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Getting daytime sleepiness issues, go back to CPAP mode?
#11
(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.

Can you flesh your comment out a bit more for me? To give some data, last night I had 5 HA and 1 OA. Two HA occurred when the pressure was 16.9 cm (essentially max for my settings) while the rest occurred at lower pressures. Are you suggesting then that I should adjust the minimum pressure to above 17 cm? BTW, I have not had any machine detected CA's.
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#12
(12-19-2012, 10:21 PM)IDRIck Wrote:
(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.

Can you flesh your comment out a bit more for me? To give some data, last night I had 5 HA and 1 OA. Two HA occurred when the pressure was 16.9 cm (essentially max for my settings) while the rest occurred at lower pressures. Are you suggesting then that I should adjust the minimum pressure to above 17 cm? BTW, I have not had any machine detected CA's.

If I set my minimum pressure at 12, I get pretty small AHI. If I raise the minimum pressure to 14 or 16, I don't get a lower AHI, but I feel better. I suspect it's some sort of flow limitation or breathing problems not long enough or deep enough to show up. It may also have to do with "vacuuming" up stomach juices while struggling to breathe.

There could also be some other effects at work. There are a lot of complex feedback mechanisms in the nervous system and respiratory system.

I do not necessarily recommend others to do this, but might be worth doing a short experiment and seeing how it works for you, especially if you're not feeling better.
Get the free SleepyHead software here.
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If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#13
(12-19-2012, 10:58 PM)archangle Wrote: There could also be some other effects at work. There are a lot of complex feedback mechanisms in the nervous system and respiratory system.

I do not necessarily recommend others to do this, but might be worth doing a short experiment and seeing how it works for you, especially if you're not feeling better.

This could also be caused by light quality and/or circadian rhythm, I've read articles about people having much more energy from light therapy, both artificial blue lights or from sunlight having a pretty big effect on both energy-levels and mood.

When my energy level dropped-off a while back, I realized I wasn't walking my dog as much as I used to, after I started walking her or more accurately, being pulled by my boxer for a half-mile a day my energy level definitely started coming back so I'm still walking.

I think the real test for Rick or anyone debating whether to use either Straight or Auto CPAP would be best served by doing their own blind study.

This would entail training a household member on how to make settings in either mode and they'd have to do a daily interview with you to help determine efficacy. They would be in charge of making all pressure or mode changes (and when) and would also have to cover the CPAP display with masking tape so you would not know what the pressure was until after the experiment was over, this also means they would have to upload the data to SleepyHead or whatever application you use and you would not be able to see it until after your study ends.

It would probably help to always use the Ramp feature with a fixed pressure throughout the entire study for say 30 minutes so you wouldn't be laying there trying to guess which mode the machine was in or what the pressure was, you'd be able to fall asleep at the same predetermined Ramp pressure every night of the study.

I'm sure I missed a couple of variables somewhere but, ultimately doing this would help to determine whether or not our "perceived" mode of CPAP therapy or pressure is actually having the effect we think it does or should.

Archangle, Thanks for specifically recommending that others do this! Too-funny

Ren
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#14
I decided to use the following pressure settings on my autoset: min 15 cm, max 18 cm, EPR 2. During rest, my median pressure is now 17 cm (up from 15) and max pressure is 18 cm (up from 16.9). Obviously two nights is insufficient to evaluate its effectiveness on daytime sleepiness. I will keep the board informed after a few week trial.

Have a Merry Christmas everyone!

Rick
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