Feeling Bad Over Good Scores: Help Please

[TiredOne789]

Hi All
I am a 70-years-young woman and longtime CPAP user who has always wondered why my scores were so low and I still felt tired much of the time. Please take a look at my stats and make recommendations. 

In the beginning of my CPAP journey, I had a plain CPAP by Fisher and Paykel, immediately experienced aerophagia, switched to an APAP, and began taping my mouth. Eventually I found the P10, which I loved, and the RESMed AirSense 10 for her.

I reluctantly gave up the P10 in 2019 because I was experiencing “chipmunk cheeks” and high leaks despite using a lot of tape each night. My doctor and DME increased my pressure to 12 and then I raised it to 15. I switched to a full-face mask, ResMed F30, which now appears to control the leaks.

Today my pressure range is 5 to 15. I started using a soft cervical collar in July with much success, resulting in fewer positional apneas. And I downloaded OSCAR. I notice that my Flow Limits are high. My doctor said they were okay. I feel like crap.

Please take a look at my data and tell me what changes I can make to feel better. I hope I’ve posted the correct charts. Thank you so very much. 

This Forum is a godsend. 

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[OpalRose]

Hi TiredOne789,
You graphs look great, but you feel like crap!  I think if you added EPR, that should help with the Flow Limitations.  I would set EPR to 2.  This can be adjusted up or down. As long as you don't see an increase in Clear Airways, this should help with the FL.
Although a min pressure of 5 is low, your results are still good. It could be raised a bit. I would try 7cm and keep max pressure as is. EPR at 2 to start.

As far as how you feel, believe me...I can relate.  I also have good numbers, but don't always feel that great.
Sometimes, we have to look elsewhere for what the issue might be.  It may have nothing to do with Cpap usage, but possible other health problems.  

Have you had a checkup lately...complete blood work?  Thyroid checked?  Also, look into vitamin deficiencies.
Low levels of some vitamins like D and Magnesium can have a negative effect on our health. Ask your doctor to be tested for these.
Good luck and post another chart after making changes.

[mesenteria]

Hi, and welcome.

Cheempunk cheeks is BECAUSE you are taping.  Your tongue loses tone as you sleep and falls away from your palate, thus allowing air to enter your mouth cavity and to inflate it. Cheempunk cheeks.

[staceyburke]

Welcome this is a great site where you will get help. 

PS (pressure support) is used to limit flow limitations. 5 for the min is to low use min 8 (it may go up as we look at more OSCAR) and PS=3.  That should help and you should not feel much difference. Give it a try tonight and post tomorrow.

[Sleeprider]

I agree with OpalRose that the solution to your problem lies in using EPR. Increase minimum pressure to 7.0, and set EPR to 2. That will start pressure at 7.0/5.0 (inhale/exhale). This will greatly reduce the flow limitations which are probably from upper airway resistance or obstruction. Reducing flow limitation will result in less effort to breathe, and your sleep should become more restful.

[TiredOne789]

Thank you Opal Rose.

My bloodwork always comes back fine. I am hypothyroid and my thyroid scores are very good. I take magnesium and vitamin D every day. I kept asking my endocrinologist why I was so tired and didn't sleep well. She said, your thyroid scores are fine; see your sleep doctor. So I did, and started making changes, but obviously not enough. I will incorporate your suggestions and post again.

Tired One

[TiredOne789]

Hi Serial Tapist!
I didn't know taping could cause "chipmunk cheeks."  Taping worked for years, then it didn't.  I will practice the tongue against the teeth trick and hopefully go back to the P10. But first will make the pressure and EPR changes others suggested here.
Tired One.

[OpalRose]

Hi Serial Tapist!
I didn't know taping could cause "chipmunk cheeks."  Taping worked for years, then it didn't.  I will practice the tongue against the teeth trick and hopefully go back to the P10. But first will make the pressure and EPR changes others suggested here.
Tired One.

Just to clarify, when practicing the tongue trick, don't place your tongue against your teeth.  The tongue should be at the roof of your mouth just behind your teeth.

It could possibly become habit to press your tongue against your teeth which in time could cause movement of teeth.  


Tongue Suck Technique:
Place your tongue to the roof of your mouth with tip of tongue behind front teeth. (Not pushing on teeth) 
Slowly suck upwards and back.
This places the tongue in a natural position, with the back of tongue sealing the back of the throat so that if you open your mouth/jaw while sleeping, no air will escape.

[TiredOne789]

Thank you for clarifying the Tongue Suck Technique.

Tired One

[Hydrangea]

I just want to throw something out there since nobody has mentioned it.

It's possible your extreme tiredness could be from the masks you're using (P10 & F30). I have struggled with severe fatigue (and other OSA symptoms) with those 2 masks, and found it to be due to the inadequate venting of exhaled air. I switched to a mask that vents better, and sure enough I felt so much better.