Brand new user - AHI is good but I'm EXHAUSTED!

[my6boyzmom]

I've only been using my Resmed Airsense 10 for three nights and according to the data I should be doing great.  Right?!  Every night that I use my CPAP I wake up more and more tired.  Please tell me this gets better!


- A very very tired Michelle

[DropKick Mickey]

Hello, I am relatively new (100 days) and can say I didn't notice much right away, but after 2-3 weeks I did start to feel noticeably less tired.  Then with each passing week I have been gradually feeling better & better.   My AHI was 110 pre-CPAP and now averaging 1.2.   I say be patient & stick with it!!!

What is really impressive to me is not only your score...but that you already have figured out how to load & use SleepHead and find this discussion board after only a few days!  

There are so many knowledgeable & helpful people on this board who are always happy to chime in.  I learned a lot of helpful tips just by monitoring the discussions.

Good luck!

[mesenteria]

I've only been using my Resmed Airsense 10 for three nights and according to the data I should be doing great.  Right?!  Every night that I use my CPAP I wake up more and more tired.  Please tell me this gets better!


- A very very tired Michelle

You are ostensibly 'treated' with your claimed AHI.  However, you do have some leaks, and these may be causing you to be more alert, or aroused, if you feel them or even are sensitive in some way.  If you get yanked out of a lower stage of sleep when they happen, you may be suffering from a lack of deeper sleep.  And, natch, you will feel more tired.

You have some snoring going on.  Often we are inured to the sounds of our own snoring, but we do awaken if we sense them.  

It happens to be the case that a great many new PAP users who have good results still feel like hell.  Even a couple of weeks later, they wonder if it's all worth it.  They're still exhausted, cranky, and now disbelieving.  That's actually quite normal.  Usually, as your health rebounds, and as you learn to get even better quality sleep, you will notice that it isn't so bad, then it's quite good, and eventually, maybe months in, you'll feel pretty darned perky.

Stay the course.  You're in this for your health, and for the rest of your life.  Remember, Buckley's tastes horrible...……………..and it works.

[Geer1]

It definitely takes a while to get used to as you and your body slowly adjusts. I slept horribly the first week and it took a few weeks before I felt like I was getting better sleep.

Are you working with a sleep therapist to adjust your settings? I see in this data is that you are having significant snore and flow limitation that caused your pressure to increase quickly. As your pressure tries to slowly drop back down you were having the odd apnea around 9-10 cm of pressure. If this data is representative of your average night (3 days isn't enough data to really tell) then you will probably find that an increase in minimum pressure (to that 9-10 cm range) will likely help.

I would stick with things and collect a few more nights data. If that trend seems consistent I would talk to your therapist about increasing minimum pressure or if you are self treating then I would increase min pressure. The main concern of increasing pressures is that it may increase the number of central apneas you are having, right now they don't seem to be an issue but if they do increase then there are ways to try and lower them.

If you increase pressure and it is hard to sleep then ramp can be used but I would leave it off unless it is necessary.

[Sleeprider]

Your pressure is set at 5.0 to 15.0 with EPR at 3. The pressure does a lot of bouncing around with a median of nearly 11 cm. This fluctuation in pressure can be disruptive to your sleep, and can move you in and out of the optimal therapy range enough that you feel "exhausted" the next morning. A smaller range will held, and it looks like you should be at 9.0 to 15.0 with EPR at 3. Your therapy looks okay, but it will improve a bit if you can have pressure moving in a smaller range.

[my6boyzmom]

Thank you all for the quick responses.  I spent my morning debating if I should "take a night off" because I was feeling so tired.  After reading your responses, I believe I will continue using the CPAP because the only way to get more useful data is to keep on keeping on.

Since I'm only a few days in, I'm thinking I should keep the pressure settings where they are for now.  If I get a few more days like the ones I've been getting, I'll probably bump the minimum up to 9.  I have a sleep dr but the last time I saw her she recommended that we follow up in 3 months.  I just don't see myself riding these settings out for that long if they aren't working for me.

I'm also considering getting a different mask.  I believe I'm a mouth breather (such a sexy term, isn't it) but the DME gave me a nasal mask with some weird strap to hold my mouth closed after I had expressed concern about feeling claustrophobic with a full face mask.  The strap isn't super comfortable and I'm apparently still snoring so maybe I need to just bite the bullet and try the full face mask ...

Michelle

[Geer1]

The only time you were possibly mouth breathing was when there were leaks at 4-6:30. Snoring is not necessarily caused by mouth breathing, it is just a vibration caused by your breathing.

[Sleeprider]

While you are only a few days in, let me assure you that your current minimum pressure lasts only a few minutes and in the last chart, you had an obstructive apnea before it reached a good pressure. You do need higher minimum pressure. While I recommended 9.0 cm as a minimum, any increase will be helpful. When we see "good therapy" on auto CPAP, the pressure only changes by about 3-cm up or down through the night. I have no reservation or doubt you need a higher minimum pressure.

[my6boyzmom]

Thank you Sleeprider!  I will change to a minimum of 9 tonight.

[Dormeo]

Michelle, I think your attitude bodes well for your success with therapy. You understand that experiments may be needed, that experiments need data, and data can come only from usage.

It is often best to try several nights (or more) before making any changes, but in this case you are right to go ahead now and raise your minimum as Sleeprider has advised. That's partly because it's Sleeprider who made the recommendation, and partly because you can see for yourself the reasons why he has made it.

The next step will be to see the results from this change. That may in turn lead to further experimentation. At each step, it'll be important to have data, as you've noted, and it will also be important to know how you are feeling during the day.

Don't be discouraged if you continue to feel unrested for a while. That is quite normal, but if your fine-tuning is headed in the right direction, improvement will come. Hang in there!