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Getting daytime sleepiness issues, go back to CPAP mode?
#1
During my diagnostic sleep study, I was found have very severe sleep apnea (AHI =130, RDI= 132, and ODI = 67). My sleep doctor prescribed a CPAP machine set at 15 cm and 2 cm EPR to my family doctor who wrote that in his prescription to the DME. Note, I did not have a titration study done. However, I responded very well to therapy with a 98% plus reduction in AHI and improved well being (no snoring, relaxed sleeping, reduced trips to the bathroom at night and more energy during the day).

When visiting my family doctor (21 days after CPAP), I discussed the potential benefits of switching my Autoset to auto mode. After some discussion he agreed, specifying that I should use a low setting of 13 cm and a high of 17 cm. After nine APAP nights, the median pressure ranges from 14 to 15 cm and 95% pressure is 16.5 to 16.9 cm. I seem to sleep well during these nights but man things are changing in a negative sense... I went from not being sleepy during the day with CPAP mode to having several sleepy bouts during the day (yawns, watering eyes, lethargy but not falling asleep). I'm thinking I should either go back to straight CPAP mode at 15 cm or perhaps APAP, reducing the range from 13 to 17 cm to 15 to 17 cm. Does that seem reasonable? I suspect my family doctor would say go back to CPAP mode at 15 cm but that's only my guess... Dont-know
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#2
everyone is different. whatever works best for you
some have better response to cpap while others like me respond better to apap
you have make sure its not leak that messing things up and disturb your sleep
also bear in mind that the 95% percentile pressure is at and below for 95%of the time ... some seem to ignore the below part

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#3
Good point about the leaks. I do have them pretty much under control where the median leak is 0 and 95% leak is like 10 to 15 cm. My autoset always displays a green smiley face each morning for good mask fit and reasonable leakage... Smile
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#4
What machine did you have before? The same one? If so, what were the AHI before and after? Number and length of events?

It is possible that you have hit not exactly a plateau, but you're getting better treatment. And most of us get sleepier the first few days or so as we are now getting better sleep and the body brain want more of it.

My sleep patterns are rather erratic but I did notice starting about day 6 or so after getting the Autoset, I was getting the nods during the day. This leveled out after an other week or more. My pressure had been 12 with the Escape but I kept hitting the top end of the Autoset so I raised it again. I had nothing to compare it to since the Escape is a dumb brick.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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
Paula,

Good questions. I've used the same machine throughout with CPAP mode for first 21 days and APAP mode last 9 days. My AHI's range from 0.5 to 1.8 over the last 21 days. Similar range in values for both CPAP and APAP modes. Based on the numbers, treatment effects should be equal but tiredness has been increasing to every day and has gotten more intense. I have an important meeting tomorrow that involves 4 hours of car travel. I think I need to ensure a good nights rest so will probably at least adjust the minimum pressure to 15...
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#6
I don't think it will make a difference but please let us know how it goes.

Your AHI is great, though! Congrats.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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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#7
I find I feel better if I up my minimum pressure a bit above where my AutoSet wants to put me and above where my AHI basically drops to zero.
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.
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#8
(12-19-2012, 09:28 PM)archangle Wrote: I find I feel better if I up my minimum pressure a bit above where my AutoSet wants to put me and above where my AHI basically drops to zero.
you know whats works best for you
I,m from the other side ... the lower the better
I like to set my minimum pressure at level which find most comfortable to fall asleep
after fall asleep the S9 adjust the pressure throughout the night
I don,t know about algorthim ... sound arabic to me Dielaughing



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#9
I have found I like to keep a narrower range in pressures so I get the best data possible. The time it spends on the low pressure while I am trying to fall asleep, it can skew the averages. I started out at 10 - 16 and now it is at 12 - 17. My AHI also dropped with each change. Right now, I have only gone over 2 in the past 11 days while before, I was hitting 3 or higher a lot.

Me likey.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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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#10
(12-19-2012, 09:52 PM)zonk Wrote: I don,t know about algorthim ... sound arabic to me Dielaughing

Laugh-a-lot Good one Zonk!
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