[Treatment] Low AHI but still tired - please help!

[courtney123]

There is no real difference between the Australian and US version except for price and things like temperature settings are not in celcius.

Well, they have different accents.
Sorry, I *just* couldn't resist

I'll go away now...

[khem26]

I am asthmatic and take some Ventolin (or something similar) regularly. I have taken some creatine (supplement) for brief periods over the last year or so also.

Google creatine asthma, you find some links and discussions on body building forums
The Mayo Clinic states that creatine has been associated with asthmatic symptoms and warns against consumption by persons with known allergies to creatine

95% and maximum pressure 18/19, seem to me the pressure is running away and maybe the cause for those central events
Not always the machine find the correct pressure, as the machine programed to increase pressure in response to flow limitation and if one have a problem with flow limitation, the pressure can reach the maximum, some people do better on straight CPAP

Try sleep on your side, less pressure on the side vs on backs, a tennis ball inside a sock (or bum bag) fastened on back of pyjama tops can help to stay on the side and prevents rolling on the back while asleep

I dont think Ive had any notable breathing/asthma difficulties since I have taken creatine and in fact, have to use the least medication for asthma since I was young. Though I will have a read over google to see better inform myself on the issue.

I will start trying to lower the pressure a bit at a time and see if this helps over the coming weeks. I did give the tennis ball trick a go but wasnt having that much success, but then again I wasnt as commited at the time to CPAP so I am going to give this another shot.

I have had the cpap machine for about 2-3 years but have only seriously used it for a brief period at the start (which I did not take seriously). But I have been more commited in the last few months to give it a shot.

I suspect that being "more committed" is your problem. You must be fully committed to using your machine whenever you are asleep, even for a nap.

Do not ever sleep without the machine.

Your mind and body must adapt to a new condition -- being able to breathe and sleep at the same time. As long as your mind is still unconvinced that you can do both of these things at the same time it will keep waking your body up to make sure it's breathing. Even if you are not aware of these awakenings they are happening and they are what's making you feel tired during the day.

If you use the machine every time you sleep you will adapt. If you spend any time at all sleeping without it you are sending that old familiar signal to your brain that it's not safe to sleep, and it says "I told you so, you just can't trust this guy to keep breathing while he's sleeping."

As you get older you will find that the extra wear and tear on your cardiovascular system will do more damage than simply make you feel sleepy during the day.

I have been on CPAP therapy for 21 months and I am still adapting. It has taken me this long to get this far. I have made a LOT of progress and I have more to make. I had 56 years to learn how to sleep without being able to breathe, and it will take time to undo that conditioning.

Be patient and don't give up. Your life depends on it.

I agree with you 100% and have been really making alot of life style changes to accommodate the CPAP to try be as consistent as I can. I'm a young guy that enjoys havign some big alcohol fueled nights which really wrecks my sleeping patterns for a few days.

I have never heard this theory expplained it the way you have but it does make alot of sense to me. I really have to put my foot down and commit to this. Of the 21 months, do you remember how far along it was for you to start feeling better? I have days where i wake up feeling FANTASTIC from the mornings till about 1pm (lunch time), then i usually crash and feel really tired again. Most other days arent so bad, but I generally dont feel 'positive' if that makes any sense. Thank you for the encouraging words, it really motivates me to hear them from someone else who has experienced my problems.

[khem26]

khem26, I live in Melbourne, the CPAP vendor is sort of right, there are two schools of thought, some people have their pressures set at large differences like you have as an auto CPAP should adjust, others prefer a minimal range between the high and low. Some people think if your pressure is too high above your required pressure it can cause centrals which is possible in some people, I already have complex SA (both obstructive and central) so it doesn't affect me. That is what Zonk was saying. Are you using Sleepyhead or Res Scan software to look at your data? You will be able to tell from that and when you can post it we can help you read it if necessary.
Re the Ramp setting again everyone has a different opinion but my pressures are 5-15, I have the ramp on 5 for 30mins that way if I go to the toilet and turn it back on I don't have to adjust the pressure settings, it stays at 5 for the next 30 mins till I fall asleep again then becomes auto.
Your AHI of 6.57 is too high it should be below 5 but that is just one night of data, you need to take it over a week or more. Some of that is made up of clear airway or centrals so lowering the high pressure may help that.
The machine should be Ok if it is only 2-3 years old, try working on your pressures and also try to minimise leaks as much as possible.

Im currently using Sleepyhead software but I also have the Resmed softwtwaare I could use as well. Was your pressure prescribed at 5-15 or did you decide to put it that way? I will try decrease my pressure slowly and see if this has any positive effects. Yeah that 6.57 was only 1 night iwth most nights typically less than 5. How do I check for leak problems? The sleepyhead results look like my leakage is 0 for most of the time.

Hi khem26, another Sydneysider here

Sorry if you have covered this already but have you considered that giving the AHI figures you are already getting, the problem may not be sleep related but something else such as a dietary deficiency?

I have thought about it alot and have had a blood test at the local doctor come back pretty much normal. I think my iron was kind of high for 1 test but it was normal for a follow up. Should I be looking for anything in particular? Do you think there could be any psychological issues I could consider as well ?

[Sleepster]

I agree with you 100% and have been really making alot of life style changes to accommodate the CPAP to try be as consistent as I can. I'm a young guy that enjoys havign some big alcohol fueled nights which really wrecks my sleeping patterns for a few days.

You either use the machine every time you sleep or you don't. The choice is yours. If you don't the problems you're experiencing now will get worse as you get older, and you will develop new problems.

You don't have to be a saint to wear a CPAP mask, you just have to wear it.

Of the 21 months, do you remember how far along it was for you to start feeling better?

I started feeling better on some days immediately. The number of days where I felt better increased slowly. It's a process.

Eventually you'll get to the point where CPAP therapy is a perfectly normal part of your life.

[Tez62]

khem26 Wrote: Im currently using Sleepyhead software but I also have the Resmed softwtwaare I could use as well. Was your pressure prescribed at 5-15 or did you decide to put it that way? I will try decrease my pressure slowly and see if this has any positive effects. Yeah that 6.57 was only 1 night iwth most nights typically less than 5. How do I check for leak problems? The sleepyhead results look like my leakage is 0 for most of the time.


khem26, I have both lots of software as well but find it better sticking with one, so I use sleepyhead. On the Sleeyhead graphs you will see one called 'Leak' you want your leaks to be below 25, if you saying yours are '0' thats very good. On the pressures, at my first sleep study my pressures were set at 4-12, I see my sleep specialist once a year for a review and have a sleep study every two years. I had my last sleep study in March this year and I took my figures in and compared them with my sleep specialist, I said I need to change to 5-15 and he was shocked and said that is exactly what he was going to prescribe. When I go for my visits now we talk more about these sites and more about SA than myself, I treat it as a learning session for me rather than a check up.