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Still Sleepy?
#1
Still Sleepy?
Hello! I’ve been diligently using my CPAP, and honestly it’s probably helped, but I’m still very sleepy all the time. I’ve been diagnosed with chronic fatigue syndrome, so some of that may just be how it is, but CFS has no treatments, so I absolutely want to do everything I can to treat everything else. I use my cpap every time I sleep excluding a nap every now and then, and I have been using it for about two months. My AHI according to myAir is consistently below one, though I have still been struggling with leaking. Any suggested next steps?
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#2
RE: Still Sleepy?
I can see that the pressure you are using is too low for adults.  You need to increase your low pressure setting to 7.  Also, if you download Oscar and post your daily results we can offer you lots more help.

Also, Welcome
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution
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#3
RE: Still Sleepy?
Thanks for the response! Is there a point to using OSCAR and modifying my pressure settings if my AHI is already under 1?
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#4
RE: Still Sleepy?
Low AHI does not equal low arousals (which your self admitted leak problem contribute to).

Arousals cause sleep fragmentation and keep you feeling sleepy.
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#5
RE: Still Sleepy?
Here are some general things to consider. We can help with tweaking things.

1. Pressure too low - even though you may have a great AHI, if the pressure is not enough for both IPAP and EPAP, you may feel like there is not enough air. A bit more pressure should help.

2. Pressure too high - too much IPAP and/or EPAP pressure may be uncomfortable. It takes time to adjust for some, whilst others cannot get used to it. Dropping pressure slowly to find the sweet spot where events are handled and it is comfortable will help.

3. Fighting the machine - when we first turn up the pressure it feels uncomfortable to breathe for some. Breathing with the machine, not against it, will be much more comfortable. Relax. Breathe normally. It should not feel like a struggle, but if it does it is likely you fighting the machine and not the machine fighting you.

4. Mask and headgear sizing - mask and headgear need to be the correct size for you. Even if they are masks just do not fit people the same way. Subtle variances in physiology make a big difference in comfort. You have to find the right mask for you, but there is no secret to it. Many of us try half a dozen or more masks before finding the right one at the correct size. Give it a chance, but do not struggle with a mask or headgear. 

5. Hose management - Find what works for you positioning the hose. Some like it in the air hanging down, others above their head, and still more that like it under the covers across their bodies. Find what works for you.
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#6
RE: Still Sleepy?
I can relate. I've been on CPAP for a few months over 5 years now and I'm never feeling like it's done much good. I have also been diagnosed with CFS and they are leaning to a combination of fibromyalgia as well. I keep staying the course. Last year, I pushed enough that the doctor changed my ResMed Autoset from CPAP mode to APAP mode and tweaked my pressures. I still have so many clear air events that I'm not sure even APAP mode is working; but, according to them, my second sleep study showed my AHI down to 13.1 from 23.7, so they are "good with me using the APAP mode" on my machine. I've been trying to push them for an ASV but I digress. I have done everything humanly possible to plead my case and yet, here I am, very little progress has been made since 2015. It's rough when you can't get a good night's sleep. I never feel quite fully refreshed.
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