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Continuous problem. Please advise.
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Visitor Offline

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Posts: 164
Joined: Feb 2014

Machine: Resmed Airsense 10 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed P10 nasal pillows
Humidifier: Resmed Airsense 10 and heated hose
CPAP Pressure: 9
CPAP Software: SleepyHead

Other Comments: Started APAP on May 26, 2014. Benefits kicked in on May 31 thanks to forum help (leakage resolved)

Sex: Male
Location:

Post: #1
Continuous problem. Please advise.
I'm using cpap consistently (as in every night for at least 7-8 hours and often more)

Settings

Start pressure 4.0

Minimum setting 8.5

Maximum 12

This gives me a (near constant) Pmean value for the last three weeks of 8.5 nearly every day (software readings)

AHI is 0 on most days

The problem

For the last month, I have been exhausted again (pretty much every day), as I was before using CPAP. This has gotten worse and now I am dragging myself through the days.

I can't figure out what is wrong. Leakeage is within range of the manual specifications for the Breas. Some days I wake up out of breath, and some days (though not often) with a dry mouth. Most obvious symptom is drooping eyelids (very bad case of it).

When I have the occasional bad night, leaving me tired during the day, I write it off as normal. When it is consistent, like last month, it wears me out. I get depressed. This is a concern, as I experienced it before using the cpap solution (which changed my life). I know it is apnea related so I'm keen to avoid medication (which I've not taken before either).

I will schedule a meeting with the specialist asap.

Some things I've tried

I refrained from asking advice on intermittent problems, have dealt with leaks as best as I could, made sure to clear passages by adjusting the nasal mask before I go to sleep, have tried every trick I could think of night after night to optimise matters, and I can't think of anything else at this stage. I also ordered a new mask (the Philips Nuance Pro Nasal Pillows) to see if a change could help. I'm using the P10, clean it regularly, make sure that the vents are cleared etc.

Advice?

This is just to check if anyone might have any suggestions on what else could be wrong. Are there things I should keep in mind when I meet with him?

Could I need Bipap? I know there are ways to check this, but I can't interpret the graphs for this issue (and really consider that the specialist's job). Paula mentioned I might look into lowering exhale pressure on the Breas, but it does not have this option.

Hope the apneaboard hive mind can suggest some possibilities I might broach with the specialist or some tips I could still try out.

Before APAP: [Image: DARTH-VADER_zpsa57946df.png]

After APAP: See avatar: R2D2 for the win!

"Be kind, for everyone you meet is fighting a great battle"
--Ian Maclaren

I don't snore! I just make creepy noises so the aliens know I'm not someone to be messed with.
(This post was last modified: 01-02-2015 08:31 AM by Visitor.)
01-02-2015 07:46 AM
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brianwood619 Offline

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Posts: 171
Joined: Jan 2014

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 16-22cm/h2o
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Peaceful Acres

Post: #2
RE: Continuous problem. Please advise.
If your waking up out of breath is there a possibility you have copd. If copd is a possibility then typically BiPap helps out better with that disorder as well as central apneas.
01-02-2015 11:20 AM
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AshSF Online

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Posts: 356
Joined: Oct 2014

Machine: PRS1 D560TS
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10, Bkup: Airfit F10 & Quattro Air
Humidifier: PRS1 60 series with Heated Tube
CPAP Pressure: 8 - 8 w/ Aflex 3
CPAP Software: SleepyHead

Other Comments: Using APAP mode with fixed pressure

Sex: Male
Location:

Post: #3
RE: Continuous problem. Please advise.
Your RERAs might still be high. I have a machine that reports RERAs as well. For me, the AHI was under 1 pretty soon but I used to feel not so fresh some mornings. I saw that RERAs were higher on those days. So, I raised my minimum pressure from 4 to 7 slowly in 1 cm increments. And I feel fresh every morning consistently now.

Now the only variable that can make me feel less fresh is the hours of duration of sleep. I need to sleep 7+ hrs to feel good.

Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
01-02-2015 11:41 AM
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Sleeprider Online
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Advisory Members

Posts: 3,392
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #4
RE: Continuous problem. Please advise.
Without data and graphs, we are left to pure speculation. Since your machine is not compatible with Sleepyhead and other software most use here to evaluate issues like this, you should probably get input from you doctor or DME who can review your data. You mention that you're managing leaks as best you can, but don't offer a leak rate. If you are in large leak much of the night, the AHI events cannot be detected by the machine, and of course leaks are detrimental to a good night sleep. If this is something you want to focus on as an issue, it would help to know if you are experiencing leaks around the mask interface, from tubing or connections, or if you might be mouth-breathing.

______________________________________________
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01-02-2015 12:38 PM
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herbm Offline

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Posts: 852
Joined: Jan 2014

Machine: ResMed AutoSet S9
Mask Type: Oral
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: ResMed H5i
CPAP Pressure: 11-16
CPAP Software: ResScan SleepyHead

Other Comments: Backup Mask: Innomed Hybrid FFM -- Oral+Nasal Pillows

Sex: Male
Location: Austin, TX

Post: #5
RE: Continuous problem. Please advise.
and with a P10, you should be able to get your leaks down to new nothing.

P10's are so quiet that any significant air noise is a leak -- get your pillow seated better, change sizes, or ensure you're keepng your mouth closed.

Also, don't sleep AT ALL without the mask -- you seem to be saying you sleep most of the night with it -- use it 100% of the time.

If you get good treatment then do pursue other causes with your doc.

Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
01-02-2015 04:37 PM
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Mr. Van Winkle Offline

Advisory Members

Posts: 258
Joined: Nov 2014

Machine: Resmed Airsense 10 Autoset
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: Airsense
CPAP Pressure: 9 -15
CPAP Software: ResScan SleepyHead Other Software

Other Comments:

Sex: Male
Location: Minnesota

Post: #6
RE: Continuous problem. Please advise.
[
Advice?

This is just to check if anyone might have any suggestions on what else could be wrong. Are there things I should keep in mind when I meet with him?

Could I need Bipap? I know there are ways to check this, but I can't interpret the graphs for this issue (and really consider that the specialist's job). Paula mentioned I might look into lowering exhale pressure on the Breas, but it does not have this option.

Hope the apneaboard hive mind can suggest some possibilities I might broach with the specialist or some tips I could still try out.
[/quote]

Have your Testosterone level checked, you sound like it could be off.
just a thought.
Good Luck hope you get better soon.

Mr. Van Winkle
01-02-2015 04:50 PM
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Visitor Offline

Advisory Members

Posts: 164
Joined: Feb 2014

Machine: Resmed Airsense 10 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed P10 nasal pillows
Humidifier: Resmed Airsense 10 and heated hose
CPAP Pressure: 9
CPAP Software: SleepyHead

Other Comments: Started APAP on May 26, 2014. Benefits kicked in on May 31 thanks to forum help (leakage resolved)

Sex: Male
Location:

Post: #7
RE: Continuous problem. Please advise.
Thanks for the replies. I can post stats, but people tend to respond that they can't figure them out as they are too differently displayed from sleepyhead etc. (I posted some in the past).

I checked leaks on the stats given by the software and they are in normal range.

I do wear the mask all the time.

I breathe at times with my mouth as the chin strap slips and head gear slip at times to different positions, leaving too much leeway (the P10 is great, but the headgear sucks). But even during nights where the gear does stay on, I have problems.

Why do you bring up testosterone Mr. V. W.? There could be other causes than a CPAP issue of course, but I've had blood tests before and everything was in normal range (including testosterone).

Before APAP: [Image: DARTH-VADER_zpsa57946df.png]

After APAP: See avatar: R2D2 for the win!

"Be kind, for everyone you meet is fighting a great battle"
--Ian Maclaren

I don't snore! I just make creepy noises so the aliens know I'm not someone to be messed with.
01-02-2015 05:24 PM
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Mr. Van Winkle Offline

Advisory Members

Posts: 258
Joined: Nov 2014

Machine: Resmed Airsense 10 Autoset
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: Airsense
CPAP Pressure: 9 -15
CPAP Software: ResScan SleepyHead Other Software

Other Comments:

Sex: Male
Location: Minnesota

Post: #8
RE: Continuous problem. Please advise.
Why do you bring up testosterone Mr. V. W.? There could be other causes than a CPAP issue of course, but I've had blood tests before and everything was in normal range (including testosterone).
[/quote]

Sorry I didn't mean to offend you in any way, I know low t can make you tired and run down (no energy) and depressed.
I'm not a doctor, but I do treat myself for low t.
Best wishes!

Winkle
01-02-2015 06:07 PM
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archangle Online
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Advisory Members

Posts: 3,159
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

Sex: Undisclosed
Location: USA

Post: #9
RE: Continuous problem. Please advise.
This is yet another example of why you need a fully data capable CPAP machine with airflow waveforms.

How did you end up with a Breas machine? Do you live outside the US? I thought those were mostly used outside the US.

I don't think the Breas does airflow waveforms, but I could be wrong. Do you have software to read your data, or do you get it off the display somehow.

You might try raising your minimum pressure. It could be that even though you're not having apnea, you're having airflow limitations. Does the Breas machine distinguish central apneas from obstructives?

You might see if there's some way to get a fully data capable CPAP among the models listed as good in my signature line. Sometimes you can find a good machine through Craigslist fairly cheaply.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
01-02-2015 06:12 PM
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Visitor Offline

Advisory Members

Posts: 164
Joined: Feb 2014

Machine: Resmed Airsense 10 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed P10 nasal pillows
Humidifier: Resmed Airsense 10 and heated hose
CPAP Pressure: 9
CPAP Software: SleepyHead

Other Comments: Started APAP on May 26, 2014. Benefits kicked in on May 31 thanks to forum help (leakage resolved)

Sex: Male
Location:

Post: #10
RE: Continuous problem. Please advise.
No offense taken Winkle. Problem is, those symptoms can stem from a number of issues. I'll get a blood test as well as consulting the specialist, just in case.

Before APAP: [Image: DARTH-VADER_zpsa57946df.png]

After APAP: See avatar: R2D2 for the win!

"Be kind, for everyone you meet is fighting a great battle"
--Ian Maclaren

I don't snore! I just make creepy noises so the aliens know I'm not someone to be messed with.
01-02-2015 06:14 PM
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