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Exasperated with Treatment
#1
I like my machine, mostly. But I'm getting exasperated with my treatment. I wake up un-refreshed. (I had a happy a feeling once, just once on awakening.) Last few days I have a headache.

My AHIs are great, varying between 0.4 and 1.7 for the past two months. My pressures feel fine to me. Sometimes I toss and turn, and I'm getting used to the mask more. I hear tales of high numbers (like 12.7 Manse Hen!) but I don't have that problem.

Three days ago (from Sleepyhead) I could see that the machine ramped up without a trigger event from 7.6 to 10.8. Then it showed a CA(!).

Any ideas oh ye sages of the PAP? Unsure

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#2
I don't get that "refreshed" feeling yet. But I am realizing that I am also not getting that almost overwhelming feeling that I really need a nap during the middle of the day either, so for now I'm just reminding myself it's better than it was before. My AHI is still 10, mostly CA. I don't wake up gasping and heart pounding. But still waking up several times a night which can't be good for restful sleep.

The ramp up would most likely be from predictive events (flow limitation or snoring detected).

The CA is most likely because everything was working so well you didn't have enough CO2 buildup to trigger a breath. Also the CO2 threshold shuffles around if you are toggling between sleep and waking, which makes an occasional CA easier to slip in.
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#3
Don't be discouraged. Your body is doing a happy dance now that you are sleeping better even if you don't actually know that when you wake up.

What is your pressure doing? Average, 90%, that sort of stuff. Also, does your flow-limit graph look like the Rocky Mountains, or Nevada's White Sands... I wonder if you might be better off if you raised the low end just a dab.

Also this just came to me: I just read where one of the causes of Altzheimers is sleep deprivation. ........................ Darn, I forgot what I was going to say.
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#4
trailrider: Don't worry about an occasional CA. I bet the duration of that CA was just over 10 seconds -- am I right?
Most of us using PAP have an occasional CA of short duration.

Some people during the start of therapy have a number of pressure induced CAs that abate with time.

The machine will ramp up pressure in response to snore, flow limitation, hypoapnea and an OSA. You may not have had a OSA or hypo -- but if you look at the snore and flow limitation graphs -- I think you'll see a reason for the ramp up in pressure. Snore and flow limitation are precursors to a OSA event; and the machine tries to anticipate and prevent them.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
Trailrider, your body might just not like the change in pressure. Basically, find a "Happy Place" then work on the AHI. What is your average pressure? Somewhere around 10? If so, try a straight setting, using no ramp, of 9 to 10 and forget the AHI. See if that makes you feel any better. Go either up or down from this point until you find that "Happy Place". You can chase low AHI numbers and still feel like crap.

I hope you feel better! Sleep-well
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#6
It also might be something completely unrelated to apnea or CPAP. I get those symptoms when I'm dehydrated.
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#7
Hi trailrider,
I want to encourage you to hang in there with it, sometimes it takes your body a while to get used to this new way of sleeping.
Good luck to you as you continue your CPAP therapy.
trish6hundred
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#8
Try to stick with it. Everyone adjust differently and feels different benefits at different intervals.
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