subtle change in the amount of daytime energy and friends and family were noticing how more energetic I was. The past two months I have been feeling very tired and have been having some unusual symptoms which at this point, are undiagnosed; at first the doctors thought it was heart related but now, there seems to be a neurological component.
I have noticed that my flow rate curve has periods of ... not sure what to call it .... oscillating type form? The height of the flow rate curve is wide and then gets very narrow, then back to wide, etc ... last night, I had five periods of this that lasted mostly around 40 minutes each time. I woke up several times, either to drink water because of thirst or extremely dry mouth, go to the washroom, and a couple of times, just woke up. Needless to say, I am tired.
I have posted recently about a very dry mouth and thirst but the leak level is low - last night it was 1.09 for avg leaks and 7.20 for 95% leaks. Even with taping my mouth, I still continue to have dry mouth and eyes. I will be seeing an internist soon and will ask about Sjogren's which someone here suggested.
I see my sleep doctor on Friday and have been doing a 'sleep diary' this week to calculate 'sleep efficiency' - he had me track in the springtime - last night I had 8 wakes ups ... I usually fall asleep within 15 minutes from lights out, and when I do wake up during the night, I fall back to sleep within 5 to 10 minutes. Still, after 9 hours with the CPAP, I woke up this morning feeling tired, with slight headache, nausea, and the usual dry throat. Grrrrrrr .
Any suggestions?
Thanks.
I'll post a segment from last night's Sleepyhead graph.

Sounds like you could be losing Cpap air out of your mouth when asleep - have you tried on any full face masks? They could solve the problem.

Couple things...

CoastalSun wrote: Additional Comments: Pressure setting 5 -7 with ramp set at 45 minutes. EPR 2. Sleepyhead data program.

Noticed in your profile you have a ramp of 45 minutes, yet you fall asleep quickly. Not sure what pressure you are prescribed, but if you fall asleep in 15 minutes, you are unprotected from apneas for the next 30 minutes. If in any of your wake ups you turn the machine off and start over, the same would apply except worse since you fall back asleep even quicker that you initially fall asleep. Consider how many total minutes each night you are asleep while in ramp. Before I knew it was a problem, I was spending most of my nights in ramp as I hit it every time I woke up (as I was instructed). At any rate, I would suggest a quick sleeper should have a short ramp period.

In the past I think you mentioned having PLMD - am I correct about that? If so, what is the status? Hopefully one of our astute data people will answer this, but I know the intensity of my breathing ebbed and flowed with my limb movements, and I'm wondering if what yours looks like could be related to limb movements or not.

Waking to AM headaches, could be our oxygen is still getting to low through the night. You can verify this either with a store-bought unit to test your overnight Sats. or ask your dr. for an overnight oxymitry test.

As to the dry mouth, I remember a mouth wash that will also moisturized the lining. one is Biotene and another is Oasis.

Julie wrote:Sounds like you could be losing Cpap air out of your mouth when asleep - have you tried on any full face masks? They could solve the problem.

She said she tapes her mouth and has minimal leaks

Very astute kteague ... my apologies. I forgot to change the ramp setting which I lowered down to 15 minutes about 6 weeks ago.
Ramp is set at 15 minutes.
When I wake up to drink or spray my mouth with Moistir product, I just lift the mask; I don't turn the machine off.

As far as the PLMD, the sleep report indicated it was mild . However, I have been having tingling/burning sensations in my hands and feet for the past several weeks, so maybe you're on to something. Something else to ask my sleep doctor.

stage0 - Morning headaches, or even noticing the headache when I wake up during the night: I will ask about doing another overnight oximetry.

And LSAT You're correct. Minimal leaks. Sleepyhead average for the last 30 days: Avg Leak 1.35 95% Leak 10.80. I don't tape every night because it doesn't make any difference with dry mouth and thirst symptoms.

Thanks!

CoastalSun wrote:As far as the PLMD, the sleep report indicated it was mild .

No way to say this is the case for you, but it is not unusual for PLMD to worsen once CPAP treatment becomes therapeutic. A person who has both apneas and limb movements waking them up during the night may find when either of the disorders is treated, they sleep enough for the other to more fully manifest.

Thanks kteague
I see my sleep doctor tomorrow so will ask him about the PLMD.
I am also being investigated for an autoimmune disorder which could be the cause of dry mouth/dry eyes.
Someone here suggested that the cause of my dry mouth was b/c of leaking. That's NOT an issue as you suggested. Just for example, last night, I taped my mouth but still woke up three times with extremely dry mouth and needed to sip water.
Over the past seven days, Sleepyhead indicates that the Leak Rate averaged 0.84 L/min and 95% Leak averaged 8.40 L/min. Last night, there were two periods of leaking (from mask because I had a taped mouth?) one lasted for 30 minutes and the second one lasted for 10 minutes ... both times, the leak didn't go about 14 L/min.
Cheers!

Oddly, I find that my mouth is driest when I do tape, as opposed to when I don't.
Of course, that could just be me, but I suspect that something else is happening.