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Please Help-I feel like crap
#1
Please Help-I feel like crap
I started with CPAP on Jan 26th and it's been up and down since trying to get used to it but I've never woken up feeling refreshed once.  In fact I actually feel worse now than I did before I knew I had sleep apnea.

A bit of history, my DR. sent me for an overnight sleep test because an echo showed I have an enlarged heart.  I've been experiencing awful breathlessness for the past 6 months, going for a cardiac CT scan next week to rule out artery disease.  I've always had problems sleeping which I thought was insomnia so I never bothered to follow up with it.  I have never woke up gasping for air or any of the other typical symptoms of sleep apnea.  

My first mask was a dreamwear small cushion (med frame) but the cushion part feels too big, so I switched to the P10 med cushion but I can't get used to the fit.

Basically I've given up multiple times over the past week and slept without the machine and I always feel better in the morning.  I'm supposed to have severe apnea and when I look at my stats the AHI is low so shouldn't this be working and making me feel better when I can use it?

I went for a titration study but don't get the results until Apr 13th, although I don't expect that will offer much to help.

I'm so confused and frustrated.  I could use some help reading last nights OSCAR chart.  Is there something in it that I'm missing?


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#2
RE: Please Help-I feel like crap
I do recall having dream after dream after dream during this stage of my sleep.  Some of them were bordering on nightmares.
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#3
RE: Please Help-I feel like crap
I have 2 questions, what is your EPR set to and have you tried autoset instead of autoset for her?

Your therapy looks good but your flow limits are high.  Flow limits are small apnea and if they are numerous they can cause you to wake up or not get into deeper sleep.


There are some very good people here for helping - they will answer soon I'm sure - hang in there.
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: Please Help-I feel like crap
I'd agree with Stacey on the possibility that flow limits is your most likely disruption culprit. Typically EPR is the tool for that on the AutoSet. If that's at 3 already then you'd need to explore raising Min pressure, maybe to 8 or a fraction is 7.x and/or trying regular AutoSet instead of for her. Of course if you try any edit and it's not helping, revert to the prior setting.
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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#5
RE: Please Help-I feel like crap
Did you sleep more than 4.3 hours? How long do you usually sleep? And do you usually go to bed around 3 a.m.?

Do you happen to know whether your titration study included trialing you with bilevel pressures greater than the EPR of 3 that your machine is capable of? I've certainly seen worse flow limitations, but if you're sensitive to them -- if they keep you from cycling through sleep stages in the normal way -- they'll leave you feeling wiped during the day. The best way to treat FLs is with pressure support, e.g., via a ResMed VAuto machine. Well worth a conversation with your sleep doctor.
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#6
RE: Please Help-I feel like crap
(04-03-2021, 08:36 AM)staceyburke Wrote: I have 2 questions, what is your EPR set to and have you tried autoset instead of autoset for her?

Your therapy looks good but your flow limits are high.  Flow limits are small apnea and if they are numerous they can cause you to wake up or not get into deeper sleep.


There are some very good people here for helping - they will answer soon I'm sure - hang in there.

I have tried the CPAP setting on 7.0 and the autoset for her 6.0-12.0 and the EPR has always been set to 3.  Ramp is now off.  I was hoping a new mask would help eliminate the flow limits.  I will try the autoset tonight.
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#7
RE: Please Help-I feel like crap
(04-03-2021, 09:27 AM)SarcasticDave94 Wrote: I'd agree with Stacey on the possibility that flow limits is your most likely disruption culprit. Typically EPR is the tool for that on the AutoSet. If that's at 3 already then you'd need to explore raising Min pressure, maybe to 8 or a fraction is 7.x and/or trying regular AutoSet instead of for her. Of course if you try any edit and it's not helping, revert to the prior setting.

I'm going to try autoset tonight with a min pressure of 8.0 and see if that helps.  EPR is set to 3.
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#8
RE: Please Help-I feel like crap
(04-03-2021, 02:25 PM)Dormeo Wrote: Did you sleep more than 4.3 hours?  How long do you usually sleep?  And do you usually go to bed around 3 a.m.?

Do you happen to know whether your titration study included trialing you with bilevel pressures greater than the EPR of 3 that your machine is capable of?  I've certainly seen worse flow limitations, but if you're sensitive to them -- if they keep you from cycling through sleep stages in the normal way -- they'll leave you feeling wiped during the day.  The best way to treat FLs is with pressure support, e.g., via a ResMed VAuto machine.  Well worth a conversation with your sleep doctor.

No it was a terrible night trying to fall asleep, the same thing happens often.  I usually sleep about 6 hours and sometimes can manage 7 but not often.  I normally go to bed around 1 am but again it's almost 2 am and I am not tired.  I know if I try to go to sleep without feeling tired it will just result in laying awake for hours.  That's the insomnia that I have had for years and I am used to that.

I don't know what they did during the titration study but will ask the Dr. on the 13th about the FL's.  The EPR is set to 3 right now and has been since I started.  

I was hoping a different mask might help.  Is this something that will get better with time?
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#9
RE: Please Help-I feel like crap
What was the result of your sleep study, other than you apparently need PAP? Also, were you or a partner ever aware that you snored frequently? Also also, have you had your sats taken (blood oxygen level)? Other than the enlargement, what else have they told you about your cardio condition, for instance the pumping efficiency?

If the sleep test was definitive for sleep apnea, then of course you need to persevere, and this is exactly the place you should go for help in optimising that (which can be a long journey). But the heart enlargement should absolutely be followed up, the cause determined (not always possible) and your cardio efficiency established. Apart from anything else, understanding why you have the condition, what your prognosis is and identifying the best treatment/management regime is vital if you're going to have any peace of mind. Stay on top of this!

Plenty of us in here (me included) have heart issues that were caused or exacerbated by apnea, so once again you're in the right place. I am now thirteen years on from my heart attack and have a good quality of life, various health issues allowed for, at 64yo.
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#10
RE: Please Help-I feel like crap
(04-04-2021, 02:02 AM)StevesSp Wrote: What was the result of your sleep study, other than you apparently need PAP? Also, were you or a partner ever aware that you snored frequently?  Also also, have you had your sats taken (blood oxygen level)? Other than the enlargement, what else have they told you about your cardio condition, for instance the pumping efficiency?

If the sleep test was definitive for sleep apnea, then of course you need to persevere, and this is exactly the place you should go for help in optimising that (which can be a long journey). But the heart enlargement should absolutely be followed up, the cause determined (not always possible) and your cardio efficiency established. Apart from anything else, understanding why you have the condition, what your prognosis is and identifying the best treatment/management regime is vital if you're going to have any peace of mind. Stay on top of this!

Plenty of us in here (me included) have heart issues that were caused or exacerbated by apnea, so once again you're in the right place. I am now thirteen years on from my heart attack and have a good quality of life, various health issues allowed for, at 64yo.

Sleep study confirmed I have severe apnea (33 events per hour), no abnormal heart rythym detected, oxygen dropped to 91%.  I was told by the Sleep Dr. that this means I will have to wear the CPAP all night/every night and every time I sleep.  A follow up titration study has been done but I don't have the results yet.

Heart issues are being investigated.  What I know so far is I have a 55% ejection fraction and they are looking at the left ventricular as a possible cause.  I have breathlessness, palpitations and sometimes pain in my chest after exercising.  I have had 2 echocardiograms and a nuclear stress test but both were not conclusive so I am waiting for a Cardiac CT which I am hoping will finally discover the issue.  That appointment will hopefully take place on the 14th and I am hopeful it will finally uncover what's going on.  I have normal blood pressure and cholesterol is perfect too, so I'm not sure what's happening with my enlarged heart, but with my other symptoms the Cardiologist wants to make sure I don't have clogged arteries.

Right now, sleep apnea is just something else I've discovered along this path to a diagnosis of my heart issue.  I do snore, very loudly some nights but never thought anything of it because my nose gets congested from time to time (allergies).
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