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Help, red blood cell count up, no energy, long time CPAP user
#1
Help, red blood cell count up, no energy, long time CPAP user
Have been using a CPAP for about 20 to 25 years currently on my 5th machine a ResMed S11 started out with a ResMed Escape. Both my S10 and S11 history sync to the cloud. 

Picked up my new ResMed S11 the first week of August of this year. Have always used the ResMed N20 nasal mask for awhile. The CPAP doctor and DME supplier both looked at my history from my prior machine a ResMed S10 and told me everything looks good and asked if I ever used the my air app told them no however I decided to download it and looking at it I saw that my leak was always high. I thought why didn't my CPAP doctor or DME mentioned this to me during my visits. I've had dry mouth for a while but never associated with the CPAP and air leak until my wife decided to mention that I really had bad breath I need to do something about it. Searching and searching I found that a air leak out the mouth will cause both dry mouth and bad breath, bingo! 

Here come my problems... Talked to my DME supplier about exchanging my N20 mask with a full face mask to take of my problems so I went with a f20 mask. At some point in the night my mouth would open some and the bottom seal of the Mask would be at the bottom of my lower lip, got a chin strap couldn't sleep with it try to different chin strap didn't work so good for what I remember. After trying and failure tried a different full face mask then a hybrid mask, then duct tape then duct tape and chin strap then my N20 mask, duct tape and chin strap last night perfect score 100 still feel like crap. Throat a litte dry, humidifier and hose set on auto. Also in the late afternoon if I sit down to get on my phone I start fighting to stay awake, it reminds me of a long time ago when I did not have a CPAP machine and I would fall asleep in meetings.  

Sometime during this, my doctor did blood work, complaining about being tired. My blood count ( CBC ) shows my red blood count is high told me to donate blood to get it down told me to stop my testosterone therapy and then recheck blood. Doctor said red blood count up from a combination of testosterone therapy and sleep apnea. 


With just my N20 mask and the mouth leak I would feel okay. I haven't felt refreshed and energized in a long time and wonder if something else could be going on with my sleep. I really would like to wake up and feel energized and refreshed throughout the day like I used to.
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#2
RE: Help, red blood cell count up, no energy, long time CPAP user
Sadly, it's quite normal for the sleep docs to look only at your AHI and use compliance.  As long as those two numbers look good, they don't even bother looking any further.
That means it's time to advocate for yourself.

Make sure your machine has an SD card and download the free OSCAR software.  It gives you a ton more information than myAir.
OSCAR - Open Source CPAP Analysis Reporter (sleepfiles.com)
OSCAR Chart Organization - Apnea Board Wiki

Browse through the Wiki here and read lots of posts. The experts here are brilliant and very helpful.
Once you have some data from OSCAR, screenshot and post here, and ask for help adjusting settings, sleep positions, and/or mask.

I'm not an expert but I would say if you're going to use tape, please don't use duct tape. It's too hard on your skin. 
Here's a wiki article on masks: Mask Primer - Apnea Board Wiki

Testosterone is very likely the cause of your elevated red blood count and that can affect your energy level (among other things). Listen to your doc and get your levels rechecked.
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