Hello and welcome guidance, charts posted ...

[SteveMac]

Hello everyone, 

I'm relatively new to the CPAP world, having used this therapy only for ~1.5 months so far.   I've tried several masks and adjusted my CPAP settings somewhat since beginning.  I was prescribed a full face mask Simplus mask and a pressure setting of 13.   I've had the minor leaks around my nose bridge blowing in my eyes as is somewhat typical and tried other Airfit F20.  It was about the same result, but irritated bridge of my nose/between eyes, so went back to Simplus and continued adjusting.  It still isn't/wasn't perfect, but got better.   I then tried a Mirage Liberty (hurt nose, prongs too firm), Dreamwear, (the nasal pillow turned out too soft and would close as I side slept often and leaned on it).   I then tried a Airfit P10 and it actually seemed pretty good to my surprise, as I was diagnosed as needed a FFM as a "mouthbreather" from my overnight study in early May.   I've stuck with P10 now for couple/few weeks.

My sleep study indicated (verbatim quote from document): 
"Moderate sleep fragmentation.  108 obstructive apneas and hypopneas present for an overal apnea hypopnea index (AHI) of 49.3.  The total time with an oxygen saturation under 90% was 3 minutes with a nadir of 88%.  Desaturation index was 5.9 events/hour.  Normal cardiac sinus rhythm. Snoring was loud.  Titration improved episodes of sleep disordered breathing.  Snoring was eliminated with CPAP.  Optimal pressure was 13 cm at which time AHII was zero and oxygen saturation was 97%"

Sorry all for long read ... just wanting to give as much information as possible for my first post.

My question/looking for guidance from you all is:   I would welcome any input / advice and I attached my Sleepyhead charts (trying to follow Sleepriders wiki guidance on doing this).   My myAir AHI is consistently under 1 (which by all measures as I've read on internet is very good), but [b]I'm still not as rested and suffering from fatigue/sleepiness that I would consider abnormal.  [/b]

Note that I did adjust my pressure setting from a prescribed constant/CPAP pressure of 13, to APAP pressure of 9-13 (and just yesterday from 10-13 as I noticed my AHI creeping up a little).

[SteveMac]

Added few additional days ...

[jaswilliams]

Based on your graphs and numbers your are well treated for Sleep Anoea. It can take a number of months for your body to recover, many people don't get a eureka moment and feel great straight away. There may be other things happening to make you feel tired

[SteveMac]

Thanks for response.  This was sort of what I expected from my amateur reading of the data.   I'll continue my therapy in hopes for feeling better over a little more time (and look elsewhere/for other reasons besides apnea for my sleepiness symptoms).

Thanks again!

[Walla Walla]

It looks like your respiratory rate is a little high and tidal volume is a little low. You might want to increase your EPR to 3cm and see if this helps you breath more comfortably.

[ShaunBlake]

SteveMac, you've learned that it sometimes (often?) takes months to recover to that wonderful nirvana of waking feeling rested, vigorous, and ALIVE!  And also it's inexplicably personal – for some folks, it's many days; some, weeks; some (as it was for me 'this time'), months.  And what I've learned is that each time I've been Dx'd, my response has been different, although the therapy has been pretty much the same.  So as long as the therapy is working, don't give up!

The great thing for you is that you've responded so quickly and are getting such consistently good results.  (<snarl>  No, I've been taught to not be jealous but I refuse to learn that lesson!)

And it's great that your body is responding.  Good job!

One suggestion I'd like to make: I notice that your pressure is maxing out at the maximum level you've set.  I think you should increase your maximum a couple of cm – it won't hurt your comfort and might provide a little more relief.  Otherwise, keep flaunting those great numbers (you showoff!) and keep looking behind you for jealous Irishmen!

[SteveMac]

It looks like your respiratory rate is a little high and tidal volume is a little low. You might want to increase your EPR to 3cm and see if this helps you breath more comfortably.

SteveMac, you've learned that it sometimes (often?) takes months to recover to that wonderful nirvana of waking feeling rested, vigorous, and ALIVE!  And also it's inexplicably personal – for some folks, it's many days; some, weeks; some (as it was for me 'this time'), months.  And what I've learned is that each time I've been Dx'd, my response has been different, although the therapy has been pretty much the same.  So as long as the therapy is working, don't give up!

The great thing for you is that you've responded so quickly and are getting such consistently good results.  (<snarl>  No, I've been taught to not be jealous but I refuse to learn that lesson!)

And it's  great that your body is responding.  Good job!

One suggestion I'd like to make: I notice that your pressure is maxing out at the maximum level you've set.  I think you should increase your maximum a couple of cm – it won't hurt your comfort and might provide a little more relief.  Otherwise, keep flaunting those great numbers (you showoff!) and keep looking behind you for jealous Irishmen!

Thank you both for the insight/suggestions.  I have already gone into "clinician mode" and adjusted the settings per your recommendations (EPR 3 and set max cm to 15).   I'll give you results in couple/few days.

Thanks again!

[SteveMac]

Hi Folks,

I've gone few days with the adjustments based on your recommendations (EPR 3 and set max cm to 15).  Attached are results.   All looks good to me, not sure if the tidal volume and respiratory rate trend is any different from before though (not sure if I'm reading right).   My events are next to nothing though, so from that angle I guess I'm very lucky.

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PS - Thanks very much for all your feedback.  You are all a super nice group of folks and very considerate and generous to volunteer your time helping others out like this (even though I'm apparently lucky that my therapy is working well by metrics, I can see how valuable / helpful you are to others that need much more help).

[Walla Walla]

It's pretty hard to increase the Tidal volume much with only 3cm pressure support to play with. If you had a BPAP you could probably increase the tidal volume more while decreasing your respiratory rate. But hopefully the EPR of 3cm will help you sleep better.

[SteveMac]

It's pretty hard to increase the Tidal volume much with only 3cm pressure support to play with.  If you had a BPAP you could probably increase the tidal volume more while decreasing your respiratory rate.  But hopefully the EPR of 3cm will help you sleep better.

My Blood Pressure readings have ticked up a bit ... correlating exactly with when I started with my CPAP therapy.  I know correlation <> causation, but it is is an interesting data point as I would have expected the opposite.    I was borderline hypertensive and now am averaging probably ~3 "points" higher in both diastolic and systolic measurements.   I have a follow up with my doctor in 3 weeks, so plan to talk to him about it, but question to you:   Would the tidal volume or respiratory rate have some implication on my blood pressure?   Would a BiPAP machine or ASV machine be anymore meaningful/helpful to me .. or am I being silly considering my results with my current autoset machine?