[Treatment] Can cpap help me?

[Noripterus]

Hey guys.


Short backstory: I'm 30 years old. As my health was/is miserable, and I have a some of the typical symptoms (fatigue, snoring, very poor sleep, heart racing at night) my doctor sent me for a sleep study. AHI 3, lowest SPO2 90%, RDI 16. The doctor sees no reason to treat it. "Not worth it, go exercise and lose some weight". I'm slightly overweight (BMI 26). But the problem has persisted much longer (10 years? I have always been tired!) than me being overweight, which has only happened in the last two years or so.

So after finding this forum I decided to self-treat. I bought a Resmed AirCurve 10 VAuto per Barry Krakows recommendation a few weeks ago.


Here are a few of the first nights:
     
   
   

I added a cervical collar (big difference) and continued to increase the pressure. This is where I am now:

   
   

I don't feel/sleep better. I'm in doubt. Do I need to further increase pressure?

[slowriter]

Did the sleep study report RERAs?

[mesenteria]

I have only looked at the first two charts and see persistent centrals.  Remembering all the while that your machine is recording a very low AHI at its current settings, and even that your pre-treatment events were under the upper limit for 'treated' anyway, what stands out are a few centrals.  I dunno if it would be at all useful, but I'd like to see if your lower pressure could be lowered down to about 6 or even 5.5 for a night to see what happens.  I'd like also to see your pressure relief, which I believe is "1", to be increased to "2" and maybe to "3" eventually to see what happens.

Please do NOTHING until you have a lot more input, especially from people who can construct a valid argument to you that you can follow, and then consider what you want to do....if anything.

[SarcasticDave94]

Hi Noripterus,

Welcome to the Apnea Board.

I’d agree with mesenteria. Let’s see what others have to say before any action. Best wishes for success.

[Gideon]

Where are your persistent centrals? yes centrals are present, they almost always are. These are nothing to be concerned about. Nothing in this thread would cause me to chase numbers. What you have proven is that none of your pressure changes have impacted your centrals, so forget about them, Watch yes, looking for a BIG change but that is all.

Which settings made you feel best? Why? How do you feel now? Do you feel the therapy is doing its job? why or why not?

Changes should be based on the answers to these questions more than your numbers, much more.

[ardenum]

When dealing with fatigue but low ahi, you'd wanna run the machine as a mini ventilator support. I have ME/CFS which is the lowest you can get with fatigue and lack of energy, you can try my settings for a couple of days.

mode: S Mode, IPAP 13, EPAP 9, Easy breathe: off, triger: very high, cycle: very low, Ti max:3.5 , ti min 0.8, Rise time 500ms,

if you sleep on stomach raise to IPAP 15, EPAP 10.

[Dormeo]

To follow up on Bonjour’s questions: during the night do you wake up frequently? Have trouble falling asleep? Or....? And during the day, do you have trouble staying awake at work? When relaxing? Or do you just feel generally gloomy and slow-witted?

I would hold off on further changes to your settings until the experts can hear from you about these questions.

It’s very hard to accept that feeling better may take time, or at least I find it hard. And yet it is true. Try shifting your focus a little from settings to the things you can do to develop new habits around sleep. They won’t work magic quickly either, but they are a way you can do good for yourself. Here are the habit to cultivate:

Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
Set a bedtime that is early enough for you to get at least 7 hours of sleep.
Don’t go to bed unless you are sleepy.
If you don’t fall asleep after 20 minutes, get out of bed.
Establish a relaxing bedtime routine.
Use your bed only for sleep and sex.
Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
Limit exposure to bright light in the evenings.
Turn off electronic devices at least 30 minutes before bedtime.
Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
Exercise regularly and maintain a healthy diet.
Avoid consuming caffeine in the late afternoon or evening.
Avoid consuming alcohol before bedtime.
Reduce your fluid intake before bedtime.

[Noripterus]

First of all, thank you to all of you for taking the time for a response. I appreciate it.

@slowriter, my study did not indicate RERAs. However, compared to the AHI the RDI is just adding the RERAs? So I assume I had about 13 RERAs per hour. Please correct me if I am wrong.


@mesenteria, my first nights were at an expiratory lower pressure of 5/6. I also tried out a higher Pressure Support, and do not like it. Of course, if you guys think that it might improve my treatment, I will try it out again. I'm sure I can get used to it.


@SarcasticDave94, again, thank you.


@bonjour, I am not so sure yet.
I'm averaging only about 5-6 hours with the mask on. My neck is often uncomfortable both from the strap and the cervical collar. Next week im going to order another pillow as well as another mask and see if I can improve things on that side.
In the last week, there were a few days that I woke up feeling alright, but it's probably too early to tell.
However, I also still sometimes wake up with my heart slightly racing, especially in the early morning. And I think it coincides with the times that Oscar reports Apneas. I'm not 100% sure though.


@Dormeo, no, I don't wake up frequently, neither do I have trouble falling asleep. I'm feeling more "fatigued" than "tired" if that makes sense.
How I feel on a certain day is so dependent on how I have slept. Either I wake up "ok" and feel like that for the rest of the day or I wake up like I was getting slapped in the face all night and feel accordingly for the rest of the day. I never wake up feeling good. 
I established good sleep hygiene over 10 years ago (because I was constantly tired). What I don't do is exercise, which I can't because it triggers my tachycardia ("harmless SVT", according the the cardiologist).

[Noripterus]

Also, does someone know what is happening in these two episodes?

1)

   

2)

   

[Dormeo]

I don’t have the expertise to comment on your charts, but I do want to encourage you to have another conversation with your doctor about exercise and SVT. He/she seems to think it’s OK for you to exercise, but you feel it isn’t. So one question might be about what you should do if you’re walking briskly or swimming or whatever and start to experience SVT. Is there a med you could take to cut an episode short? Another question might be whether there is a regimen of gradually increasing exercises that it would be beneficial for you to try. Maybe with the help of a physical therapist?