[CPAP] CPAP working but Still Exhausted

[BigT]

Hi everyone,
I have had a cpap machine for 4 years and have my AHI well below 1.0 almost every night.
 
I am however still exhausted, and have no idea why.
My current plan is to buy an O2 meter and see if that can shed any light on things, and then perhaps try a bipap machine.
 
What type of O2 sensor would be best?
Any other advice would be appreciated.
 
Thanks
T.

[Walla Walla]

message deleted.

[Sleeprider]

You have treated your sleep disordered breathing successfully, so your answer probably lies elsewhere. As far as O2 sensors, the units sold by Supplier #19 come highly recommended by those that use them, and the CMS 50F would be a comfortable and, I think, Sleepyhead compatible solution, at under $99 USD.

Have you done a complete physical and blood workup?

[BigT]

Thanks Sleeprider,
I’ve been tested for everything over the last few years and am now just stating with a sleep psychologist.
 
About the only thing I can think of, is that it is the pressure stopping me from hitting deeper sleep and feeling rested when I wake up.
I did find a post on here where another user reported the same thing and found bi-pap made all the difference.
 
Thanks for the tip re: CMS 50F

T.

[Sleeprider]

That's a pretty good analysis of your situation. Your current machine is giving you effectively, 3 cm PS, and if this was bilevel, you would be at PS 3 over EPAP min 9.0 and IPAP max 19.0. Of course, your actual maximum IPAP pressure is 13.0. Have you tried lower minimum pressure? The only thing you're missing is PS greater than 3.0 cm.

[BigT]

“Your current machine is giving you effectively, 3 cm PS,”
The 3cm figure is due to EPR, is this correct?

“Of course, your actual maximum EPR pressure is 13.0.”
Why is this? Shouldn’t it be 16cm  (Max 19 – 3 EPs = 16cm)

“Have you tried lower minimum pressure? The only thing you're missing is PS greater than 3.0 cm.”
I’ve tried lower pressure and always have more events – I haven’t tried it for a while so will try 11cm for a few days and see what happens.
 
I find that hypos more that obstructive tend to make me more tired, is this common as far as you know?
 
I also have lots of periods of rapid breathing; at will hit 50 breaths /pm most nights
I have no idea why, what could I check?

Thanks for your help, it is much appreciated.

[trish6hundred]

Hi BigT,
WELCOME! to the forum.!
Good luck as you continue CPAP therapy and also with getting it fine-tuned to meet your needs; you have come to the right place for guidance, hang in there for more responses to your post.

[Sleeprider]

“Your current machine is giving you effectively, 3 cm PS,”
The 3cm figure is due to EPR, is this correct?

“Of course, your actual maximum EPR pressure is 13.0.”
Why is this? Shouldn’t it be 16cm  (Max 19 – 3 EPs = 16cm)

“Have you tried lower minimum pressure? The only thing you're missing is PS greater than 3.0 cm.”
I’ve tried lower pressure and always have more events – I haven’t tried it for a while so will try 11cm for a few days and see what happens.
 
I find that hypos more that obstructive tend to make me more tired, is this common as far as you know?
 
I also have lots of periods of rapid breathing; at will hit 50 breaths /pm most nights
I have no idea why, what could I check?

Thanks for your help, it is much appreciated.

Hi BigT.   I was using your EPR in that comparason as equal to PS, and as I said, with a minimum CPAP pressure of 12 and EPR at 3, the bilevel analogy is PS 3 over min EPAP 9, Max IPAP 18.   You are well treated and the machine is not raising pressure very high, and your 95% pressure is under 13 cm.   It seems you are at the correct optimized pressure, and could perhaps experiment with lower minimum pressure.  The fact you have tried that and gotten more events shows you have really nailed this, so I'm not suggesting any changes.  Good job!

If you are hitting 50 BPM, we would need to look at a closeup of the flow rate during a period of high resp rate to judge what is possibly causing that. High respiration rates occur in some people and can be due to irregular breathing that causes the machine to double-count a single breath cycle, or perhaps it is tachypnea unrelated to CPAP.  We can look, but as a layman I have no expertise in suggesting a cause.  Your overall respiration rate and 95% are within normal bounds.

[BigT]

Thanks Trish for your warm welcome.