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4 weeks in - now what?
#1
First - thanks to all of you "professionals" who have answered my prior questions. You are all SO much more helpful than my medical professionals.

So - after 4 weeks of using my CPAP every night- I don't notice any improvement in my afternoon fatigue issues. Afternoon fatigue was the reason my doc originally ordered the sleep study - otherwise in excellent health, thin, neither I nor my spouse have even been aware of me waking up and gasping for air. (I am age 64, am not on medications, and there doesn't appear to be anything wrong with me other than the sleep apnea diagnosis.)

My AHI readings have been below 10 for the last two weeks - in the sleep lab they were 30 - so I guess that's good. Still - they jump around a lot - occasionally as low as 3.5, but more often 6 or 7. I get 100% mask fit and 0% periodic breathing readings most nights. I haven't been able to download the SleepyHead software because I didn't dare disable the firewall protections on my computer (my office has tight security protocols).

So - what next? Does it take this long to notice a positive effect of using the CPAP? Thanks in advance for your responses!
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#2
JaneAM,
It's hard to advise if your not using software and there is no data to see.

Do you have any idea what the breakdown of your AHI is? (How many Obstructives, hypopneas, clear airways?).
Does the DreamStation display give you at least a 90% pressure reading?

It sounds like your only option is to use a work computer to download SleepyHead, which I would never do. Could that get you fired??? Somewhere along the way, you may have to consider buying a small computer for home use.

Also, it may take longer to adapt than others and having fatigue can be caused for many reasons, besides your Apap not having the optimal settings, which can only be determined by seeing your numbers.

Have you had a complete physical lately? Have you had your thyroid checked?




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#3
Thanks OpalRose - maybe I'll get a different home computer to use for the SleepyHead software. Wonder if it can work on an IPad?

My 90% pressure readings range from 7.0 to 13.0. They are usually around 8.0. Last night - with a 9.8 AHI I had 11 clear apneas, 45 obstructive apneas and 17 hypopneas. The night before I had a 3.4 AHI with 6 clear apneas, 8 obstructive apneas and 14 hypopneas.

I have had a complete physical and thyroid checked - all good.

Thanks for your always insightful responses!
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#4
What are your machine settings? It sounds like the may be wide open 6-20.
If that is the case I would recommend some adjustment. Perhaps 6-15 to start. But as suggested you will need to get access to a computer that can be used with Sleepyhead or Encore software so you can evaluate your results.

No, the software will not work on an iPad or Android device. Encore requires Windows. Sleepyhead can run on Windows, Linux or Mac. You will need an SD card slot to read the data card from the PAP machine.
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#5
Unfortunately, it doesn't work on IPad. I wish it did.

Just from the figures you gave above, you have a lot of Obstructives and hypopneas. With a 90% number around 8 or higher, I would say your minimum pressure is too low.

If your okay with making adjustments to your pressure, I would move the minimum up to 7 and watch for a week.

You may also want to consider lowering the max pressure to 13 or 14.

If you are using one of the AFlex settings, set it to 2. I wouldn't use 3 until you see if the clear airways lessen a bit.

Good luck, those changes should help, but still hard to determine without seeing the graphs that SleepyHead provides.
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#6
The number of events you list and the AHI number all suggest that this may be a likely reason why you are still tired. Your SA is not well controlled. I agree with what the others have posted. Some changes to your settings are likely necessary to bring your AHI under 5 consistently. Until you get SH, log your changes and keep track of your data daily. As Opal said, make a change, watch for at least a week. RERAs, although not calculated in the AHI number, can also effect your sleep because they arouse you even though they may not wake you. SH will show how many RERAs you are having as well.

Respiratory Event Related Arousal (RERA) – You may also see this is your sleep study. This event is one that is
occurring in your Respiratory Department that is causing your oxygen level to go down and causing your brain to
have arousals. It just doesn’t meet the criteria to be called one of the events above. These events can also last
anywhere from 10 seconds to over 2 minutes depending on severity
http://www.americansleepmedicine.com/upl...nology.pdf
Coffee
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