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1 Month into CPAP - Still Exhausted. What Data to Post?
09-28-2016, 11:50 AM
09-28-2016, 12:23 PM
I noticed you changed your EPR setting from 2 to 3. This may be triggering the increase in clear airway events. I would either turn it down to 1 or preferably off.
Try that for a few days and see if it makes a difference.
I still see that you may need further adjustment to your pressure settings, but try one thing at a time.
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09-28-2016, 01:07 PM
I think I can set it to have an EPR of 3 during the ramp while I'm falling asleep, then to go to 1 or ditch it altogether after that point. I'll give that a shot.
09-28-2016, 02:01 PM
you are 95% at very close to 12, your max. Typically you set the min at 2 cm below 95% and max at 2 cm above.
You are having more OA's than CA's, so I would suggest you handle the OA's first which should also get rid of the snores and keep the pressure from jumping around so much. This may help decrease your CA's.
09-28-2016, 04:13 PM
(09-28-2016, 02:01 PM)PoolQ Wrote: you are 95% at very close to 12, your max. Typically you set the min at 2 cm below 95% and max at 2 cm above.
I think this is a good rule of thumb, but I thought OpalRose's advice to reduce EPR was better in this case, so I didn't comment further. It's possible that the OA is triggered by a low EPAP and that the new CA is from the pressure support. I like the idea of leaving pressure settings alone and reducing therapy EPR and seeing where this goes, before increasing pressure.
09-30-2016, 10:56 AM
09-30-2016, 03:35 PM
Well, your median pressure is within 2-cm of the 95% now . It's worth noting that your OA has been cut in half since you last posted data, from 2.74 to 1.30. The OA improvement has been turned into hypopnea events, otherwise CA is mostly unchanged. I think a minimum pressure of 8.0 might avoid about half the obstructive and hypopnea events, and that should drop you in to the 2-2.5 AHI level, with mostly CA residual.
This is good progress! You posted data, but it would be helpful to know how you feel, and what disruptions you sense.T
09-30-2016, 07:22 PM
This is what my overall data looks like: http://take.ms/ZVkcG
OA, on a nightly basis, seems to vary between 0.5 - 4, so I'm not sure yet if it's averaging down permanently, since we're dealing with early data. CA is definitely up, though, compared to the lower pressure period.
I still feel exhausted all the time. I haven't been able to detect any positive difference in my daytime sleepiness since starting CPAP therapy. Sometimes, it feels worse.
09-30-2016, 08:51 PM
Well, what you posted was kind of worst case as opposed to typical. Based on the history, your best data results were 9/5 with EPR at 2. Everything else with higher minimum pressure was worse. That kind of changes things for me with regard to the higher minimum pressure. You're getting the hours, and the therapy is mostly working well. You might want to go back to what worked best, and consider that there are other things with similar symptoms. Have you had a complete workup including T?
09-30-2016, 09:04 PM
Sometimes the exhaustion is from chronic low-level clinical depression. Worth getting that checked out and maybe trying a low dose of an antidepressant. Also thyroid or vitamin issues. And of course keeping up with the CPAP therapy.
I'm not a medical professional but have dealt w/ issues of chronic exhaustion and fibromyalgia. Hang in there.
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