Very Frustrated w Results

[BlueJay22]

Hi All, 

To say I have been frustrated w my results would be a understatement. I started my therapy this past Apri, but have been exhausted all day, even w some adjustments to the pressure settings. 

I also sleep w a mouth guard as I also grind my teeth @ night 

I sleep on my side 

You're insights and advise is greatly appreciated  

Main Issues :  extreme fatique during the day , many clear apneas each night 

Resolved Issues : minimal obstructive apneas 

Reason for my post : looking for possible feedback & advise if I need to look for a ASV machine to treat Clear Apneas?

Current Settings : ( Resmed Airsense 10 Auto CPAP) 
Min. 11 to Max 18 
Ramp time of 20 & Starting pressure of 8
EPR : 2 
Humidity level 2 : 
Mask : full face Simplus + 

Results 

[Walla Walla]

Well from what I can see your not using the machine much every other night. That would have more to do with it than the CA's. Your API is low.

[Gideon]

Your numbers are excellent!!!
Personally I would not change anything.  IMHO you do not need ASV, not even close.  Many would love to have your numbers.

The important question now is How do you feel.

You stated extreme fatigue during the day, what is the nature of the fatigue?, Please be specific.  Your CA events are not currently an issue unless they are what is disturbing your sleep.

[BlueJay22]

Hi Bonjour, 

That is the thing , even this the AHI are good , I am tiered during the day. 

Any way I can reduce the clear apnea’s ?

Thanks

[Gideon]

I doubt that correcting the remaining CA events will have much, if any, impact on your therapy.

Need to focus on your being tired during the day.  How does it manifest itself, time of day, your "feelings", sleepy, falling asleep, mentally drifting, forgetfulness, groggy, low Oxygen Sats,

Search on Sleep Hygiene, I think you may find it more helpful.

To correct for CA events usually calls for lowering pressure, frequently not using EPR, and commonly going to a fixed pressure.  In your case turn off your EPR and lower yout ptressure by 2 cmH2O.  That should match your current therapy.  Note that lowering pressure could increase your Obstructive Apnea, though setting EPR to 0 and lowering your pressures should have no impact.   The next steps would be to go to fixed pressure and only making small changes.

Fred

[BlueJay22]

Hi Fred: thanks your feedback 

I have done a full round of blood tests and they found nothing to explain my fatique. I let feels like I am tiered all of a sudden in the afternoon.

So, you suggest EPR : 0
And set settings to 9 to 11 auto clap 

Now if I want to try CPAP mode what pressure would u recommend I start at ? I took a nap the other day and used 8 on the cpap and had AHI 5 , so maybe try 12 ? 

Thanks

[Gideon]

you can leave it in auto with a range of 9.4 to 9.4, then adjust from there.

[Sleeprider]

I think I would just set pressure at 9 and leave it at that. Fragmentation is why you're not feeling rested. Higher pressures don't seem to be addressing any real events, and you often break therapy when pressure crosses the 9.5 threshold. Why bother; just keep pressure lower. CPAP or Autoset with EPR at 2, minimum 9 maximum 9.

[HalfAsleep]

Something else could be going on to cause fatigue. I crash in mid-afternoon; it's from hypoglycemia (per a fasting blood sugar test). A little sit for tea-time fixes the problem. The doc also randomly checked my Vit D level; it didn't even register. Since I no longer eat fortified cereals, drink fortified milk, or live in a sunshine state, this probably should not be a surprise. I perked up a bit once I got the D straightened out.

So many things can cause fatigue: allergies, food intolerances, boredom, over-commitments, low-grade viruses, too much sitting...

In the same way that docs don't think to test for sleep apnea, many other items are off the radar as well.

Plus, every body is different.

What I'm saying is that fatigue may have a constellation of causes and remedies, and apnea may be only part of the picture.

Hang in there...

[Gary1of2]

You did not say how long you been onpap. It takes somtimes 3 to 6 months for some people to start feeling the results. Each of us are different. Me personally started felling better 3 months in where i dont need to take naps and getting better every day. So hang in there.