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How to get to 100%?
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tokyo43 Offline

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Posts: 27
Joined: Jun 2013

Machine: RESMED S9 Elite (Fixed pressure CPAP)
Mask Type: Nasal pillows
Mask Make & Model: F&P Pilairo Q
Humidifier: RESMED H5i/climite line
CPAP Pressure: 8.6
CPAP Software: ResScan SleepyHead

Other Comments: 46 yrs old, 5'11, 180lbs.

Sex: Male
Location:

Post: #1
How to get to 100%?
Hello all.

I've been on fixed pressure CPAP since 2009 and have never felt completely rested, i.e. 100%. Up until a couple of months ago before I started taking Ambien I would say I felt about 50% rested on a typical day due to it being difficult to sleep wearing the mask.

Now that I'm on the Ambien I can easily sleep 7+ hours straight but still I only feel around 75% rested on a typical day. I feel much better in the morning than I used to (clearer head and more rested), but I still almost always have a mild headache in the morning and never ever feel completely refreshed. I can at least fight through the fatigue and cloudy head now without too much of a problem, but it's not fun.

The last few months I typically see averages of 1.5 to 1.9 AHI on my S9 when I check it after I wake up. Before I started taking Ambien my AHI was hovering around 0.5 - 0.9. I'm guessing that the slightly higher AHI is not the problem, but I did try bumping up my pressure from 6.4 to 7.4 with no noticeable improvement (symptoms or AHI). So I reset it back to my prescribed 6.4.

So in trying to figure this out I have a few questions.

1) Is it possible I'm breathing though the mouth for long periods even though my S9 is reporting (misreporting?) AHI's of under 2? How to check for mouthbreathing?

2) I feel like the Ambien is working very well, but maybe I'm wrong and having mild side (after) effects? Suggestions?

3) Should I go ahead and inquire with my GP about a medication(?) to help clear my head and make me more alert? Or would that be premature?

4) Would having another sleep study be worthwhile? i.e would an experienced sleep specialist be able to pin point the problem or would all they tell me is that my SA is under control?
(This post was last modified: 06-07-2013 03:30 PM by tokyo43.)
06-07-2013 03:27 PM
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PaulaO2 Offline
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Posts: 8,067
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #2
RE: How to get to 100%?
1 - do you have the Escape or the Elite? If the Escape, all you have to go by in terms of leaks is the smiley face. Green means the leaks were low, red means a bad leak night. Wait, you said it told you the AHI so you must have the Elite.

2 - ambien is a sleep aid, not an alert aid. There are some medications that some people have tried to help with the daytime sleepiness. It is my opinion that sleep aids don't help with daytime sleepiness or alertness. They may or may not help you sleep but they are a bandaid to whatever the real problem is.

3 - it has been since '09 that you started? Have you ever had another sleep study? Have you mentioned any of this to your sleep doc? One thing you can do is look at the data for your machine (assuming you have the Elite). You can do this using either ResScan or SleepyHead. Both are available here.
http://www.apneaboard.com/forums/Forum-Private-Files-and-Links

4 - a sleep study would be worthwhile if you have a non-data capable machine. I do think it is time to go see the sleep doc and share what is going on.

I also suggest starting a sleep diary. Note down when you went to bed and what kind of day you had (work day w/ high stress or fun day with family). Note when you woke up and how you felt (bad dreams, slow to wake up). And try to also note how you felt during the day in terms of sleepiness.

Another suggestion is if you have had the same machine since '09, you may want to take it to the supplier and have them check the pressure. They should do this for free although some a-holes like to charge for this "service". Some times a machine will lose it's oomph and will not be putting out the pressure it says it is. This doesn't happen as often with these better machines but yours is about 4 yrs old and may need to be checked just to be sure.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


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06-07-2013 03:39 PM
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trish6hundred Offline

Advisory Members

Posts: 6,449
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #3
RE: How to get to 100%?
Hi tokyo43,
WELCOME! to the forum.!
You could try a chinstrap if you suspect that you are mouth breathing .
Best of luck and hang in there for more suggestions.

trish6hundred
06-07-2013 03:47 PM
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tokyo43 Offline

Preferred Members

Posts: 27
Joined: Jun 2013

Machine: RESMED S9 Elite (Fixed pressure CPAP)
Mask Type: Nasal pillows
Mask Make & Model: F&P Pilairo Q
Humidifier: RESMED H5i/climite line
CPAP Pressure: 8.6
CPAP Software: ResScan SleepyHead

Other Comments: 46 yrs old, 5'11, 180lbs.

Sex: Male
Location:

Post: #4
RE: How to get to 100%?
(06-07-2013 03:39 PM)PaulaO2 Wrote:  1 - do you have the Escape or the Elite? If the Escape, all you have to go by in terms of leaks is the smiley face. Green means the leaks were low, red means a bad leak night. Wait, you said it told you the AHI so you must have the Elite.

I have the Elite. I always get the green smiley face, but it doesn't seem to be very sensitive to leaks or mouth breathing. I think I'll try a few experiments.

2 - ambien is a sleep aid, not an alert aid. There are some medications that some people have tried to help with the daytime sleepiness. It is my opinion that sleep aids don't help with daytime sleepiness or alertness. They may or may not help you sleep but they are a bandaid to whatever the real problem is.

Right. In addition to Ambien I was thinking of going on a 2nd medication, an Alert med also, to help me during the day, but would rather avoid that.


3 - it has been since '09 that you started? Have you ever had another sleep study? Have you mentioned any of this to your sleep doc? One thing you can do is look at the data for your machine (assuming you have the Elite). You can do this using either ResScan or SleepyHead. Both are available here.

I haven't seen a sleep doctor for a couple of years. I had a second sleep study in 2011 where they raised my pressure from 5 to 6.4.

I'll try to post a screen shot of my ResScan data later.


4 - a sleep study would be worthwhile if you have a non-data capable machine. I do think it is time to go see the sleep doc and share what is going on.

I also suggest starting a sleep diary. Note down when you went to bed and what kind of day you had (work day w/ high stress or fun day with family). Note when you woke up and how you felt (bad dreams, slow to wake up). And try to also note how you felt during the day in terms of sleepiness.

Good idea. I'm not consistent with my sleep schedule so that's another issue I can track, record, improve on.

Another suggestion is if you have had the same machine since '09, you may want to take it to the supplier and have them check the pressure. They should do this for free although some a-holes like to charge for this "service". Some times a machine will lose it's oomph and will not be putting out the pressure it says it is. This doesn't happen as often with these better machines but yours is about 4 yrs old and may need to be checked just to be sure.

I bought the tool to check pressure, but haven't done so in a long time. I'll try it and post the results. Thank you for all the suggestions.
06-07-2013 04:04 PM
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Bompa Offline

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Posts: 854
Joined: Mar 2012

Machine: DreamStation Pro
Mask Type: Nasal pillows
Mask Make & Model: Nuance Pro
Humidifier: DreamStation Heated Humidifer
CPAP Pressure: 12.0
CPAP Software: SleepyHead Other Software

Other Comments:

Sex: Male
Location: Falkenburg,

Post: #5
RE: How to get to 100%?
Hi Tokyo

I am a mouth breather and wear a chin restraint.

The best sign I get from mouth breathing is bad dry mouth.

I've taken the restraint off once in a while to see if I can keep my mouth shut while sleeping.

Sleep-well Coffee
06-07-2013 05:27 PM
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zonk Offline

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Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #6
RE: How to get to 100%?
All the smiley face tells you, 70% percentile leak is less than 24 L//min

I think you need to schedule an appointment with your sleep doctor as been over two years since pressure been adjusted
06-07-2013 05:57 PM
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tokyo43 Offline

Preferred Members

Posts: 27
Joined: Jun 2013

Machine: RESMED S9 Elite (Fixed pressure CPAP)
Mask Type: Nasal pillows
Mask Make & Model: F&P Pilairo Q
Humidifier: RESMED H5i/climite line
CPAP Pressure: 8.6
CPAP Software: ResScan SleepyHead

Other Comments: 46 yrs old, 5'11, 180lbs.

Sex: Male
Location:

Post: #7
RE: How to get to 100%?
I tried to post an screenshot of my ResScan data, but got an error msg: "not allowed to post images". Sad

Last night my leak rate was 17.2.

(06-07-2013 03:47 PM)trish6hundred Wrote:  Hi tokyo43,
WELCOME! to the forum.!
You could try a chinstrap if you suspect that you are mouth breathing .
Best of luck and hang in there for more suggestions.

Thank you Trish.

(06-07-2013 05:27 PM)Bompa Wrote:  Hi Tokyo

I am a mouth breather and wear a chin restraint.

The best sign I get from mouth breathing is bad dry mouth.

I've taken the restraint off once in a while to see if I can keep my mouth shut while sleeping.

Sleep-well Coffee

I tried a chin strap for a couple of nights, but that was years ago. I'm planning to wear it tonight.
06-07-2013 05:58 PM
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tokyo43 Offline

Preferred Members

Posts: 27
Joined: Jun 2013

Machine: RESMED S9 Elite (Fixed pressure CPAP)
Mask Type: Nasal pillows
Mask Make & Model: F&P Pilairo Q
Humidifier: RESMED H5i/climite line
CPAP Pressure: 8.6
CPAP Software: ResScan SleepyHead

Other Comments: 46 yrs old, 5'11, 180lbs.

Sex: Male
Location:

Post: #8
RE: How to get to 100%?
(06-07-2013 05:57 PM)zonk Wrote:  All the smiley face tells you, 70% percentile leak is less than 24 L//min

I think you need to schedule an appointment with your sleep doctor as been over two years since pressure been adjusted

Thanks for the info. Last night my leak rate was 17.2. Which I think is ok?

I'm going to see my regular doctor so I can get the referral for the sleep study. I wish they would have prescribed me an auto-CPAP though.
(This post was last modified: 06-07-2013 06:05 PM by tokyo43.)
06-07-2013 06:03 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #9
RE: How to get to 100%?
(06-07-2013 06:03 PM)tokyo43 Wrote:  Last night my leak rate was 17.2. Which I think is ok?
95% leak was at or below 17.2 L/min for 95% of the time
Chinstrap as suggested can help keep mouth closed and minimize mouth leaks
06-07-2013 06:32 PM
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tokyo43 Offline

Preferred Members

Posts: 27
Joined: Jun 2013

Machine: RESMED S9 Elite (Fixed pressure CPAP)
Mask Type: Nasal pillows
Mask Make & Model: F&P Pilairo Q
Humidifier: RESMED H5i/climite line
CPAP Pressure: 8.6
CPAP Software: ResScan SleepyHead

Other Comments: 46 yrs old, 5'11, 180lbs.

Sex: Male
Location:

Post: #10
RE: How to get to 100%?
(06-07-2013 03:39 PM)PaulaO2 Wrote:  Another suggestion is if you have had the same machine since '09, you may want to take it to the supplier and have them check the pressure. They should do this for free although some a-holes like to charge for this "service". Some times a machine will lose it's oomph and will not be putting out the pressure it says it is. This doesn't happen as often with these better machines but yours is about 4 yrs old and may need to be checked just to be sure.

Just checked it with my Fisher and Paykel water column manometer.

Machine is actually set for 7.3.
Manometer reading is 6.8.

(06-07-2013 06:32 PM)zonk Wrote:  
(06-07-2013 06:03 PM)tokyo43 Wrote:  Last night my leak rate was 17.2. Which I think is ok?
95% leak was at or below 17.2 L/min for 95% of the time
Chinstrap as suggested can help keep mouth closed and minimize mouth leaks

So you're telling me that 17.2 is not good? I need to read up on mask leakage.
(This post was last modified: 06-07-2013 06:45 PM by tokyo43.)
06-07-2013 06:44 PM
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