[CPAP] New cpap user with data to look into!

[mildOA]

Hello everyone! This is my first CPAP machine, AirSense 11 with AirFit P10 nasal pillows. I've had it for one month, and I believe I've worked out the physical comfort kinks, so I'm ready to analyze the data! Glad to be hear and learn from you awesome folks! I fully intend to become an expert at this.

For a little background, I have mild obstructive sleep apnea. I've noticed one major improvement so far since getting the CPAP - I no longer get up to urinate at all anymore; it used to be 2-3 times per night. Very happy about that one.

The one slightly disappointing thing so far is that I don't feel that much different on the tiredness scale. Before CPAP, I was used to being in bed from having my last memory of "falling asleep" and first memory of "getting up" about 9-10 hours apart and still need a nap in the afternoon. (I have since  hesitated to call that "sleep" given that sleep apnea was consistently disrupting it without me knowing.) Unfortunately, it seems that I'm in bed about the same amount and often still feel that need for an afternoon nap creeping up on me.

So, from all of this, I can gather that I must be getting a greater amount of REM since that's where the anti-diuretic hormone is coming from. But something is not clicking for the tiredness aspect, of course ignoring that it may just take a few more months for that to change if it is just a "time" thing.

From my initial critiques, I have come to understand that I had some leaks, my resp. rate is too high, tidal rate is too low, and hitting flow limits.

I was told to look into changing the following settings to try to fix this:

• setting from "nasal" to "full mask"
  
• lower bound pressure from 4 -> 7, (feels much more comfortable) and now 7 -> 10. upper bound 15
  
• EPR -> 3
  
• look into leaks, maybe some tape to close mouth
  

Below I have my data from last night. (Ironically it was short usage.) Nevertheless, I included 1 hour of wearing the cpap while awake at the end to see what my "baseline" levels are for the heck of it.

Do you have any further advice for me?

[staceyburke]

Welcome. Your data looks pretty good but your flow limits are still a little high. I would raise your EPR to 2 and see if that brings them down. It should hep them and your sleep.

[CPAPfriend]

Did your sleep study score you an RDI?

I don't want to give you the overused platitude of "you've just started CPAP and it can take some time to see better sleep", but one month in is still very early, so I think it's partially warranted here.

There are many reasons that you might feel a need for an afternoon nap, for example, the reasons could be dietary. It's normal to feel a dip throughout the day, especially if you're doing a heavy lunch or a lunch that dysregulates your hormones.

What makes you think that ADH is coming from REM stage specifically?

I second the raise in EPR. All of your apneas are central and likely treatment-emergent. They'll often go away once you've properly acclimated to the therapy with time.

[mildOA]

"Did your sleep study score you an RDI?

I don't want to give you the overused platitude of "you've just started CPAP and it can take some time to see better sleep", but one month in is still very early, so I think it's partially warranted here.

There are many reasons that you might feel a need for an afternoon nap, for example, the reasons could be dietary. It's normal to feel a dip throughout the day, especially if you're doing a heavy lunch or a lunch that dysregulates your hormones.

What makes you think that ADH is coming from REM stage specifically?

I second the raise in EPR. All of your apneas are central and likely treatment-emergent. They'll often go away once you've properly acclimated to the therapy with time."

Thank you for your comment!

Just checked the study, nothing about RDI anywhere. All of my "respiratory disturbances" are hypopneas in the study.

Question regarding the "it's still early" thing. What is it about CPAP therapy that regular use accumulates to produce a positive benefit? The amount of times I've heard "it depends on the individual" or "you'll get used to it eventually" is incredible. Not once has someone elaborated or directed me to a resource which explains _why_ that is, though. After doing my own digging, I came across things like cumulative lack of brain restoration from disrupted sleep can cause myriad problems, so even after restoring sleep, it will take a while for the brain to catch up restoring itself, to put it in layman terms. Other things were like body adjusting to the physical discomfort of the apparatus and body acclimating to a sudden, external form of support which it can now habituate/become dependent on to aid itself, etc. I understand why the go-to answer is "it takes time" to kinda point to everything in this area, as it can get very complex.

I am good on diet. All whole foods, nothing processed, balance of meat, vegetables, fruit, and stay hydrated with water. I exclude the times where I overeat and indeed get 10x as sleepy.

ADH from REM is admittedly an educated guess. There was no other variable change except CPAP. I still felt tired, still felt like I needed a nap, still woke up a few times in the night. However, did not need to urinate a single time at night since night 1 of CPAP. I can't find any other explanation from my own research, at least.

You can bet I'm going to be seeing through this CPAP stuff consistently and meticulously. I am frankly tired of being tired.