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New user feeling worse
#1
New user feeling worse
I have searched through the threads here and haven't found a real match to my situation.  I am almost 55 years old and was diagnosed with sleep apnea back in June. I recently got my machine and an N20 silicon nasal mask. 


For the last week or so I have been using the equipment and believe it or not adjusted almost immediately. I could even say the mask setup wasn't uncomfortable at all, just a little different. If it matters I am a very restless side sleeper and turn over often during the night. I Had an ahi of 26 from the sleep study and now am seeing the following numbers (average) over the last week...

copied from Oscar:

[font=.AppleSystemUIFont]AHI -  .74[/font]
[font=.AppleSystemUIFont]Obstructive Index -  .02[/font]
[font=.AppleSystemUIFont]Hypopnea Index -  .53[/font]
[font=.AppleSystemUIFont]Unclassified Apnea Index -  0.0[/font]
[font=.AppleSystemUIFont]Clear Airway Index - .19[/font]
[font=.AppleSystemUIFont]95% Flow Limitation -  .19[/font]
[font=.AppleSystemUIFont]RERA Index -  .74[/font]
[font=.AppleSystemUIFont]Average Leak Rate - 8.32[/font]
[font=.AppleSystemUIFont]95% Leak Rate -  32.40[/font]
[font=.AppleSystemUIFont]% of time above Leak Rate threshold -  14.01[/font]
[font=.AppleSystemUIFont]Average Pressure -  8.13[/font]
[font=.AppleSystemUIFont]95% Pressure - 10.66[/font]

Ever since I started the therapy I have woken up in the morning EXTREMELY dizzy, lightheaded, fogged over and sick. The feeling can take hours to subside. Before therapy I had some of these issues in the morning but this is a whole new level of bad then previous. I called my Dr and he said looking at the numbers there is no issue with my cpap therapy and not to change anything. Unfortunately he didn't give me anything to help either. He offered me stimulants but I am extremely prone to anxiety especially with prescription drugs so opted not to use these. 

Figured I would post here and see if anyone has had similar issues or have any recommendations. All I see is that my leak rate is higher than it should be but again when I asked the dr about that he said the numbers are good so the therapy is working and I should go see a psychiatrist for the anxiety.

I look forward to reading the thoughts of those who have been doing this for a while. If needed I can post Oscar data
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#2
RE: New user feeling worse
Nice professional doctor you have there. CPAP will just work Mr. Patient and if there's any complaints, then you have mental issues. I think this doc is related to the one half the rest of us used.

OK as for your sleeping issues, you could present us the screenshot of OSCAR. I'm not sure what the key combo is on Apple, but you're going to screenshot it somehow that's equal to a Windows F12 key.

The list of stats is somewhat helpful, but actually setting charts will be much better.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: New user feeling worse
           

Lets see if this posts properly
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#4
RE: New user feeling worse
You have ver high mask leaks and with those you are not getting reliable AHI.

I would suggest trying these settings
Min 7
EPR 3 full time

Fox your mask leaks, that is the most important part.

I will find the mask primer link and post it so you can read it.
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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#5
RE: New user feeling worse
http://www.apneaboard.com/wiki/index.php/Mask_Primer
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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#6
RE: New user feeling worse
(03-15-2022, 09:19 PM)staceyburke Wrote: You have ver high mask leaks and with those you are not getting reliable AHI.

I would suggest trying these settings
Min 7
EPR 3 full time

Fox your mask leaks, that is the most important part.

I will find the mask primer link and post it so you can read it.

Ok I understand that the mask leaks are probably my issue. I thought as much though my dr said not to worry about them. Looking at that article you linked to I suspect that I am having mouth leaks. I will try a mouthguard and see if anything changes.

I get the setting the min to 7 that makes sense to me, but the changing EPR from off to 3? I was told EPR can cause CA's due to it causing a Co2 imbalance. Again I am here seeking help so questioning things only to understand. I am not one to just change settings without understanding why.

Can you please explain what from my data led you to suggest the EPR setting you did as I dont FEEL like exhaling is an issue at all, so I am guessing there is something in my data that suggests the need for that change.
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#7
RE: New user feeling worse
Epr can cause centrals but you showed none. The reason it does it gets rid of CO2 and the body delays breath when CO2 is low, not because of lack of oxygen

EPR lessens the exhale to make exhale easier. You are now at 5, exhale is your min. When we raise the min of 7 and EPR 3 your exhale is 4 (4 is the absolute lowest the machine can go)

EPR also (and most importantly helps with flow limits), you did not add that chart so I don’t know if yours are large or not but looking at your leaks and higher pressure, I think you do have flow limits that are causing problems with leaks and higher pressure.

Your leaks look like mask leaks NOT mouth breathing. Moth breathing shows as a large FLAT leak. Yours are all spiked which shows mask leaks.
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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#8
RE: New user feeling worse
(03-15-2022, 10:15 PM)staceyburke Wrote: Epr can cause centrals but you showed none. The reason it does it gets rid of CO2 and the body delays breath when CO2 is low, not because of lack of oxygen  

EPR lessens the exhale to make exhale easier. You are now at 5, exhale is your min. When we raise the min of 7 and EPR 3 your exhale is 4 (4 is the absolute lowest the machine can go)

EPR also (and most importantly helps with flow limits), you did not add that chart so I don’t know if yours are large or not but looking at your leaks and higher pressure, I think you do have flow limits that are causing problems with leaks and higher pressure.

Your leaks look like mask leaks NOT mouth breathing. Moth breathing shows as a large FLAT leak. Yours are all spiked which shows mask leaks.

sorry, didnt know what to post hopefully this will help

           
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#9
RE: New user feeling worse
Yes that shows the flow limits and they are high pushing up  the pressures and causing mask leakage.  You will still need to address the mask leak.  The more area the mask covers the more places you can get leaks.  A nasal pillows mask like the resmed p30 or p30i is what I would try.  If you have tried that type of mask you can try going a size from med to large.


I hope you can get a change to try those settings - they should help.

When you post keep the left column without the date (remove date by clicking the triangle in the date line). and use F12 to take the screen shot.
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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#10
RE: New user feeling worse
Well I changed settimgs like we discussed and tightened the mask (perhaps to much as getting sore spots)

I still dont feel good at all but the numbers did change, unfortunately while I do see data on the sdcard for last night Oscar when I do the import, imports no data for last night.

   

But based on the airsense report:

Pressure:  8
Leak: 11L/min
AHI: 3.4
Total Ai: 3.3
Central Al: 3.3

So leak definitely went down but all the other numbers went up, I was well below 1 on all the ai numbers, and again I really still dont feel good, so while the pressure is very promising I am kinda wondering, whats next and whats up with oscar for last night?

I did just for good meaure try and rebuild all the data in Oscar and no change, all my previous data still there, last nights data is not.

Thanks for all your help
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