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And here's my first zero
#11
(02-08-2017, 12:15 PM).ppca Wrote: Yes! Following OpalRose's advice, I managed to force myself to keep the mask on all night. I was always cautious not to rip something out when turning in bed, but last night I decided to stop worrying about it.

The result was 8 hours of usage, 0.5 AHI...and yes I did wake up multiple times and still feel tired today, but I guess it will take a lot of time before I may start feeling better. At least, I hope so.

I know it's  hard for some to adapt to, but you seem determined and want to learn, so keep plugging away.  

Even though I adapted fairly quick, I had alot of anxiety in the beginning, and had to talk myself into wearing the mask.  Even after 2+ years, I still have those occasional sleepless nights and feel tired the next day.
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#12
(02-08-2017, 01:59 AM)ppca Wrote: Louis R,

I was prescribed CPAP 3 years ago, after the initial study which showed 15.3 AHI. After struggling for a few months trying to get used to it, and using it on and off (trying to use it, I should say), I pretty much gave up.

Since my sleep quality is very poor, especially recently (I'm waking up numerous times throughout the night, and feeling tired all the time), I went for a new sleep study, which is the one showing 5.2 AHI, almost completely normal. However, the report also shows oxygen desaturation below 90% during 96.7% of total sleep time, with mean desaturation at 88%, which is definitely low.

Waiting to see the doctor will take months and months, unfortunately. But in the meantime I re-started my therapy, with CPAP machine parameters based on my first prescription. I am really getting low AHI numbers on a daily basis, always below 1, and usually around 0.7, which is great. I have no idea at this time what the oxygen numbers are during the night, with the mask on, but like I said, an oximeter I ordered online is on its way, and I hope that may give me a better overall picture. I have reasons to hope that these oxygen numbers will be good too, based on the fact that the original titration study 3 years ago showed completely normal desaturation. And right now, I am using the same pressure as what was originally prescribed, based on that titration study.
ppca,

Wow, it's strange that your latest test was better than the older one, normally we get worse not better. That is unless someone was to loose a bunch of weight or had some health issue that took a turn for the better.
My first several sleep studies were boarder line like yours is, and like you I was still very tired and felt terrible throughout the day. I believe that the other folks on this forum that are very knowledgeable with sleep apnea will agree that you definitely need CPAP therapy. Also, once you get your oximeter you'll be able to monitor your low O2 levels.
See if you can speed up your doctor's visit if possible... I'd keep bugging them or find another MD if you can.
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#13
The really strange thing is that I felt way better when I was diagnosed with 15.3 AHI, than right now with 5.2 AHI. The only reason I went for my first sleep study was I had a bit of irregular heart beat (that problem didn't last for very long anyway), so my family doctor recommended I do a sleep study. I did not have any sleep problems at that time, at least not that I knew of. I thought that my sleep quality was actually very good.

In the last couple of years that has changed. Waking up all the time, feeling very tired all day, and my sleep study AHI now shows 5.2. I really don't know what to think. That is why I am somewhat hesitant to expect that my CPAP therapy will help me.

By the way, my body weight has not changed.

It definitely will be nice to be able to monitor my oxygen levels, and see what the difference with and without the mask will be. That may possibly explain a few things.
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#14
(02-08-2017, 04:09 PM)ppca Wrote: The really strange thing is that I felt way better when I was diagnosed with 15.3 AHI, than right now with 5.2 AHI. The only reason I went for my first sleep study was I had a bit of irregular heart beat (that problem didn't last for very long anyway), so my family doctor recommended I do a sleep study. I did not have any sleep problems at that time, at least not that I knew of. I thought that my sleep quality was actually very good.

In the last couple of years that has changed. Waking up all the time, feeling very tired all day, and my sleep study AHI now shows 5.2. I really don't know what to think. That is why I am somewhat hesitant to expect that my CPAP therapy will help me.

By the way, my body weight has not changed.

It definitely will be nice to be able to monitor my oxygen levels, and see what the difference with and without the mask will be. That may possibly explain a few things.

Have you ruled out, or has a sleep study physician ruled out you suffering from central sleep apnea (CSA). I think that you definitely need some kind of further testing. Waking up frequently at night and a 5.2 AHI doesn't add up unless your bladder is filling up and you are urinating frequently. Why are you waking up at night and why are you so tired with a AHI of 5.2 is the question.
I see you are in Canada... is it difficult to get the needed medical testing up there??? I hope you find and get the proper therapy.
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#15
There is no diagnose of central sleep apnea. I have the full report of this latest sleep study with me, including all numbers and charts. Under central apneas there is nothing but N/A's and zeros. The only ones that show are hypopneas, resulting in this 5.2 AHI index.

Hypopneas are flagged in the printed report, as the number is higher than 5. In the interpretation section (first page of the printed report), it is reported as mild obstructive apnea. How and why did that number go down from 15.3 to 5.2 in three years, I have no idea. It was a different sleep clinic that did the testing this time, but it shouldn't matter.

Other than hypopneas, the only other thing flagged in the report is oxygen desaturation (96.7% of the total sleep time was below 90% oxygen saturation level). Mean O2 saturation shows 88.8%.

I went for a titration study two weeks later, but unfortunately it was a failure, as I could not sleep at all, so no report available.

Now that I am on CPAP, my AHI is always below 1 (0.64 average). Number of events per night averages the total of 3-4 only, out of which 1-2 are hypopneas and 1-2 are clear airway events.

I guess I am doing the right thing, being on my CPAP therapy now. The only thing I can think of that bothers me is these oxygen numbers. Once I get an oximeter, it will be interesting to see what difference in those numbers CPAP treatment makes. I hope I will see these numbers go up with the mask on, compared to a few trial runs that I will do without the mask.
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#16
Hello PPCA

I wonder if the arousals are because you are a mouth breather. Do you use a chin strap or cervical collar?
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#17
(02-09-2017, 04:54 AM)holden4th Wrote: Hello PPCA

I wonder if the arousals are because you are a mouth breather. Do you use a chin strap or cervical collar?

Not a mouth breather. I guess I would be seeing lots of leaks in my SH reports in that case, and there are hardly any. Also, no dry mouth issues either.

I do have a bit of a problem breathing through one of my nostrils. Not too severe though, and it appears that 7 cmH2O pressure easily fights this, allowing me to breathe normally.
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#18
I don't want to weigh in on whether you actually need CPAP or not, though it sounds strange to me that you feel tired like you do with such low numbers. But I do want to tell you that it takes much longer than three weeks for sleep patterns to readjust. I'm not exaggerating when I say it took six months for me to stop waking up and laying awake half the night. This was a big nuisance because I was used to sleeping 8 hours straight, with apneas of course, which made me exhausted by morning, but I certainly wasn't used to laying awake during the night. Now I usually have one waking period around 3am, and then I sleep again until 6 or 7.
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#19
(02-09-2017, 09:41 PM)Russatrice Wrote: I don't want to weigh in on whether you actually need CPAP or not, though it sounds strange to me that you feel tired like you do with such low numbers. But I do want to tell you that it takes much longer than three weeks for sleep patterns to readjust. I'm not exaggerating when I say it took six months for me to stop waking up and laying awake half the night. This was a big nuisance because I was used to sleeping 8 hours straight, with apneas of course, which made me exhausted by morning, but I certainly wasn't used to laying awake during the night. Now I usually have one waking period around 3am, and then I sleep again until 6 or 7.

I most likely do need CPAP. My AHI at sleep study 3 years ago was 15.3, which would qualify for moderate case of apnea. How and why it showed only 5.2 at the latest study (not that there's anything wrong with it Grin ), remains to be seen.

When I mentioned that I wake up multiple times during the night, I wasn't specific about the fact that it only takes less than a minute to fall asleep again. It is not like I'm lying there in bed fully awake for long periods of time. It is just that my deep sleep doesn't seem to last long enough, and is frequently interrupted by these short periods of being awake. Even though, now with the mask on, I may be seeing a bit of improvement. Too early to say.

I'm aware that a few weeks of CPAP is not enough to draw any conclusions. That is why I am determined to persist with the therapy.

Once my oximeter arrives, it will be very interesting to see what my oxygen saturation is, and check to see if it improves with CPAP. My guess right now would be - yes.

Thanks, Russatrice.
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#20
(02-07-2017, 02:30 PM)ppca Wrote: After just a little over 3 weeks of therapy, I've hit my first zero. While my AHI numbers are consistently below 1, this is still nice to see, even though I can't really say that I feel any improvement in energy levels. Still a lot of fatigue throughout the day, a bit of headache too.

My average overnight usage is about 4.5 hours. I then pull the mask off and get another 2-3 hours of sleep without it. Reason for me doing so is that I feel less restrained without the hose being there and limiting my movement in bed. I know it may be more psychological then physical, but it still bothers me.

I'm waiting for an oximeter that I ordered online to arrive, and really looking forward to compare my oxygen numbers with and without the mask.

I may have been through what you're going through.  I'll have been doing the CPAP therapy for a year this April.  My numbers have nearly always been below 1, and I sleep about 4.5 hours a night, but always seem to fall asleep watching the news about 11 and wake up between 1 and 2 and then go to bed, so, am also getting 2-3 hours of non-CPAP sleep per night.  Yeah, I've known it is not a good thing, the respiratory therapist told me very clearly to wear the mask each and every time I sleep.  It isn't something I do on purpose, but it does nonetheless put me in the same situation as you, having periods of sleep that are not CPAP-assisted.  What took me to CPAP was not fatigue, headaches, etc.  I began having random events of heart palpitations that took months to catch on an ekg and be identified as atrial fibrillation.  AFib is known to be related to sleep apnea, so I was given a battery of tests and scans and a sleep study.  The sleep study revealed I had an AHI of 6 - borderline normal, but it was the only test that came back showing any sort of abnormality, so the posse of doctors put me on CPAP.  I do still get AFib attacks though they're not happening as often and are shorter and milder than before CPAP.  I've attributed that as much to the meds as to CPAP, but the discussion around your posting has connected some dots for me - that possibly the reason I still do have AFib episodes at all could be because I'm still stressing my heart with unassisted apneas that happen during the 2-3 hours of unprotected sleep.  So thanks to all of you for that! 

I think, in my first months of CPAP, I, too, would have taken off the mask had I not had the fear of AFib and blood clotting and strokes to scare me into keeping it on.  Not that I felt like the mask or hose was ever uncomfortable - it was just that I'd wake up a lot during the night anxious to check that I hadn't dislodged it because it did seem to leak a lot overnight and I figured that was happening when I turned from side to side.  This is a DreamWear mask.   Eventually I hit the Internet to find a different style mask, and in that process, came across Phillips instructions guiding how to size the DreamWear mask, and discovered the tech who "sized" it for me had chosen the wrong fits for me - the mask frame was too small and the mask cushion was too big.  None of the other masks I'd bought had been as good for me as the DreamWear, so I bought a size larger frame and a smaller cushion to give the DreamWear another try, and all has been well since then.  What was waking me during the night was that I was always nervous  that my moving around had dislodged the mask, so when I moved from side to side I'd wake up fully to check the mask, fidget with that, find my glasses so I could read the ResMed display and do a "mask check," and I wasn't sleeping solidly as I had been before CPAP.  However, when the "is this really worth it?" thoughts came into my head, and I would have taken the mask off and simply slept the rest of the night, those thoughts were quickly countered with "yes, it's a crummy night's sleep but it's better than having a stroke", and, so, the mask stayed on.  Happy to say now that having the right fit of mask frame and cushion keeps the whole setup much more securely in place and I sleep solidly.   Even though, with the other masks I tried, the hose near my face wasn't particularly a problem, it is still more comfortable at the top of my head.  But I never believed sleep was going to really get back to normal, I thought the interrupted nights were just going to be my new normal and a crummy night's sleep was going to be the price I had to pay to reduce my stroke risk.  Amazingly, better nights of sleep returned and I sleep until either the sun or the alarm wakes me up.  So, please stick with it, it really might get better.  Re/the oximeter, I bought one, too, though did that before the CPAP started.  After I learned I had apnea I was freaked out that I was actually not breathing at night, so while I waited to get the CPAP machinery I bought an oximeter with an alarm that I could set to wake me up if my oxygen level got too low.  Also, it records, so I can see how the levels go all night.  Eventually learned that, through the monitoring of my pulse, it also has shown an AFib event that happened while I slept.  Levels were usually good before CPAP but are now consistently very good.  Very handy gadget!
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