[Symptoms] Daytime sleepiness, extreme fatigue. Need help figuring out what's wrong.

[Expat31]

Can you post a simplified presentation of your graphs?

All we need are, in order of importance :-

1.Events
2.Flow rate
3.Pressure
4.Leak rate
5.Flow limitations

This will give us some better visibility having just the essentials. and their interrelationships, at a glance.

(To get the 5 graphs onto one page, go to File, Preferences, Appearance, Graph settings, Graph height, and set to say 130, you may have to go lower depending on your particular screen resolution.)

Important instructions.

 1) To take a screenshot of your Daily screen.
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  2) And please read through Attaching images, files and posting charts.


Thanks a lot.

[Expat31]

Hi, I have just been looking through your sleep study. 

Can you add the OSCAR respiration rate graph also?

Thanks

[PeaceLoveAndPizza]

A few comments...

The sleep study confirms what we already knew, but good to see them verify it. Your respiration rate is a bit high and  tidal volume is a bit low, which matches the higher respiration rate.  I am surprised the study did not mention it. You should discuss with them whether the standard APAP is the proper machine for you. We have some folks on here very knowledgeable in advanced machines like the ST, ST-A, and ASV, so hopefully someone will look at things and comment.

One thing I think needs to be changed is the pressure range as your median is almost 11 is to raise your minimum to 10. The max is fine at 15. You still have enough flow limitations to warrant an increase in EPR as well.

Mode APAP
Min pressure 10
Max pressure 15
EPR 3 full-time

You can give that a go for a few nights and let us know how it works out.

Now, regarding your question where to go from here... One thing to remember is use of a CPAP will help with those things it can with pressure and pressure support. What it cannot do is correct for sleep issues themselves. Years of poor sleep hygiene or physical issues are beyond the ability of a CPAP to solve. 

Start with this article and see if anything resonates.

https://www.sleepfoundation.org/sleep-hygiene

There are plenty of articles on sleep hygiene, so it is a good rabbit hole to go down learning about ways to get better rest. We are all guilty of poor sleep hygiene at times, so being aware of it is the first step.

[FrustratedSleeper99]

Thanks!

I'll send charts with the recommended settings later on when I have a moment. I'll update the settings on the CPAP as well to your recommendations.

My headache seems to be getting worse over the days. It's more noticeable now. It's kind of all around the head, sometimes on the neck. It's not super painful, it has more of an light achy/"restricted bloodflow" type feel.

I happen to be in a low COL country (going back home tomorrow) so got a brain MRI on the cheap, just in case there's something else going on. Will see if that turns anything up, hopefully not.

As for sleep hygiene, my bedtime is normally between midnight and 3am and tends to fluctuate quite a bit. I'll focus on having a more set bedtime and set routine and see if that works.

Bit worried about the headache and if I'm silently killing myself or something, and not sure what else to test. The spO2 seems fine so it's not oxygen deprivation headaches, not sure what else is going on let's see what happens over the next few days. This is harming my ability to work properly and enjoy life thank you guys for the advice so far

[FrustratedSleeper99]

MRI came back normal luckily, nothing out of the ordinary and no strokes detected.

[Lucid]

Hi, FrustratedSleeper99

It would also be worth thinking about what else has changed in your life leading up to these headaches and and tiredness.

Have you been at your current weight for more than a year, or have you gained weight over the last year?  Are you eating more carbs or salt, or getting less exercise than before?  Has your blood pressure increased, any swelling around your feet and ankles?  Have you had Covid or any other infectious disease?  You mention being temporarily in a low cost of living country -- have you had any insect bites?  There are some very nasty and insidious diseases that you can get from insect bites that that might not be very noticeable initially and would not be detected in the usual blood tests.  Have you had an eye exam?  Do you smoke, if so, have you been smoking more leading up to this?

This is all just off the top of my head.  Think about anything else that has changed.

Weight might not be what's causing this, but I guarantee that if you can lose 5 percent of your body weight in a healthy manner you will feel way better.

Good luck and take good care.

PS:  Expat31 -- what a great video that is!

[PeaceLoveAndPizza]

Regarding the headaches

• Is it something new or have you always had them either sporadically or consistently?
  
• If you sleep without the CPAP do you still have them?
  
• When did they start?
  
• Are they affected by our CPAP pressure being higher or lower?
  

The one thing that still stands out remains the low tidal volume coupled with the high respiration rate. 

I would like to try an experiment, if you are willing. Give the following settings a go.

Mode CPAP
Pressure 11
EPR 2 full-time
No ramp

I want to see if the higher pressure is the cause of the headaches, so by fixing it at 11 and giving a bit of EPR it may help.