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+--- Thread: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled (/Thread-3-Months-on-CPAP-still-tired-despite-Dr-saying-my-apnea-is-controlled)
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled - Dormeo - 01-23-2022
I'm glad to hear you'll be seeing the sleep doctor on Feb 2. Here are some ideas about what to tell him:
1. You do not feel more rested, despite a low AHI.
2. This: "It's worth noting that I did have lung surgery last year which has unfortunately left me with what the respirologist calls a "mild restriction" so even during the day time it isn't always easy breathing for me. I don't have COPD or anything, it's more just a result of the nature of the surgery and the intentional chest wall scarring.My lung capacity is lower than it should be."
3. A printout of a chart showing the extent of flow limitations, plus a zoomed-in view showing the flattened tops of your inspiratory flow-rate curves.
4. If possible: data from a recording oximeter. You'd need to get hold of one quickly to generate a few nights of data.
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled - highwaystar86 - 01-26-2022
(01-23-2022, 11:48 AM)Dormeo Wrote: I'm glad to hear you'll be seeing the sleep doctor on Feb 2. Here are some ideas about what to tell him:
1. You do not feel more rested, despite a low AHI.
2. This: "It's worth noting that I did have lung surgery last year which has unfortunately left me with what the respirologist calls a "mild restriction" so even during the day time it isn't always easy breathing for me. I don't have COPD or anything, it's more just a result of the nature of the surgery and the intentional chest wall scarring.My lung capacity is lower than it should be."
3. A printout of a chart showing the extent of flow limitations, plus a zoomed-in view showing the flattened tops of your inspiratory flow-rate curves.
4. If possible: data from a recording oximeter. You'd need to get hold of one quickly to generate a few nights of data.
Just saw this reply, thank you! That was really helpful and I'm hoping he is willing.. I mean he wasn't too hesitant to prescribe Modafinil before we even tried to get the PAP therapy working better lol
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled - highwaystar86 - 02-02-2022
Well.. it's official that the sleep doctor is useless. After telling him about my lung history and the flow limitations that I can see HE SAYS THAT MAYBE WE SHOULD DROP THE PRESSURE BY ONE CM. I told him that I've tried upping the pressure and it doesn't fix my flow limitations, plus it makes it harder to exhale for me. He said yes so maybe we drop it back down to 7cm again because I think at 9 during the titration study it made your apneas worse.. I said no, you told me 8 last time which was wrong because the sleep technician told me in the morning that he had to go 11cm before my apnea events were cleared. So he insisted that we try 11 with CPAP for a month, completely ignored me bringing up the BiPAP and the fact that I've been using 11cm it hasn't fixed the flow limitation PLUS it makes me burp a lot, most likely because EPAP of 8 is too much for me
My question is: Someone is selling a ResMed Aircurve 10S near me. Is that one good compared to the V-Auto?
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled - Gideon - 02-02-2022
My preference is for the VAuto which has an auto mode, but it also has an "S" mode. The difference is similar to the difference between your elite and the AutoSet. Yes we can work with it.
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled - Dormeo - 02-02-2022
To amplify, the 10 S can provide greater pressure support than the 3 you get now with EPR, but it does this via an unvarying IPAP and an unvarying EPAP. So it's analogous in that way to your current machine.
Please ask to see the run hours on the machine for sale. I believe you can find them by going into the clinician menu.
I am incredibly disappointed to hear what happened with the sleep doctor. That's just plain wrong, and you deserve better, as indeed anyone would.
One piece of advice I'd continue to give: get a recording oximeter that is compatible with Oscar so you can see what is happening with your O2 levels during the night (and during the day, for that matter). If all is well, great. If it isn't, then you'd want to talk with a pulmonologist. (If need be, the A10 can be used to deliver supplementary oxygen during the night.)
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled - highwaystar86 - 02-02-2022
Thank you both for the replies. I am getting the seller to send me a photo of the Hours Used before I go any further with that.
I am seeking a second opinion from another sleep doctor but I'm not holding my breath. At this point I'd basically rather shell out the money myself for a BiPAP with everything I've read about UARS and flow limitations after coming onto these forums. I'll probably end up having to wait months for an appointment and may not even find someone who is cooperative on first try.
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled - Sleeprider - 02-02-2022
When optimized for pressure support the VPAP-S is a very good machine with all the features of the Vauto except automatic pressure adjustment. You still get all the trigger and cycle sensitivity, Ti Min/Ti Max and Easybreathe™. Great machine.
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled - Geer1 - 02-02-2022
I wouldn't expect second opinion to be any different, most doctors don't treat flow limitations with bilevel.
To me considering the S all comes down to price. If the price of S is good then grab it, give it a try and if its limitations don't allow ideal results then resell it and get a vauto. The S does nearly everything the vauto will do except raise the pressure when you have flow limitations.
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled - highwaystar86 - 02-03-2022
(02-02-2022, 05:07 PM)Dormeo Wrote: To amplify, the 10 S can provide greater pressure support than the 3 you get now with EPR, but it does this via an unvarying IPAP and an unvarying EPAP. So it's analogous in that way to your current machine.
Please ask to see the run hours on the machine for sale. I believe you can find them by going into the clinician menu.
I am incredibly disappointed to hear what happened with the sleep doctor. That's just plain wrong, and you deserve better, as indeed anyone would.
One piece of advice I'd continue to give: get a recording oximeter that is compatible with Oscar so you can see what is happening with your O2 levels during the night (and during the day, for that matter). If all is well, great. If it isn't, then you'd want to talk with a pulmonologist. (If need be, the A10 can be used to deliver supplementary oxygen during the night.)
The used machine has been used 5600 hours since January 2020 so now I’m a little hesitant. Two years of usage
I’m finally going to get my copies of the sleep studies from my GP but I was wondering about a couple things. We are talking about what seems to be UARS here based on the flow limitations correct? Also, would it make sense for me to collect a bit of OSCAR data at a higher pressure setting to see how my flow rate looks? I’m thinking 30 mins while I’m relaxing or something.
I don’t even remember if I mentioned this earlier or not but I am 35M, 6’3 and 148lbs which is the typical build for UARS from what I’ve learned.
RE: 3 Months on CPAP, still tired despite Dr saying my apnea is controlled - Gideon - 02-03-2022
(02-03-2022, 03:08 PM)highwaystar86 Wrote: Also, would it make sense for me to collect a bit of OSCAR data at a higher pressure setting to see how my flow rate looks?EVERY detailed, zoomed chart you have posted has shown us a very highly flow limited breathing that is indicating difficulty breathing and making you feel like **** most of the time. And you have the best of the best looking at it here and offering advice based on that data.
IMHO get a BiLevel. You need it!