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Still fatigued with CPAP - looking for advice
#1
Still fatigued with CPAP - looking for advice
Hi all, I'm trying to use my CPAP device for the second time after perceiving no benefit the first time around. I have been diagnosed with a mild case of OSA. Since then I have lost a lot of weight. About two months into this second attempt, I have not seen a benefit in terms of fatigue. Was hoping to get my charts examined to see if there was a setting I should update or tweak.

Thank you all for your help, it is truly appreciated!


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#2
RE: Still fatigued with CPAP - looking for advice
I would try the following settings

Max 12
Min 8
EPR Full time
EPR 3
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Still fatigued with CPAP - looking for advice
Yep. I generally look at my charts to see at what pressure the machine reacts to events such as OA or H, andhigher flow limitations. In the posted charts, the reactions mostly are occurring while at pressure 6.5 to 7.2, so I would make my min pressure about 7.4.

I would also change my ramp pressure 5.5 to 6.0, and see how it does. That is, until you are so used to the pressures that you can just turn ramp off.

QAL
Dedicated to QALity sleep.
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#4
RE: Still fatigued with CPAP - looking for advice
Just turn off the ramp.  It doesn't have any therapy purpose.  It only eases you up to your minimum pressure setting if you find it uncomfortable at the start.
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#5
RE: Still fatigued with CPAP - looking for advice
I think the above suggestions are very helpful, however, we get a lot of comments on here from people using CPAP and saying they are still tired or not receiving any benefit. Your data show use times of 6.5 to 7 hours. Are you being awakened or are you aware of any discomfort related to the CPAP, or is your CPAP the cause of poorer sleep? Is your AHI between 0.3 and 1.0 worse than prior to therapy? If both answers are no, then it's not the CPAP and you need to start looking at other external factors. If either is yes, then some changes may be needed.
Sleeprider
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#6
RE: Still fatigued with CPAP - looking for advice
Thanks for the advice all! I will begin to move the pressure settings up to the recommended levels.

@Sleeprider - My tested AHI was 6 I believe. I will be retesting soon as I've lost significant weight since getting that number. As to sleep duration, this is not a consequence of CPAP and this is my sleep duration with or without CPAP. I've been unable to sleep longer than this amount the last couple years. I simply wake up after 6ish hours with zero sleep pressure remaining.

Thanks again!
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#7
RE: Still fatigued with CPAP - looking for advice
Have your ever tried running the machine in the CPAP mode?  If not I would suggest that you try it, set your pressure at a constant 9cm and perhaps your EPR at 3.  See if you feel any better after a few nights.
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#8
RE: Still fatigued with CPAP - looking for advice
I agree with OldSteve on this, apap mode causes more arousals and microarousals than static pressure, so please set your machine to cpap mode (or use min9 max9) but set EPR to 2. With the same min/max flow limits will be recorded, but in cpap mode it will not.
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