cant seem to get stable results after 1 yr

[Mr Pink]

Dear Forum,

Like most of you I too have a long story of getting used to the CPAP (ResMed10). In fact its been a little over 1 year that I own one and just about 4 months that I use it consistently. What brings me to You is the search for advise. My doctors are not very reliable and I don't have the feeling they care about post "CPAP" prescription issues. So I used this board here, OSCAR and my original diagnosis report to meddle with my device in an attempt to find the "prefect" setup and setting. 

What drives me to the board here is, that I was actually quite OK with my sleep for the last couple weeks and I even got that good old feeling back, when you dont want to get out of your bed in the AM because you feel so relaxed and sleepy and dizzy when you walk to the bathroom. Didn't have that for a long time.  Lately and albeit me using the mask all night (6-7hrs sleep) I wake up cranky, agitated with burning eyes and my pillow is soaking wet. Last week I was out traveling all week in Cali with the fam  and I rested well. I attached a SS of one of those nights, where I thought I slept well. 2 days this week (not so well), 2 days last week (very well)

My hope is that you guys see sth in the data to where you can compare this week vs all the last ones. When I look at it, it appears as if this week I have the best week ever according to the data. No event flags, low AHI etc but sh**ty rest. Not sure what to make of it and looking for advise/direction. 

I did enter my setup and settings into my profile but if you need more information, please do not hesitate to ask. 

I am not sure if screenshots from any given day will suffice, so if you need the actual device file - lemme know and I am happy to PM. 

Also I wonder whether others have similar experiences to where they sleep through the night with the CPAP on but wake up super alerted and attentive but tired and not comfy in their blanket. Not sure you get my drift. I am tired but cant sleep, not even when driving for hours. Its like being force awake on redbull. 

Anyways - Thank y'all for any advise that you might have. I also have the diagnosis report if someone needs it.

[PeaceLoveAndPizza]

I do not see much difference between the two charts. Both have similar leaks, flow rates, etc. 

The biggest issue I see is getting the leaks under control. With that many leaks waking up and still being drowsy/foggy is to be expected. It may be that you are chin-tucking, which is causing the mask to shift by pushing it against your pillow or tugging on the hose. 

Before digging into it too deeply, I think a soft cervical collar is worth a go. I use the Caldera ReLeaf, but there are quite a few out there from which to choose. Folks seem to like the Velpeau and Core from Amazon as well. The SCC would help keep your head from dropping down and will also help keep your airway more open by not allowing you to kink it.

Some reading to consider…

https://www.apneaboard.com/wiki/index.ph...cal_Collar

[Mr Pink]

Thanks kindly for taking a look and I go ahead and try the collar. Will report back once its in my posession. Could the leaks be from me taking off the mask to go to the restroom and letting the autoshutoff take care of the device. I noticed that after line 5s it shuts off the airflow after I take it off.

[PeaceLoveAndPizza]

It is not the auto start/stop. Those are large leaks over 30+ minutes.

[Sleepster]

and just about 4 months that I use it consistently.

That's a good sign. Keep that up. The previous 8 months when you didn't use it consistently don't really count much as part of the adaptation period.

What brings me to You is the search for advise. My doctors are not very reliable and I don't have the feeling they care about post "CPAP" prescription issues.

Very typical. Unfortunately. There are good doctors and respiratory therapists out there. I've heard of them, just never had one!

So I used this board here, OSCAR and my original diagnosis report to meddle with my device in an attempt to find the "prefect" setup and setting. 

That's what a lot of us have had to do. And it works!

What drives me to the board here is, that I was actually quite OK with my sleep for the last couple weeks and I even got that good old feeling back, when you dont want to get out of your bed in the AM because you feel so relaxed and sleepy and dizzy when you walk to the bathroom. Didn't have that for a long time.

It will come back. You just have to give yourself time to adapt. This is up to you, but you may want to explore sleep meds with your doctor to help you adapt.

Also I wonder whether others have similar experiences to where they sleep through the night with the CPAP on but wake up super alerted and attentive but tired and not comfy in their blanket. Not sure you get my drift. I am tired but cant sleep, not even when driving for hours. Its like being force awake on redbull. 

Sounds like it might be anxiety. Something else to discuss with your regular doctor.

I agree with the advice you've been given about the leaks. Getting them under control is secondary only to compliance, which means using the machine whenever you sleep, every time you sleep.

Your pressure settings don't match what you have in your profile. That kinda threw me off until I figured it out. Also, try doing away with ramp. It's like training wheels, you don't need them once you learn how to ride.

[Mr Pink]

Thanks a mil for the kind words and encouragement.  Tonight I will try my new mask that I have received, same model tho. Also do some shaving for it to sit a bit better. The hint with the leaks is good and I will take the ramp down to 5 tonight. Already switched off EPR and see how it goes. Glad I have you guys with your advise. 

THANKS - I will report back

[staceyburke]

Your oscar of april 17 shows a large amount of positional apnea.

You can see positional apnea where either H or Oa events are clustered together.  Getting rid of as many as you can will lower your AHI.  Positional apnea can NOT be controlled by pressure changes.  You have to find out what position you are getting into and cutting off your own airway.  Have you changed your sleep position?  Sleeping on your back?  Using more (or new) pillows?  These things can cause positional apnea by chin dropping to your sternum and cutting your airway.  Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar.  I have a link to collars in my signature at the bottom of the page.  It shows people who are not wearing a collar and the SAME person wearing a collar.  There is a huge difference between the two.

[erolalper]

Your oscar of april 17 shows a large amount of positional apnea.

You can see positional apnea where either H or Oa events are clustered together.  Getting rid of as many as you can will lower your AHI.  Positional apnea can NOT be controlled by pressure changes.  You have to find out what position you are getting into and cutting off your own airway.  Have you changed your sleep position?  Sleeping on your back?  Using more (or new) pillows?  These things can cause positional apnea by chin dropping to your sternum and cutting your airway.  Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar.  I have a link to collars in my signature at the bottom of the page.  It shows people who are not wearing a collar and the SAME person wearing a collar.  There is a huge difference between the two.

Hi, I am really curios about how to determine an apnea is positional or not. Can you explain it? Thanks.

[Sleepster]

Hi, I am really curios about how to determine an apnea is positional or not. Can you explain it? Thanks.

You look for clusters of apneas and hypopneas. You see a cluster, then no clusters, then possibly another cluster, etc. This indicates that there is something about the position you are in that is causing the obstructions, such as your chin dropping. That is why a soft cervical collar is recommended to see if it can make the clusters go away. Or perhaps it's due to rolling over onto your back, in which case sewing a tennis ball into the back of your nightshirt is recommended to see if that can make the clusters go away.