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11-24-2024, 04:04 AM (This post was last modified: 11-24-2024, 04:12 AM by 2SleepBetta.)
RE: Still feeling fatigue during the day even though using CPAP device regularly
Jukka, you wrote:
"...I sleep most often on my side but I feel is easier for me to fall asleep on my back. Quite often I fall asleep on my back, then wake up and continue the sleep on my side (sometimes not able to catch the sleep any more). I can share some fresh charts from Oscar and try to sleep on my side. Regarding the night for November 8th I don't recall any more how much I slept on my back."
Phlegm being a key factor, I'm sure, in your poor sleep it's important you not only try to get control in, say, ways Geer1 or others suggest. Try their or your own approaches, one by one, through a fair trial period: at least a week? a month? longer?
But, also, immediately do more, all you can, in addition to, or as an alternative to, what you've tried to remove positioning effects (e.g., you raising the head end of your bed). That raise up is one of the three "positioning" ways to reduce your troubling sleep disruptive factors that you can control: your three different sleep position options: raise the head of the bed or use a wedge; wear a firm enough cervical collar that fits almost snug against the bottom of your jaw; prevent supine sleep.
Don't reduce but, maybe, raise the head of the bed more or add an upper body wedge. Get a high-enough cervical collar to eliminate or reduce any chin tucking's airflow interference. Take whatever measures are needed and tolerable to ensure you sleep on your side, not on your back. Do all three, one at a time—even all at once if you can. If you sleep no worse doing it, try all three at once ASAP. Just get to a place where you enable better assessments of any dietary, Rx and nostrum-use changes you try. Your trials of your foods, drugs and nostrums, I expect, will require the most trials, time and care to evaluate them. Positioning benefits, if any, should far more quickly become visible in OSCAR or, more importantly, in how rested you feel. (I assume, you will try raising your pressures like PLaP or as I suggested for EMIN (8 or 9 cm) and as you have suggested.)
As in my small-font, colored caveats in my signature area far below: I'm sure you understand this but feel it must be made clear: Any trials you attempt are your own choice and your own responsibility. I and others here are commenting based only on our own lived experiences and from our readings about problem solving here on the forum and elsewhere. We laymen give you our thoughts about how you might improve your sleep, all based on how we interpret information you may or may not provide us. None of us have medical credentials, so far as I know.
To almost exclude any doubt you might have about whether you have slept on your side or supine, I suggest the following simple method. I do assume you can fall asleep on your side—because I know this method makes it very difficult to roll over to side sleep and that would definitely cause arousal. But, if the method gives you more and longer snatches of sleep than you have been getting, there would be a net benefit in better rest and it would clear away a bit of those things that obscure your path toward finding much more restful sleep.
Far simpler than how I stopped my supine sleep, you might try this. Get a sturdy shoe-box size box and an ordinary strong waist belt. Cut minimal slots at the bottom edge of the opposite narrow ends of the box. Slip the belt through the slots and atop the bottom of the box and buckle the belt snugly around your waist. Try your DIY supine block for at least a week. See if it, in addition to raising your exhalation pressure to 8 or 9 cmH20, helps your sleep and your OSCAR graphs. You may well need to tape in reinforcing pieces of sturdy cardboard to maintain shape of the box and to prevent belt slots in the box from enlarging. Sufficient rigidity of the box bottom against your back will keep the block from moving past your hips. The longer the box and it span across the back, the less free movement toward or away from the supine position. Here is a link to the supine block I fashioned using what was apparently a surveyor or timber cruiser's light canvas vest with good durable metal snaps https://www.apneaboard.com/forums/attach...?aid=33700 .
I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.
Of my 3 once-needed, helpful, and adjunctive devices I have listed, only the accelerometer remains operative (but now idle). My second CMS50I died, too, of old age and the so-so Dreem 2 needs head-positioning band repair--if, indeed, Dreem even supports use of it now.
RE: Still feeling fatigue during the day even though using CPAP device regularly
Jukka, you wrote:
"...I sleep most often on my side but I feel is easier for me to fall asleep on my back. Quite often I fall asleep on my back, then wake up and continue the sleep on my side (sometimes not able to catch the sleep any more). I can share some fresh charts from Oscar and try to sleep on my side. Regarding the night for November 8th I don't recall any more how much I slept on my back."
Phlegm being a key factor, I'm sure, in your poor sleep it's important you not only try to get control in, say, ways Geer1 or others suggest. Try their or your own approaches, one by one, through a fair trial period: at least a week? a month? longer?
But, also, immediately do more, all you can, in addition to, or as an alternative to, what you've tried to remove positioning effects (e.g., you raising the head end of your bed). That raise up is one of the three "positioning" ways to reduce your troubling sleep disruptive factors that you can control: your three different sleep position options: raise the head of the bed or use a wedge; wear a firm enough cervical collar that fits almost snug against the bottom of your jaw; prevent supine sleep.
Don't reduce but, maybe, raise the head of the bed more or add an upper body wedge. Get a high-enough cervical collar to eliminate or reduce any chin tucking's airflow interference. Take whatever measures are needed and tolerable to ensure you sleep on your side, not on your back. Do all three, one at a time—even all at once if you can. If you sleep no worse doing it, try all three at once ASAP. Just get to a place where you enable better assessments of any dietary, Rx and nostrum-use changes you try. Your trials of your foods, drugs and nostrums, I expect, will require the most trials, time and care to evaluate them. Positioning benefits, if any, should far more quickly become visible in OSCAR or, more importantly, in how rested you feel. (I assume, you will try raising your pressures like PLaP or as I suggested for EMIN (8 or 9 cm) and as you have suggested.)
As in my small-font, colored caveats in my signature area far below: I'm sure you understand this but feel it must be made clear: Any trials you attempt are your own choice and your own responsibility. I and others here are commenting based only on our own lived experiences and from our readings about problem solving here on the forum and elsewhere. We laymen give you our thoughts about how you might improve your sleep, all based on how we interpret information you may or may not provide us. None of us have medical credentials, so far as I know.
To almost exclude any doubt you might have about whether you have slept on your side or supine, I suggest the following simple method. I do assume you can fall asleep on your side—because I know this method makes it very difficult to roll over to side sleep and that would definitely cause arousal. But, if the method gives you more and longer snatches of sleep than you have been getting, there would be a net benefit in better rest and it would clear away a bit of those things that obscure your path toward finding much more restful sleep.
Far simpler than how I stopped my supine sleep, you might try this. Get a sturdy shoe-box size box and an ordinary strong waist belt. Cut minimal slots at the bottom edge of the opposite narrow ends of the box. Slip the belt through the slots and atop the bottom of the box and buckle the belt snugly around your waist. Try your DIY supine block for at least a week. See if it, in addition to raising your exhalation pressure to 8 or 9 cmH20, helps your sleep and your OSCAR graphs. You may well need to tape in reinforcing pieces of sturdy cardboard to maintain shape of the box and to prevent belt slots in the box from enlarging. Sufficient rigidity of the box bottom against your back will keep the block from moving past your hips. The longer the box and it span across the back, the less free movement toward or away from the supine position.
I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.
Of my 3 once-needed, helpful, and adjunctive devices I have listed, only the accelerometer remains operative (but now idle). My second CMS50I died, too, of old age and the so-so Dreem 2 needs head-positioning band repair--if, indeed, Dreem even supports use of it now.
Machine: Resmed Air Sense 11 Auto Mask Type: Full face mask Mask Make & Model: Phillips dreamware Full Face Humidifier: Resmed CPAP Pressure: 8.6 cm to 10.6 cm CPAP Software: OSCAR
Other Comments: 35+yrs on CPAP-98% compliance * VCOM at machine*
RE: Still feeling fatigue during the day even though using CPAP device regularly
Jukka.
Hope all is well, or getting better.
You have lots of great advice from people here.
I want to restate about Breathing exercises.
What i am suggesting will get you into a state of Rest and Digest!
You will settle down the sympathetic nervous system and trigger the para sympathetic which involves settling down your Vagus nerve.
It works, and it does not take a lot of time to get results!
You MUST try some exercises!
I swear they work!
And others here, would you please try and let me know how you make out?
We need to get on board so others can be confident of these results.
RE: Still feeling fatigue during the day even though using CPAP device regularly
Thank you Geer1 and SeePak for your valuable comments.
I will pay attention to positioning effects and try to avoid sleeping on my back.
Actually I had bought earlier a t-shirt that has a pocket for a foam roll in the back.
I had stopped using it because it made changing from side to other a bit difficult.
I have now started to use it again.
I will also raise the head end of my bed more. I had raised it earlier about 2 inches but I think it should be raised even 6 inches.
Regarding mental health issue. Yes, during the past years I have had lots of (mostly) work related stress.
I have been working in the IT industry for about 36 years now.
"I want to restate about Breathing exercises.
What i am suggesting will get you into a state of Rest and Digest!
You will settle down the sympathetic nervous system and trigger the para sympathetic which involves settling down your Vagus nerve."
I am eager to try the breathing exercises that you suggested.
Can you advise where can I find those exercises? Preferably those that are free of charge.
I found some videos by Patrick from YouTube already.
Kindly share if you have some links.
Regarding: "I'm sure you understand this but feel it must be made clear: Any trials you attempt are your own choice and your own responsibility."
Yes. I am very grateful for all the advices the people have given but of course I don't get them as 'doctor's orders'.
I definitely understand it is all on my own responsibility. I am the best expert on issues related to my own health because I know myself the best ;-)
I will post later this week some graphs from Oscar.
I have tried both pressures a) from 8 to 15 cm and b) from 6 to 8 that have been recommended in the replies.
Apologies in case I have missed some of you recommendations or changes in them.
Machine: Resmed Air Sense 11 Auto Mask Type: Full face mask Mask Make & Model: Phillips dreamware Full Face Humidifier: Resmed CPAP Pressure: 8.6 cm to 10.6 cm CPAP Software: OSCAR
Other Comments: 35+yrs on CPAP-98% compliance * VCOM at machine*
I'm assuming that due to your it work you are familiar with how to use different programs including those on a mobile phone if not I will direct you to an exact exercise let me know the main thing you need to know is that for Stress and Anxiety the exhale breath needs to be longer than the inhale breath and all breaths need to be light slow and deep meaning using your diaphragm to breathe.
I would love to hear how you are making out both of the exercises and your sleep and stress levels.
RE: Still feeling fatigue during the day even though using CPAP device regularly
I attached 5 graphs from this week. I had set the pressure settings as follows:
- for the 1st: min 6 and max 8
- for the 2nd: min 8 and max 15
- for the 3rd: min 10 and max 15
With pressure min 6 and max 8 I felt 'brain fog' and exhausted.
With pressure min 8 and max 15 I felt still exhausted but maybe not that much as with the previous settings.
With pressure min 10 and max 15 (last night) I felt probably the best. Not refreshed really but not so exhausted.
I don't know how much can be deduced from these graphs, because in my case there are variable factors (mucus problems, digestive issues) that vary from day to day.
He is saying:
"And like you, I was very firmly in zombie status despite my obstructive apneas going away. And again, It's down to getting used to breathing normally with the variable pressures. Those pressures and wonky breathing can and do cause new users to partially wake up. And cause the increase in day time sleepiness. And it can be frustrating."
He had changed pressure settings from min 8, max 10 --> to min 10 max, max 15, which seems to have improved the situation significantly.
Myself I have been considering also should I try constant pressure instead of automatic/variable pressure but I am not sure what could be the appropriate level in my case.
As far as I understand Airsense 11 can be switched to use CPAP instead of APAP.
I have also started the breathing exercises (as recommended by SeePak) with Oxygen Advantage app. I feel already I can reduce anxiety but need some more experience still.
RE: Still feeling fatigue during the day even though using CPAP device regularly
Jukka, I should have better explained the attachment I inadvertently double posted above.
The uppermost red sleep-angle trace converges in steps from about 0440 to about 0510 when Snore and OA jump higher because my sleep position is by then supine. Snore and OA continue high in that position until I turn over and sleep on my other side at about 0730 and there is little Snore and no OA afterward.
Flow limits seem lower during that bad Snore and OA period, but my opinion is that was because effects of such high Snore were masking a lot of flow limits. That noted, my flow limits for that whole night look typical, and they are not much changed now as I am again using my Airsense 10 Autoset, temporarily, for an experiment.
My unstated points about that chart and the boxes was a try to keep you off your back.
Others will likely differ. But because I will soon be experimenting with use of cpap mode and fixed pressure——no EPR and no Pressure Support—I'd now be trying, if in your shoes, a fixed pressure of 11 cmH20, based largely on your last chart. But that may not be better for you.
I've not yet gone to fixed pressure because of some experimental comparative work begun with APAP PS3 and cpap EPR3, the same IMAXes. My long time PS has, until these experiments lately, been PS4 which reduces FL presentation dramatically. But I can't say I feel more rested than with the Autoset which always shows so many FL. Accordingly, I'm expecting good things once I soon change to fixed pressure cpap. Maybe I'll begin to have dreams again, a good sign of restorative REM stage sleep.
I've long used EPR3 and PS4 in my PAP history, almost since 2015.
I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.
Of my 3 once-needed, helpful, and adjunctive devices I have listed, only the accelerometer remains operative (but now idle). My second CMS50I died, too, of old age and the so-so Dreem 2 needs head-positioning band repair--if, indeed, Dreem even supports use of it now.
Machine: Resmed Air Sense 11 Auto Mask Type: Full face mask Mask Make & Model: Phillips dreamware Full Face Humidifier: Resmed CPAP Pressure: 8.6 cm to 10.6 cm CPAP Software: OSCAR
Other Comments: 35+yrs on CPAP-98% compliance * VCOM at machine*
RE: Still feeling fatigue during the day even though using CPAP device regularly
Hi Juuka, so glad you are feeling better.
Getting control of axiety and stress, thru conscious awareness of their prescence, will allow immediate consciousness of breathing and then doing an execise to bring that under control or supplement good vibes!
Also, accurately diagnosing problems, allow problem solved!
If Positional is now known to be an issue, like one of the other moderators said, you need to be doing all you can about that!
I love laying on my back for sleep, but i cannot do it reliably, cause from day to day things change anatomically for me, and probably you too.
It feels so comfortable nodding off, but you may not realize how long you really did lie on your back AND how many events you had!
I know this happens to me, just lately even.
The neck collar can be invaluable for this.
You are getting great advice from the AB group, and appear to be following with your understanding of all this, so that's great!
I know you will be having some obvious success any time soon!
RE: Still feeling fatigue during the day even though using CPAP device regularly
I would say that not all fatigues and sleepiness and humans are because of sleep apnea.
ALso
your stuffiness and nasal mucus production and post nasal are also a factors for the CPPAP to work well. I would pay a lot of attention attention on this issue.
It seems such a variable pressure. Is it an autoset CPAP? Agree with changing the minimal pressure slowly up to see if that helps.
Remember body position also plays a role. I would work on devices that keep your body on the side rather than on your back. Sleep apnea worsens in most people when on their back.
I dont know your weight but if its too high, I recommend a wedge pillow to improve your lung mechanics and allow you to breath better while in bed.
It's soo hard sometimes...