Not feeling better, advice?

[Easylistener]

Ok so I have posted here about my huge nose issues and am still working on getting a mask that I can get to seal...I have the f20 and have been working hard on getting it to seal right....

I have been trying to get this apnea under control for a long time and using the P960 auto sv bipap machine just hasn't made me feel better....I have been back on it for a little over 2 weeks and my ahi have come down since I last used the machine 2 years ago but I still feel exhausted even after using it and actually I think I feel even more tired using the machine then without....My girlfriend just can't sleep anymore with out the machine as I snore so loud that I even wake some of our 6 kids during the night...I have lost 60 lbs since I started to use the machine again and that has helped my ahi come down and needing a little less pressure, but like I said hasn't helped me feel well rested..

So what am I missing here, it has to be something right?  I read and hear all these stories about how much better people feel after switching to using a pap system.  I had very bad obstructive sleep apnea and since getting my ahi down to the 3-9 range depending on the night hasn't seemed to help....

I have attached a couple screen shots of my sleepyhead reports, this being my first time doing it please let me know if there is something I missed or need different order...I read the help section so I was able to follow some of it, but that doesn't mean I did it all right....

Any help would be appreciated...

[mesenteria]

... but I still feel exhausted even after using it and actually I think I feel even more tired using the machine then without....My girlfriend just can't sleep anymore with out the machine as I snore so loud that I even wake some of our 6 kids during the night...I have lost 60 lbs since I started to use the machine again and that has helped my ahi come down and needing a little less pressure, but like I said hasn't helped me feel well rested..

...

Your experience is surprisingly typical...believe it or not.  At least half of all PAP therapy recipients/practitioners have the same unhappy, disappointing, and unpleasant feeling even some weeks into their therapy.  It does get better over time, so try not to fret.  You have spent years getting to the point where you are in trouble, and it won't be rectified as quickly as it takes to renovate your kitchen.   

You still need to get 'dialed-in'.  It looks like you have a wide range of snoring, AHI, periodic breathing, and so on, and it may eventually be everyone's agreement that you're on the entirely wrong kind of therapy (including that you may have the wrong kind of device working for you and will have to change it, but let's not jump off the dock just yet...there may be ice down below).

I see clustering.  Your 'faults', when they are depicted in sleepyhead, show clusters of events, and it is almost certain to be related to your head's position, including how it is turned and held by your body.  Most of us end up on our backs for at least part of the night, often later on in the two hours prior to waking.  Generally, back-sleeping (supine as it is known) is not good.  Our tongues relax and slide back, palate tissue sags to meet it, and the result is all that 'vibratory snoring' sleepyhead says you experienced.  And/or, our head and neck sag into the pillow and we end up with our chins tucked down over our upper chests.  More closure and restrictions of the airway.  More obstructive events depicted in sleepyhead.

You may profit from the use of a soft foam 'cervical collar'.  They're available on line and at drug and medical supply stores.  The collar will resist your chin-tucking.

I'll let the more knowledgeable gurus here talk you through your charts and suggest changes to your therapy settings.

[Easylistener]

Thank you so much for your feedback....

I might have forgotten an important piece here and not sure if anyone else is on here that has a medical condition called ehlers danlos syndrome.... This condition is part of the issues with masks not sealing and probably some of these obstructions.... All my connective tissues are super lax and that causes all my joints to dislocate super easy.... Among other issues associated to connective tissues being more playable....

My doctor talked about a different machine but since I am on Medicare we have been trying to save me some money and use the one I already have.... I know several others here like the ResMed devices better... Just not sure if that's what I need....

Thanks again for everyone that's has looked at my stuff and I hope more will have some advice to help me.

[Sleeprider]

We are going to be more concerned with respiratory abnormalities that might be present, or how any disorder affects your mask-fit. I know you are convinced that you have allergies that preclude the use of a nasal pillows mask, and that you are a chronic mouth-breather, but I have seen both of these problems overcome by the direct nasal pressure. Anyway, a nasal pillows mask like the Airfit P10 is only $68 out of pocket on Amazon with all sizes included. It might be worth a try.

You are currently using the PRS1 960 with EPAP min 10.0, PS 0 to 10. Your events are predominately OA and H. Have you tried a PS min of 2.0 to try to resolved the hypopnea?

[Easylistener]

I have not tried a Ps min 2...something I can try tonight....

I have not tried that nasal pillow model but I did try 2 different ones back in 2015 when I first got the machine.... It worked good for half the night but then I would open my mouth and the air would just leave out it.... I could try it again.....

[Easylistener]

OK my machine won't let my change the Ps min number.... Anyone know y?

[Sleeprider]

The PRS1 DS960 allows adjustment of PS min, and the manual reads as follows:

PS min - This screen allows you to modify the Minimum Pressure Support setting. This setting is the minimum difference that is permitted between IPAP and EPAP. You may adjust the setting from 0 cm H2O to the difference between the maximum pressure setting minus the maximum EPAP setting.

[Easylistener]

Ya I go into the set-up menu where I can make adjustments and I can change the Ps max and all the other settings but when I go to Ps min and push select button it highlights the 0 but when I spin the knob to adjust the number it just stays at zero..... I don't know what's up.... I even read the manual also to make sure I am doing it correctly..... Maybe I will take a video to post so someone can let me know what I am doing wrong... I changed the Ps max from 10 to 12.5 to make sure I was doing it right... I will have to change that back.... I don't know what I am missing or doing wrong, but it has to be something... Is it tied to another setting that maybe needs to be higher?

[Gideon]

try setting PS Max to 3 (just to try setting) then set PS min to > 0

[Easylistener]

OK I set psmax to 3 with no issues but it still won't let me set Ps min off of 0...i changed my Epap min to 11 also instead of 15 the other day and that has helped me sleep steadly through the night and hasn't changed my ahi either..... So I know I am in the right setup menu section and using the select knob and twisting the knob is the way to change the settings.... I am so frustrated with this whole machine and bipap in general as I am so tired on it and I didn't feel this exhausted before using it...