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Is sleep apnea even the main issue?
#1
Is sleep apnea even the main issue?
  • I've been on APAP for ~1.5 months 
  • Tired all the time. Can/will sleep gobs (12 hours/night if possible, up to 15 hours if I've only been getting 8-9 hours the previous couple nights).
  • Only change on APAP I've noticed is that I dream (or at least remember dreams) now.
  • I (stupidly) tried adjusting the pressure myself after reading some stuff about UARS here, so I have experimented with min pressure of 7+ with EPR of 3. No noticeable changes (other than maybe no longer dreaming?). I changed it back to 4-15 (which was prescribed) and EPR of 1. Noticed some dreams, so that... seems better.
Take-home sleep study showed pAHI < 2 and pRDI of 11 (17 pRDI during REM).

Before I had even gotten APAP, a repository therapist had suggested that given my "low numbers", something else might be causing me to sleep for 12+ hours.

So the question stands: Do I just need to fuss with some settings/give it more time? Or is it possible sleep apnea is not the main issue?


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#2
RE: Is sleep anea even the main issue?
Been experimenting with CPAP Mode/constant pressure of 5 (and 1 EPR). May have been random chance but it felt a bit better when getting up. Will continue and experiment going up/down 0.2 or 0.4 at a time.

I know typically people on this forum recommend 7 or 8 pressure with 3 EPR for people with UARS. Not sure if that's just "typical" or more definitive and I'm just not use to higher pressures or something else is going wrong (I don't seem to have an issue sleeping with the higher pressure, though).


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#3
RE: Is sleep anea even the main issue?
What I see are high amounts of Flow limits.  There is a flow limit chart take a look at it.  Flow limits are apnea just like obstructive and hypopnea they are just not timed and smaller events.  You can see how they are classified in my signature.  

Flow limits can cause sleep interruption or just keeping you from getting into deep sleep.  The way we try to stop them is what you have already tried...  I would suggest a min 8 and EPR of 3.  As I said you tried min 7 EPE 3 without success.  But I would like to see one night with the new settings and see how your flow limits respond.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#4
RE: Is sleep anea even the main issue?
Tried it for the past two nights. Flow limits do seem lower. Not feeling great, but that could be due to only getting 8-9 hours of sleep the last 3 nights.

Pictures are in order:

Night 1 Start
Night 1 + Night 2
Night 2 End


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#5
RE: Is sleep anea even the main issue?
Here's a longer stretch on those same min 8 epr 3 settings. AHI is low like it always is--as for flow limit, I'm not exactly sure what a "normal" flow limit graph would look like.


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#6
RE: Is sleep anea even the main issue?
I would move the min to 9 and see if that helps. Your flow limits are not large but they are numerous. But I don’t know if it will help. Give it a couple of days and post again comparing how you are FEELING.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#7
RE: Is sleep apnea even the main issue?
Well, I tried 2-3 nights on each of the following settings:
  • 9 min, 3 EPR
  • 9 fixed, 3 EPR
  • 5 fixed, 1 EPR
  • 9 fixed 3 EPR (again, for comparison)
5 fixed/1 EPR did not make me feel any better. All of these settings quite frankly felt... similar. I felt miserable on 5 fixed, on 9 fixed 3 EPR I slept 10 hours and then was still exhausted after getting up and making food and sleep another 3. I find it extremely hard to evaluate what feels better/worse since it's generally always bad and it varies day-to-day even on the same pressure settings.

From my understanding, it should be obvious when I start to get quality sleep. Have I just not found the right pressure yet?
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#8
RE: Is sleep apnea even the main issue?
Most of the time it is not a night and I feel great. It takes many nights starting to feel better. You need to give it a little time at the same setting. I suggest the min 9 and EPR 3.

I’d like to see what your charts looked like with those settings.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#9
RE: Is sleep apnea even the main issue?
Here's two nights with 9 fixed and one night with 9 min. The 9min night had a surprising amount of leaking (not normal), however all the previous 9min nights no longer have daily graphs since they were 10 days ago.

There seem to be fewer events and flow limits on 9 fixed than on 9 min. Should I still go for 9min or should I stick with 9 fixed?


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#10
RE: Is sleep apnea even the main issue?
Either would be fine. The Epr 3 works the same with either one. The difference is IF you need more pressure to stop obstructive events the fixed can not raise the pressure to stop it. However, you have very few events at 9 so do which ever you want.

Just give it a few days to start feeling the therapy.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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