Brazen Therapy Thread

[Brazen]

I really do appreciate the input and support.

I'm just so cranky about all things cpap.
I feel worse using it then not.
The doctors who prescribed it have no interest in the actual effectiveness of treatment. 
If a patient was prescribed a medication that did not resolve the health concern it would be deemed as ineffective, discontinued, and other treatments would be explored. Why isn't the same true with cpap?
Instead, the insurance company holds me hostage by saying I have to show 4hrs use/night or they won't pay. 
My other doctors won't consider other possible causes for fatigue if I'm not addressing the OSA diagnosis. 
Forced compliance with ineffective treatment.

[BuffaloBob]

I had a similar situation about 5 years ago: sudden muscle weakness, crankiness, falling asleep at the wrong times...

I went through MRIs to see if it was a brain tumor, I took (another) treadmill test, we tried different meds, I saw a neurologist, had carotids checked, and I went through a sleep study.  I started with a CPAP, but my regular doctor finally said, I should probably just learn to live with it.

That wasn't acceptable, so I did some online research and now take an assortment of supplements, specifically magnesium and potassium citrate (muscles and more!), and I switched to a full face mask. 

That's all it took!

Good luck with your situation!

[Brazen]

@Buffalo Bob
Thank you for sharing your experience. 
Sorry your doctor was less than helpful.
I take magnesium (and iron, vit d, vit b, calcium) and I use a full face cpap mask. 
My doctors have only agreed to very limited testing, with inconclusive results. They blame OSA.

It's all just very frustrating.

[BuffaloBob]

Well, dang.
Sorry to hear that, too.
Please keep us posted as things go along.

[Brazen]

Well, I'm less cranky about cpap today.
I think maybe the fixed 9cmw pressure has improved treatment a tiny bit. Maybe?
AHI (RDI) is often under 1, flow limit 95% is often under 0.03.
It's still looking to me like arousal breathing multiple times a night.  I would just love to see 90-120min stretches of sleep with nothing but steady flow rate, zero spikes.  Maybe not realistic.

I do have some interesting flow rate spikes, followed immediately by a short large leak flag. What would cause that?
Fixed 9cmw pressure means the machine isn't increasing pressure in response to the flow rate so it's not higher pressure causing a leak.
Maybe movement in bed -- movement causing flow rate spike and slight mask movement?

[Brazen]

Below is an example of a rough recent night.
Maybe some chin tucking? I don't feel like I commonly have clusters suggesting chin tucking. The later part of the night (5-6:15) just loaded with flow rate spikes and RERAs. ugh.

Interestingly, the first 60-90 minutes of most nights shows steady flow rate without spikes, looks to me like restful sleep.  Yet my fitbit never documents REM sleep during or near that time period.
I have very little confidence in fitbit data.

[quiescence at last]

perhaps you are associating restful sleep with ones that dreams occur in.  But, that does not necessarily imply REM sleep occurred.  REM sleep generally is not the sleep that is the most tranquil.  In fact, it can be quite the squirrelly time of random respiration rates and reduced tidal volume, or at least fluctuating tidal volumes.  the other generally calm state is nonREM Stage 3 (NREM 3) also called slow wave sleep (SWS) and deep sleep where delta waves abound and few Alpha/Beta/Theta waves occur. SWS sleep is generally the most physically restorative, while REM seems to be more effective as emotionally restorative.

QAL

[Brazen]

@Qal

Thanks for the insight!

Prior to cpap, I would consider restful sleep as dead to the world, no awakenings. (but I was waking each morning still exhausted)

Since cpap, I have OSCAR so I would associate restful sleep with even patterned flow rate charts, no spikes.  I understand REM can cause spikes in breathing/flow rate, so I do look for that after 70-120 minutes of even/regular flow rate.  Any other flow rate spikes I blame on arousals or respiratory disturbances.
Maybe I'm completely wrong in my data analysis. Wouldn't be the first time.

I understand N3 and REM are both considered essential for restorative sleep.
I no longer dream with cpap. Sure, it can be argued my REM isn't being disrupted so I just don't remember my dreams - no way to actually know that's the case and since I still feel exhausted all the time I'm inclined to disregard that argument.