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Almost 6 months on APAP still tired.
#1
Almost 6 months on APAP still tired.
Hey,
I've been using my APAP machine for almost 6 months now but still can't seem to get better regarding my energy levels.
My polysomnography study showed an AHI of 17.2/h and is now down to most nights to less than 1-2 AHI/h.
The initial settings were very lazily made, the pressure being between 4 cm and 20 cm H2O.
I tried to do some research and modify those values myself and got something that made me feel a bit better but still not great.
I have posted a picture of OSCAR from last night: https://i.imgur.com/QqDHtBp.png (would attach it here but I need 4 posts it seems to do so)
I also uploaded the files in case anyone wants to look closer at them: https://www.mediafire.com/file/cg10kqu4z...6.rar/file

Thanks for taking the time to read this
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#2
RE: Almost 6 months on APAP still tired.
Welcome  I think you can just post a few more times in this thread you then you can attach your Oscar report directly.  I cannot read the report on Ingur, as the print is too small for my old eyes.
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#3
RE: Almost 6 months on APAP still tired.
This sounds so familiar. Been on APAP for a while now, but just don't feel any different.

I'm curious why there is even a minimum or maximum pressure for APAP. Shouldn't it just adjust to what you need?
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#4
RE: Almost 6 months on APAP still tired.
Many have the setting 4-20 when they take it home because it is an autoset so it will go to the correct number for therapy - WRONG!

IF it set that way 4 is the inhale and exhale pressure.  4 is to low for an adult, these same machines are used for children.  Most adults need at least 8 on the inhale or they feel air starved.

Setting at 4 mean that when there is an event does happen the machine must ramp up to therapy pressure.  Wild swings from low to high disturbs sleep.  Setting the min number to near the therapy pressure makes the swings much less and disturbs sleep less.

The Flow limits are apnea also and are limited using EPR.  EPR can be set at 1, 2 or 3.  EPR (exhale pressure relief) is subtracted from the min for the exhale pressure.  The problem is 4 is the lowest any pap machine can go so setting min 4 EPR 3 does nothing (min 4 - EPR 3 is lower than the machine can go)  The min needs to be at least 7 to use EPR 3.

I'm sure there are more reasons to those are the main problems of just letting the machine set the pressures.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#5
RE: Almost 6 months on APAP still tired.
From what I know it will adjust to your needs but it's much better on a lower range.
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#6
RE: Almost 6 months on APAP still tired.
(02-07-2022, 02:08 PM)Deborah K. Wrote: Welcome  I think you can just post a few more times in this thread you then you can attach your Oscar report directly.  I cannot read the report on Ingur, as the print is too small for my old eyes.

           
Here are a few screenshots of my most recent sessions. Hopefuly this time they're clear.
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#7
RE: Almost 6 months on APAP still tired.
The main thing to understand is that the automatic nature of these machines only consists of increasing pressure when your breathing is poor and it does so in a reactive, not proactive, manner.

It starts at the same min pressure each night and then increases pressure because your breathing is poor. Eventually it finds a pressure that fixes the breathing issues and then it continuously tries to lower the pressure down until breathing degrades again causing pressure to increase again. These machines aren't smart enough to realize that you only have poor breathing below x pressure and they don't incorporate that into the next nights settings.

As for your data there isn't anything obviously wrong. Main thing I would try and work on are the leaks because they can disrupt your sleep.
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#8
RE: Almost 6 months on APAP still tired.
(02-07-2022, 03:19 PM)Daveyc123 Wrote: This sounds so familiar. Been on APAP for a while now, but just don't feel any different.

I'm curious why there is even a minimum or maximum pressure for APAP. Shouldn't it just adjust to what you need?

I believe there are two issues.
* sleep quality
* medical standards

The medical standard is the big thing.

I came to Toronto and was referred to the sleep-doc-from-*ell. I was in his care for almost 15 years.  

From the start I had to wear my mask with my machine on for at least 4 hours every day. My AHI had to be less than 5.  
If I wasn't compliant he threatened to pull my driver's license. 

The machine I had when I started and the one he prescribed after the other one became noisy had a clock that accumulated hours. I had to bring my machine in. He would turn the machine on and check the hours. Over 4 a day? Check! Compliant!

Considering that this is treatment is absurd.

In Ontario there aren't enough doctors or nurses, or hospitals. I was lucky (?) to have a family quack. I mean doctor.

I believe that there is a big fix in.  Doctor works for the hospital/prescribes a machine.  Hospital owns a substantial part of the DME provider.  A machine costs way more than I could buy from a US company.  Except they won't sell to me when I've tried.  

Rant's over.
DaveL
compliant for 35 years /// Still learning!



I'm just a cpap user like you. I don't give medical advice. Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

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#9
RE: Almost 6 months on APAP still tired.
Hey - I don't have any advice, but wanted to let you know that I'm in the same boat. I've been on APAP for a while, but am still tired.

One thing that could be helpful is for you to post a couple of zoomed in sections of your graphs, 2-3 minutes so that there's a better view of your flow rates.

I note that your inspiration time is longer than expiration. I have the same. This might be a signal that you're not getting the best results from your treatment, but I've not found anything concrete on this as of yet (and someone with much more knowledge than me might tell me that's crazy talk).
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#10
RE: Almost 6 months on APAP still tired.
For the Experts:  Marcel's apneas are mostly centrals.  Is that the problem?
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