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3 months into CPAP. Still feel tired
#1
3 months into CPAP. Still feel tired
It has been more than 3 months I have been using CPAP. Though i feel 60-70% better than earlier but still feel tired or sleepy during daytime. And waking up in the morning is as hard as before even after sleeping for 8-10 hours.

My AHI in sleep study was 3.1. These days it's less than 2.0. But mostly I see central events. Many days there are no obstructive events. Are these CA's CPAP induced? I found that I am drooling a lot more after using CPAP. 

I found that AHI less than 5.0 is considered normal (no sleep apnea). In that case, am I diagnosed wrong? Do I really need CPAP?
I suffer from all the year around cold ,stuffy nose due to dust allergy. Could it be the reason?

I have attached few recent sleepy head snapshots and my sleep study report for expert opinion.


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#2
RE: 3 months into CPAP. Still feel tired
(03-13-2019, 10:01 AM)T818 Wrote: It has been more than 3 months I have been using CPAP. Though i feel 60-70% better than earlier but still feel tired or sleepy during daytime. And waking up in the morning is as hard as before even after sleeping for 8-10 hours.

My AHI in sleep study was 3.1. These days it's less than 2.0. But mostly I see central events. Many days there are no obstructive events. Are these CA's CPAP induced? I found that I am drooling a lot more after using CPAP. 
Your CA's are not treatment induced.  Per you sleep study you had them prior to CPAP

I found that AHI less than 5.0 is considered normal (no sleep apnea). In that case, am I diagnosed wrong? Do I really need CPAP?
I suffer from all the year around cold ,stuffy nose due to dust allergy. Could it be the reason?  
That could be an Issue

I have attached few recent sleepy head snapshots and my sleep study report for expert opinion.
I see a good amount of Flow limitation.  This may or may not be impacting you. It could be RERAs, a series of flow limitations resulting in an arousal.    Here is a writeup about spotting them Optimizing_therapy RERAs
I would set EPR to 2 to see if it helps. A pressure difference between EPAP and IPAP is typically used to treat flow limitations.  You may need to increase your max pressure by 2 as well.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

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#3
RE: 3 months into CPAP. Still feel tired
Your sleep study shows an apnea index of 3.1 and that does not include the 25 hypopnea and high respiratory disturbance index (a.k.a. respiratory event related arousals (RERA) of 12.8 per hour. Your need for CPAP is further shown by the low oxygen levels that were documented. Your titration study, only evaluated a pressure range of 4 to 9 cm and showed a significant reduction in RDI. Even with treatment you had 2.3 arousals per hour.

Your Autoset is set to a pressure from 6.0 to 9.0 pressure, and there is no EPR (exhale pressure relief) being used. Your graphs show a persistent flow limitation, and that is what is driving pressure to near the maximum setting. In addition your inspiratory time is slightly longer than expiratory time. All of this means I think you should introduce EPR into your settings. EPR is like bilevel pressure, and produces a lower exhale pressure. This should normalize the respiratory timing, improve flow limitation and be more comfortable. The risk is that the use of EPR in your case may increase the central events. Your CA events are not serious at the current levels, and normally those will decrease as you adapt to therapy. I recommend you go into the comfort settings, and turn on EPR, Full-Time at a setting of 1. That will provide a 1-cm pressure relief. This is a slow start to introducing EPR because we want to see how you respond to it, and eventually I would like to try higher settings if you tolerate it.
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#4
RE: 3 months into CPAP. Still feel tired
It is not worth thinking that all symptoms would come from sleep apnea. There are many internal organs in the human body whose poor functioning can cause fatigue.
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#5
RE: 3 months into CPAP. Still feel tired
3 years into therapy, still feel tired.
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#6
RE: 3 months into CPAP. Still feel tired
Thanks for your suggestions. I will try out the settings. Hope will see some improvement.
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