tired and yawning

[ZBarker01]

        My AHI is down pretty low but Im still feeling pretty tired after a few months of therapy, I'm still tired and yawning all day long and waking up feeling weird like I still didn't get much sleep, like I didn't breath all night long still. Here is some charts from last night, if anyone could give me insight on why im still exhausted and feeling like im still not breathing at night and oxygen is still diving that would be great.

[Phaleronic]

Please turn IPR off for one night and see how you feel, that should help your flow limits, but you'll likely need to increase minimum pressure as you become more comfortable, the reason why you feel tired is because of the arousals and microarousals that the flow limits are creating during sleep.

[ZBarker01]

Im not sure how I go about turning off IPR. Im pretty new to the machine. It's a resvent ibreeze. Any ideas how I go about doing that on this particular machine

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I found it. Sorry. Haha. it was actually pretty easy to find. I'll turn that off and see how things go tonight

[Phaleronic]

Sure thing ZBarker01, happy you've found the forum So you were able to get into the clinical menu?

[ZBarker01]

Yes I have it all figured out. I have follow up appointment with doctor next week so Im going to try and talk with him about it too. Though from what im gathering its like pulling teeth to get them to listen to you once your AHI is good, but I still just don't feel very rested, at all!

[ZBarker01]

Another curiosity question, because this is new to me, but I find it fascinating, the whole sleep apnea thing in general... Why would IPR being off help with flow limitations and stuff? Someone also told me that my min pressure is to low for an average adult being at a 4 that 7 is usually the standard, does that mean the minimum that the machine is pushing while not having an apnea? Also im guessing I can't change my minimum pressure the doctor would have to, I have no clue how to get into clinical settings.

[Phaleronic]

Another curiosity question, because this is new to me, but I find it fascinating, the whole sleep apnea thing in general... Why would IPR being off help with flow limitations and stuff? Someone also told me that my min pressure is to low for an average adult being at a 4 that 7 is usually the standard, does that mean the minimum that the machine is pushing while not having an apnea? Also im guessing I can't change my minimum pressure the doctor would have to, I have no clue how to get into clinical settings.

Sure, those are good questions, IPR is the ibreeze variant of exhalation relief pressure, with resmed it's EPR, and with phillips it's Flex, with Lowenstein it's softpap.  Per unit of of application (1-3) each variant decreases pressure by 1cm, so if your IPR is on 1 it is lowering pressure by 1cm, if it is on 3 it is lowering pressure by 3cm.  

Flow limits are directly correlated to restricted or obstructed airways, and the usual suspect is lack of pressure to keep the airway open (unless the airway closed because of sleeping position).

[ZBarker01]

Thanks for the information. Hoping the doctor and I can get this thing dialed in so I can get some real sleep. I turned it off last night but haven’t got the chance to look at the results.

[SarcasticDave94]

Almost every Apnea Board member needs to be proactive and take the wheel on their settings. Your doctor might suggest edits, might order a script change, and might get the DME to edit them over the air. What isn't a might is you'll pay for the visit to discuss what setting needs changed and why. Another definite, is this process won't take 2-3 minutes.

You know how to access the clinical menu, so make the changes. This fixes ALL the flaws from above. You decide what needs changed and why, you do it in SECONDS, for free, without discussion or debate. And in the US at least, this self edit is legal. Don't let anyone say it's not.

[Phaleronic]

Dave is 100 percent correct too on this-you are you own best titration specialist