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[CPAP] New CPAP user and still tired
#1
           
I have been on CPAP Dreamstation Pro for three weeks now and still feel sleepy during the day.  Oftentimes my AHI will be 2 or less but my RERA or UF2 events will be much higher.  I also sometimes have O2 desat with some of the UF2 events similar to what a hypopnea would be. 
Before Cpap treatment my O2 levels would drop to 70% and I would be below 90% for up to an hour a night.  My o2 desat does not normally fall below 86% now for no more than 1 minute or so a night


Also I usually wake up 2 or more times at night with a very dry mouth.  I occasionally wear a chinstrap but struggle with it due to slight nasal stuffiness.    

Settings initial (May-10- May 24): 
Pressure 10.5
Cflex+      2.0
Ramp       6.0
Mask        Pico (nasal)
Adap Humidity : 3-4

Settings May 25 with chinstrap
Pressure 10.5
Cflex+      1.0
Ramp       6
Smart Ramp on
Adaptable Humidity on level 4

Any thoughts or suggestions?
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#2
(05-26-2018, 11:30 AM).REMless Wrote: I have been on CPAP Dreamstation Pro for three weeks now and still feel sleepy during the day.  Oftentimes my AHI will be 2 or less but my RERA or UF2 events will be much higher.  I also sometimes have O2 desat with some of the UF2 events similar to what a hypopnea would be.

Before Cpap treatment my O2 levels would drop to 70% and I would be below 90% for up to an hour a night.  My o2 desat does not normally fall below 86% now for no more than 1 minute or so a night

Also I usually wake up 2 or more times at night with a very dry mouth.  I occasionally wear a chinstrap but struggle with it due to slight nasal stuffiness.    

How do you monitor your oxi saturation?  What is the total time (sum of all episodes) of oxi sat below 90%?  (Yes, I've been told by medical experts that anything below 90% is bad, and 88% gets them frantic even for a brief duration.)

I can't speak to your RERAs or UF2s (except to note that I've read one of the gurus explaining that  RERAs with "good" AHIs is not worrisome.)  I can say (from personal experiences, not any expertise) that low O² saturation will cause exactly the feelings you note.  Even though very brief, multiple events, particularly within a certain length of time will effect you because your body (and brain -- which some suggest I don't have to worry about) doesn't sufficiently recover during your sleep.  (I didn't get any specific info about the necessary elapsed time between episodes; <shrug> sorry, I was distracted by all the bad and $$$ stuff they were telling me)


I'm sure some of the gurus will chime in and inform you about the RERAs and UF2s, and will gently (or brutally Laugh-a-lot ) correct any of my blunders.

Please keep us informed of your progress.
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#3
Welcome to the forum.
Your AHI numbers look good. I don't like seeing substantial leaking, especially when it spikes the way your does. If it was just leaking due to the mask fit, then the leak rate will change with pressure. Your pressure is constant so why is leaking changing drastically? I think you might have mouth leaking which can disturb your sleep. I suggest that you wear a chin strap and try taping. The purpose of taping is to get data when you know that you do not have mouth leaking. Cheap the integrity of the tape seal in the morning by trying to blow out of your mouth to ensure that the seal was good.
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#4
(05-26-2018, 08:28 PM)ShaunBlake Wrote:
(05-26-2018, 11:30 AM).REMless Wrote: I have been on CPAP Dreamstation Pro for three weeks now and still feel sleepy during the day.  Oftentimes my AHI will be 2 or less but my RERA or UF2 events will be much higher.  I also sometimes have O2 desat with some of the UF2 events similar to what a hypopnea would be.

Before Cpap treatment my O2 levels would drop to 70% and I would be below 90% for up to an hour a night.  My o2 desat does not normally fall below 86% now for no more than 1 minute or so a night

Also I usually wake up 2 or more times at night with a very dry mouth.  I occasionally wear a chinstrap but struggle with it due to slight nasal stuffiness.    

How do you monitor your oxi saturation?  What is the total time (sum of all episodes) of oxi sat below 90%?  (Yes, I've been told by medical experts that anything below 90% is bad, and 88% gets them frantic even for a brief duration.)

I can't speak to your RERAs or UF2s (except to note that I've read one of the gurus explaining that  RERAs with "good" AHIs is not worrisome.)  I can say (from personal experiences, not any expertise) that low O² saturation will cause exactly the feelings you note.  Even though very brief, multiple events, particularly within a certain length of time will effect you because your body (and brain -- which some suggest I don't have to worry about) doesn't sufficiently recover during your sleep.  (I didn't get any specific info about the necessary elapsed time between episodes; <shrug> sorry, I was distracted by all the bad and $$$ stuff they were telling me)


I'm sure some of the gurus will chime in and inform you about the RERAs and UF2s, and will gently (or brutally Laugh-a-lot ) correct any of my blunders.

Please keep us informed of your progress.

I am using a O2 Vibe.  The UF2's and desaturations do somewhat correlate. 

Ironically the sensor just quit working two days ago-- waiting on a replacement.

May 23:
    Lowest Sp02 87%
    < 90% duration 1m

May 22:
    Lowest Sp02 86%
    < 90% duration 2m

May 17:
    Lowest Sp02 87%
    < 90% duration 48s
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#5
(05-26-2018, 09:41 PM)tedvpap Wrote: Welcome to the forum.
Your AHI numbers look good.  I don't like seeing substantial leaking, especially when it spikes the way your does.  If it was just leaking due to the mask fit, then the leak rate will change with pressure.  Your pressure is constant so why is leaking changing drastically?  I think you might have mouth leaking which can disturb your sleep.   I suggest that you wear a chin strap and try taping.  The purpose of taping is to get data when you know that you do not have mouth leaking.  Cheap the integrity of the tape seal in the morning by trying to blow out of your mouth to ensure that the seal was good.

I have a chin strap that I have used sporadically-- its a little tight for my big head.  I will have to get brave to use the tape as I don't know how much I get nasal stuffiness during the night. I never have 100% nasal flow but I would guess that I usually have at least 70-75% patency.
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#6
(05-26-2018, 10:11 PM)REMless Wrote:
(05-26-2018, 09:41 PM)tedvpap Wrote: Welcome to the forum.
Your AHI numbers look good.  I don't like seeing substantial leaking, especially when it spikes the way your does.  If it was just leaking due to the mask fit, then the leak rate will change with pressure.  Your pressure is constant so why is leaking changing drastically?  I think you might have mouth leaking which can disturb your sleep.   I suggest that you wear a chin strap and try taping.  The purpose of taping is to get data when you know that you do not have mouth leaking.  Cheap the integrity of the tape seal in the morning by trying to blow out of your mouth to ensure that the seal was good.

I have a chin strap that I have used sporadically-- its a little tight for my big head.  I will have to get brave to use the tape as I don't know how much I get nasal stuffiness during the night. I never have 100% nasal flow but I would guess that I usually have at least 70-75% patency.

The only time I can breath completely through my nose is when I am using a pillow mask.  It forces air through the nose and helps me keep the pathway open.
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#7
(05-26-2018, 11:18 PM)tedvpap Wrote:
(05-26-2018, 10:11 PM)REMless Wrote:
(05-26-2018, 09:41 PM)tedvpap Wrote: Welcome to the forum.
Your AHI numbers look good.  I don't like seeing substantial leaking, especially when it spikes the way your does.  If it was just leaking due to the mask fit, then the leak rate will change with pressure.  Your pressure is constant so why is leaking changing drastically?  I think you might have mouth leaking which can disturb your sleep.   I suggest that you wear a chin strap and try taping.  The purpose of taping is to get data when you know that you do not have mouth leaking.  Cheap the integrity of the tape seal in the morning by trying to blow out of your mouth to ensure that the seal was good.

I have a chin strap that I have used sporadically-- its a little tight for my big head.  I will have to get brave to use the tape as I don't know how much I get nasal stuffiness during the night. I never have 100% nasal flow but I would guess that I usually have at least 70-75% patency.

The only time I can breath completely through my nose is when I am using a pillow mask.  It forces air through the nose and helps me keep the pathway open.

I have ordered another chinstrap to see if it will fit better.  Would a nasal pillow mask be better than a nasal mask with mild to moderate nasal congestion.  Also, which type of tape is suggested? 

Thanks for your replies.  The Cpap thing is somewhat of a struggle.
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#8
Hello REMless

Your user name is so apt. As a fellow REMless sleeper pre CPAP, I feel sure that with your current data you will be on your way to getting the REM sleep you desire when the mask fit/pressure levels drops into place. These are early nights yet, hang on in there as thing will improve. And yes early usage of CPAP was a nightmare for me too. The FFM caused most of my nights to be full of leaks and it was dreadful.

I would advocate the use of the soft neck collar as it is really useful in keeping the mouth shut and aligning the head and neck to prevent obstructions. I found that a chin strap did not prevent my mouth from opening and whilst others recommend mouth taping, I know that it would irritate me.

The nasal pillows are very useful in blowing clear my nasal passages when congested. It is only when my nose has been dripping that it has been hard to use. I now have nasal sprays for those rare occasions and apply it before I sleep.

You might want to consider raising your pressure level by a notch ie 1cmH2O to deal with those obstructions, hypopnea and RERAs. Or alternatively you might want to consider reducing your flex as your EPAP at 8cmH2O is probably the culprit.
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#9
(05-26-2018, 10:06 PM)REMless Wrote: <snip>
May 23:
    Lowest Sp02 87%
    < 90% duration 1m
May 22:
    Lowest Sp02 86%
    < 90% duration 2m
May 17:
    Lowest Sp02 87%
    < 90% duration 48s

My fear (obviously?) was that it wasn't OSA causing your feeling of fatigue, but low O².  Fortunately that problem appears unlikely.

You may have already read accounts of others who've struggled with tiredness for long periods before finding relief.  In fact I'm one who — in this latest bout  — went about 2-1/2 months before finally experiencing any relief from the exhaustion and urgent need for a nap on waking.  I had not had that experience the previous two times I was treated; relief was immediate.  Certainly there are several more factors now than then — age as well as medical/physical — and neither my medical practitioners nor I have identified a likely cause. <shrug>  For me, I just keep plugging away, doing the best I can.

I think you've gotten some great suggestions, and expect you'll be learning some relevant information, increasing your understanding and aiding your trek.

Please continue to post your progress!
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#10
remless
as Apnea Infant said "You might want to consider raising your pressure level by a notch ie 1cmH2O to deal with those obstructions, hypopnea and RERAs".

Welcome
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