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Good stats, good sleep, but still tired...
#1
Hey everyone!

So, I've been using my Darth Vader machine for 2 weeks.

My stats overall is good. In fact, it's really good. But my problem is that I'm still tired. In the past two weeks I have not woken up once feeling as good as I did the day after I slept at the sleep clinic.
The last couple of days I've woken up with I slight headache. It's almost the same feeling I had before treatment, suspecting the reason for it due to oxygen deprivation to the brain.
There's no specific reason I can think of for still being tired. Every aspect I can think of my life has not really changed lately: Health, stress levels, not using medication.
I'm getting very comfortable with the mask and breathing. So comfortable, I sometimes wake up forgetting that I have a mask on.

   

   

I have no idea what the reason/s might be for this. Any help / advice is appreciated!
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#2
You probably wont like my answer, but some people take longer than others to become accustomed to the machine. Some may take months for their bodies to adapter and during that time it is not unusual to feel tired when getting up. Some people are lucky and feel better right away, but from what I have read here, that is not most.

Hang in there, have patience and don't make too many adjustments too fast - wait weeks between adjustments.

It will get better.
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
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#3
Thanks Frank,

I far as I can tell, I've become accustomed to it. I rarely take it off during the night. In the beginning I would wake up 5-10 times a night, now only 2-3 times. As far as I can tell, I'm getting a good night rest.

I haven't made any adjustments yet, especially since I'm achieving the stats I'm looking for.

I will keep on using the settings as it is. I just thought I'll ask the question, as it's puzzling that the stats are good but I'm not really feeling a big difference. I have to mention though, I do get up easier in the mornings, but by lunchtime I'm my old self.

Side note (question): I'm currently on APAP 6-14 with a 90% pressure of 8. What will happen should one change the pressure to, say, 8/9 CPAP? Will it be a good or bad thing? I currently like the APAP setting, especially the ramp feature, it's comfortable.

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#4
Lourens1190,
Follow these instructions on posting your data, then someone will take a closer look.

https://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur

OpalRose
Apnea Board Moderator
www.ApneaBoard.com

How to Organize and Post ScreenShots

http://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur

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
My apologies OpalRose,

Here's a link to my Sleep results album as well as the last few days below:

Album: http://imgur.com/a/9l3bb

[Image: ETsqiepl.jpg]

[Image: ZtpFTx4l.jpg]

[Image: ZtF6rbKl.jpg]

[Image: iOxZUvUl.jpg]

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#6
The 640 pixel width on your images keeps them too small to be easily read. Otherwise you have very good results on leaks and the pressures are well dialed in. You have numerous breaks in therapy indicating a disrupted sleep, which is an obvious problem for fatigue. Learning why those breaks are ocurring would be important to finding a solution.

Your use of EPR at 3 is resulting in an EPAP of 4-cm most of the night. While this is not hurting your therapy, I would encourage you to either increase your minimum pressure a bit, or decrease the EPR. So minimum pressure of 7 with EPR at 3, or leave your minimum pressure at 6,and cut EPR to 2. With either of those settings you will have a starting EPAP pressure at 4, but it will rise with IPAP. I think you will find this stabilizes pressure a bit and might reduce your night trips to the bathroom, or whatever is happening there.
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#7
Thanks Sleeprider! My apologies, I'll get it right one day. Dielaughing

Okay, i'll try it after 2-3 weeks from now. As I've mentioned in the OP, I've been using my APAP for 2 weeks so far. After collecting a months data, I'll start playing around.

I thought I'll ask the question, maybe there's something 'simple' I'm missing...
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#8
(10-25-2016, 08:40 AM)Lourens1190 Wrote: ......
I thought I'll ask the question, maybe there's something 'simple' I'm missing...
Welcome. Here's something simple you can try. In SleepyHead, open the events tab. Expand a category - doesn't matter which - left click on any one event. Now in the Flow Rate graph right click four times. You now have a window of a little over 3 minutes. Now left click in the events graph as near to the start of session as you can. Note how your flow rate - ie. your breathing - is irregular. You can navigate the entire event graph maintaining the 3-minute window, either by left clicking once anywhere in it, or by right dragging it. In this manner, you can explore your breathing patterns at the same zoom level for the whole session. If you do this over several sessions, you will get a feel for your breathing pattern during wakefulness, during sleep, around an event, and when there is an unflagged disruption. A sleeping pattern is very regular, very boring, possibly resembling a sine wave. Wakeful breathing is usually less regular and may have a different respiration rate than the sleeping pattern. Disruptions - which are probably micro arousals - will be significantly less regular. Since your events are few, the question is whether many unflagged micro-arousals are causing lack of restorative sleep. I get them myself. They do not trigger the machine algorithms, but probably contribute to poor sleep quality just the same.

Be aware that micro-arousals are not necessarily caused by apneaic events per se. There is a variety of other possibilities. For example, they could result from simple bodily movement. Also, even a very regular ("sleepful") flow curve can have irregularities - for example, a truncated inhalation peak. The first step is simply to determine what's there (or not there).

This is not a therapeutic process in itself. But it can lead to a sharper awareness of your sleep architecture, which in turn may lead to suggestions for therapeutic tweaking. If you care to publish the graphs, show a 3-min window of the regular ("sleep") pattern and one or two of the irregular patterns with no associated event, one that contains a CA, and one that contains an obstructive event. The veterans here may then have suggestions. For greater clarity, overlay the zero point dotted line. (Right click to left of FR graph, choose "dotted lines" from submenu. Thicken the line in File=>Prefs=>Appearance)

Good luck and better sleep.

-Ron

We are such stuff
As dreams are made on, and our little life
Is rounded with a sleep.
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#9
rkl122,
Wow, thanks for the detailed response! It's much appreciated!

Here are a few 3min captions:

Awake Flow Rate:
[Image: eR8lmyDh.jpg]

Asleep Flow Rate:
[Image: bmwbGWih.jpg]

3 Unflagged Events:
[Image: 9M4YwUzh.jpg]

[Image: qLRQUpzh.jpg]

[Image: cATcwn2h.jpg]

Is this what an arousal looks like? This is just before I woke up.

[Image: bKqJPvch.jpg]


Sorry for my ignorance and stupid questions. One day I will be able to read the graphs better.
Is there perhaps a thread that gives examples and explanations for them?
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#10
Your results look great, and are relatively unremarkable. The respiratory flows are normal. If your want to really learn how to interpret these graphs, the Wiki article by robysue (Beginners Guide to Sleepyhead) is your best bet http://www.apneaboard.com/wiki/index.php?title=Robysue

Your early breathing waveform showing regular rounded inhalations and expirations is typical of awake breathing before sleep onset. This is followed by the rhythmical respiration for early stage 1-2 sleep. The flow disruptions that follow may be sleep stage change, or just some volume irregularities. Hard to tell from the wave form alone. At 00:12:00 the ragged breathing is accompanies by a single snore and a leak. Looks like a change in position and possible arousal. Note your pressure has gone up 2-cm here.

At 02:50 breathing is irregular with a couple flow limitations and leaks. Pressure is at 6 and rising due to the flow limits. The irregular breathing may be movement or an arousal from deeper sleep stage. The flow limitations are visible as the sharp inhalations that tail off at a 45 degree angle.

Your final shot at 03:01 you are at your highest pressure of the night (events that cause pressure increase were earlier, don't know why) with a couple minor leaks. Nothing too remarkable about this, and looks like you might shift position a bit or a micro arousal.
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