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I’ve been on cpap for possibly 20 years or so, and I rarely feel rested when I wake up and I’ve been trying to figure out why.
I’ve made lifestyle changes (lost weight), exercise regularly, wake up/go to sleep at the same time etc, but I still don’t feel rested. I’ve ruled out other reasons for fatigue (been tested for lots of things by other doctors)
My Sleep Doctor says my apnea is being addressed via CPAP therapy, when I mentioned I still felt fatigued he says that happens to about 20% of people, and offered Modafinil.
I’m going to go see a neuro sleep specialist next month, as up until now I’ve only seem pulmonary sleep specialists.
One thing that isn’t working well, I’ve been seeing a lot more of the red frowny face lately. The last few nights have been better since I’ve changed the pillows to large, adjusted the position of the pillows (in my nose) and safety pinned the hose to my shirt. (I put a rubberband around the hose and attached the safety pin to the rubberband so the hose stays in place when I sleep)
No more frowny face for the last few nights, but the machine reports 38L/min (Doctor says it should be around 20)
One other data point, I looked at sleepyhead statistics, and it seems that my average leak rate has been increasing since I got this machine last summer.
I’d love to try and get the leak rate down, so any advice greatly appreciated. (My doctor says the next step is a full face mask, but I’d prefer to keep the pillows if there are other tweaks I can try)
The leaks are not doing you any favors, as they are very disruptive to sleep. Some people have found a soft cervical collar helps nudge the jaw enough to prevent leaks, just go for a loose comfortable fit. Hopefully this will pass.
Just to get it out of the way, you might want to do a testosterone test. Surprising how many of us are low and it can have similar fatigue.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
How old are your head gear and mask? They need to be replaced periodically. Finding a mask that fits right is one of the most important and difficult things. Do you wake up with a very dry mouth or throat? That could indicate that you open your mouth and allow air to flow through, a full face mask could help with this. Wipe down the sealing surface of your mask daily to remove facial oils. Have you read the Mask Primer in the wiki, if not read it. Try different masks, I find I get the best results with the old style with the forehead brace. You've been doing this as long as I have I hope you can figure this out.
Had a testosterone test recently, Doctor said levels were normal.
Is a cervical collar preferred over a chin strap, or are they basically doing the same thing? (I ask because I probably have a chin strap, but I'd have to buy a cervical collar to try it)
nosleeptilbklyn,
Chinstraps tend to pull up and to the rear, causing your jaw to be pulled rearward. This can cause discomfort. The cervical collar pushes directly up on the lower jaw with less chance for jaw discomfort. Additionally, the collar aids in the prevention of "jaw tuck" which promotes OA's. If you already have a chinstrap then try it. If it works, then you saved a few bucks.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Machine: Resmed AirSense 10 AutoSet For Her Mask Type: Full face mask Mask Make & Model: Resmed f20 Humidifier: Resmed Integrated humidifier CPAP Pressure: 11/14 CmH2O CPAP Software: Not using software
Other Comments: I started CPAP in 2008. Totally blind since birth.
Points made above about the collars all ring true. A long and corroborating story follows.
I struggled with full face masks, chinstraps (3 types purchased and one improvised from a baseball cap) as a side-sleeping-mouth-breather and was continually awakened with leakage, a significant amount over the 25 "limit".
I kept reading here about nasal pillows, but considered my mouth breathing a barrier. After a year and a half fighting the leakage problem with the mask fitting guidance, 3 brands of masks and the various straps, I ordered the popular P10 and resolved to find a way to use it, which I did--using the various chin straps, Lansinoh (sp?) and sealing my mouth in a variety of my early ways. Leakage problems were reduced a lot and sleep was much better. I was not doing well with the tongue-seal technique, but was trying and was getting better, bringing my cheek puffing down and somehow getting beyond some initial aerophagia.
Seeing the many Forum mentions of them, I was skeptical about how a cervical collar could do the job--but liked the idea of getting rid of straps that put a "ditch" across the top of my head and, yes, pulled the jaw back (probably adding to OSA). I got a collar for about $14 at either the ceeveess or walg store in early June and have continued using Lansinoh.
Wow! Results have been amazing and the collar is comfortable, loose enough to comfortably insert a couple of fingers between the collar and jugular area of my neck. I do have to be sure my bed pillow does not put pressure upward on the side of the collar as I lie on my side. After a couple of months use the tongue seal is better, aerophagia has gone away and now I'm regularly getting zeroes for leakage.
I think I still need my current and best mouth-sealing element and I use one described elsewhere on the Forum, in my chin strap days. It uses the effective and skin friendly Silipos Gel-E Roll. For safety I (easily) improvised an anti-asphyxiation valve using one from the F10 mask . Some on the Forum think one would wake up if the air pump stopped. I didn't want to take a chance since I once had had a lot of OSA's from 90 to maximum of 135 seconds before self-titration using Forum advice (no thanks to my sleep MD who was fixated on AHI<=5 and compliance with the 4 hour usage requirement).
So comfortable and pleased with what is working, I haven't yet tried to eliminate the artificial seal. Next, I need to find out why there are so many flow restrictions in my breathing that don't rise to the reportable event level. All said, thanks to helps here on the Forum I am sleeping good after following a long and twisting path to get here in nearly 2 years.
Bottom line. The collar has done wonders for me, though it may not be for everyone. Reportedly it works for many people without need for any artificial sealing element.
2SB
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.
