Determining Efficacy of CPAP

Hello everyone. I'm new to this forum and have a question for anyone who wishes to weigh in. I am wondering how you determine the efficacy of CPAP therapy. I have been using CPAP for about 5 months now and I've finally started sleeping through the night, although I don't know that the quality of my sleep is where I would like just yet. I still sometimes wake feeling tired, with a sluggish memory and poor concentration. My doctor has looked at the CPAP data and it indicates that I am having very few apneic events each hour (<1), which is encouraging news. However, I have a difficult time reconciling this with the way that I feel many days - low energy, tired, and foggy. Aside from the CPAP data, how does one determine whether CPAP is effective? Is the data collected by the CPAP machine accurate? Have others had similar experiences and then later had further improvements in the way that they feel each day? My doctor has told me of other patients who (eventually) wake feeling very refreshed, a feeling they have not experienced for many years. I'm still waiting for this to occur and crossing my fingers.

I recently purchased a Masimo iSpO2 pulse oximeter so that I can occasionally get some O2 saturation measurements through the night and initial measurements show my O2 sats falling to a low of 90% for a few seconds, as well as measurements of 91%-93% for 5-15 seconds, but otherwise measurements of 94% and above for the remainder of the night. I understand that the lowest measurements may be a result of movement or other artifacts, so I'll have to wait until I have more data.

I would appreciate hearing your experiences regarding CPAP therapy and the progression of any improvements over the first year of use. Thank you very much for your input.

Most of us on this board have the software for our machines to make sure that our therapy is optimized.
Mostly, I check to make sure that my mask is not leaking. If the machine is in large leak then you are not getting your
therapy.

I wish you well..

zmbee wrote:Hello everyone. I'm new to this forum and have a question for anyone who wishes to weigh in. I am wondering how you determine the efficacy of CPAP therapy. I have been using CPAP for about 5 months now and I've finally started sleeping through the night, although I don't know that the quality of my sleep is where I would like just yet.

The effect depends on how bad your AHI and SPO2 levels were before you started and How long you actually have been wearing it. Unless you use your cpap machine 100% when ever you sleep, including your naps, you are not helping your self. If you are only now wearing it all night then you start counting from now and it can take up to 6 -12 months for the good quality sleep and O2 to repair the damage done by years of untreated OSA

I still sometimes wake feeling tired, with a sluggish memory and poor concentration. My doctor has looked at the CPAP data and it indicates that I am having very few apneic events each hour (<1), which is encouraging news. However, I have a difficult time reconciling this with the way that I feel many days - low energy, tired, and foggy. Aside from the CPAP data, how does one determine whether CPAP is effective? Is the data collected by the CPAP machine accurate? Have others had similar experiences and then later had further improvements in the way that they feel each day? My doctor has told me of other patients who (eventually) wake feeling very refreshed, a feeling they have not experienced for many years. I'm still waiting for this to occur and crossing my fingers.

You can look at the data yourself (depending on the machine you have) Tells us what you use and people can show you how to read the data and install the software. AHI can be below 1 but if they all appear during rem and last a long time then an average is a false picture.

Caveat here: this comment is my own personal experience, others may have had different experiences.

Efficacy in my treatment has been measured in two ways. How did I feel in the morning and what was the measured AHI as reported by my CPAP machine.

For the first about three years, I mostly didn't feel much better in the morning but my AHI numbers steadily declined to an average less than 5. Incidentally, treatment with an AHI is considered to be effective.

Six months ago, I switched to a different machine, a PR System One ASV machine.
Since then, I feel much better in the morning (most mornings) but my AHI now is much higher and is frequently above the magic number of 5.0.

So, I conclude that my treatment is more effective even with higher AHI than before with a lower AHI.
Sometimes it just takes time and perseverance.

If your machine collects efficacy data, get the appropriate software and monitor your progress.

Hello, and welcome. In general, we measure effectiveness by looking at both the data logged by our machines and subjective indications of how we feel after making any particular change. Unfortunately, this can be a difficult process for people who are new to CPAP. First, since you are new you may not have found the most effective settings for your needs yet, so that is usually a source of doubt for people who don't think they feel as well as they should. Second, you don't know how you will respond to CPAP therapy yet.

Some people feel better right away, but many do not. Untreated sleep apnea causes physiological changes and damage to the body that take time to undo. It is quite common for people to be no more aware of the tiny incremental improvements in how they feel than they are about the growth of their hair. It is only after a long time, and only when before and after can be directly compared is any change apparent. Two examples from the past few weeks on this board are a new user that didn't feel like they were getting any better but just made a long drive without getting sleepy that they had always had to stop for a nap halfway through before and another user that didn't think the machine had made any difference until their supplier took the machine back for a few nights during an exchange and they suddenly realized how much worse they used to feel without it when it was gone.

For a small number of people, sleep apnea and CPAP is just one piece of a complex mix of issues and treatment in their medical puzzle. For them, CPAP may not make them feel any better by itself. However, it is still an important treatment as it lets the doctors focus in on the remaining suspects and symptoms and helps them see the rest of the puzzle without the effect of sleep apnea helping to hide them. Unfortunately, that is a discouraging place to be since you get all the inconvenience of life with the hose but the benefits don't materialize until after another diagnosis and treatment.

I wanted to take this opportunity to thank everyone who replied to my post. I've learned a lot from the information found on this forum. I found ResScan online for free and have begun following the data from my ResMed S9 CPAP machine more closely. Thank you again for your input and suggestions.

Before cpap, I usually woke up feeling like a cross between Bill the cat and Gollum.
With cpap, I feel like a well-rested human being, not a young one, but that would be a bit much.

chunkyfrog wrote:Before cpap, I usually woke up feeling like a cross between Bill the cat and Gollum.
With cpap, I feel like a well-rested human being, not a young one, but that would be a bit much.

but very nice if it worked that way, I could stand to shed a few years myself, as long as I get to keep the the things I learned and memories.