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Sleep Hangover (Update - Round Two)
#1
Sleep Hangover (Update - Round Two)
[attachment=7047][attachment=7046][attachment=7045]I'm back with Sleepy Head Data for reviews. To Recap:

Using CPAP machine for just over a year now. After initial getting use to machine/mask, can now sleep entire night with mask on. receiving good numbers (i think) from sleep data and can feel the difference. I am, however, waking up with hangover type symptoms including foggy brain, light-headed, slight nausea, shakes, pressure below eyes, a general blah feeling. it lasts all day long. i am not having headaches nor dehydrated., i am not taking any sleep aids or any other medication. no other health issues that I am aware of. 

anyone else experience this? 

is it just taking time for my brain/body to adjust? build-up of anxiety (it was a long/difficult road to get my brain/body to accept CPAP machine use)?

Allergies? the 'pressure' under my eyes tell me its time to sleep yet my body feels refreshed. no excessive yawning during day. No congestion or runny nose just sneezing spells. can allergies just present itself with sinus pressure and no congestion?

have family doctor appointment in two weeks. any insight/thoughts about above that i could present to him appreciated.

Thanks to all,

Dave
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#2
RE: Sleep Hangover (Update - Round Two)
At first glance, your numbers look good. But you have fairly high Flow Limitation and RERA’s.

It may help to raise your pressure to 8.5. You may need to raise up to 9cm, but wait a couple days to see if FL and RERA’s even out a bit. Flow Limitations and RERA’s can cause many arousals that your not even aware of.
OpalRose
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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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#3
RE: Sleep Hangover (Update - Round Two)
sounds like an easy tweek to make. I'll give it a try

another thought I've Had: Pressure at 8.0 now. EPR set at 3. if i understand correctly, that means my pressure when exhaling is 5.0 seems rather low. could this be causing issues?
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#4
RE: Sleep Hangover (Update - Round Two)
Dave, I'm no expert.  However, the EPR is relief that your AirSense provides for easy exhalation, so it wouldn't be causing FLs (and I can't imagine how it would cause a RERA (Respiratory Effort Related Arousal).  I'm concerned with your fixed pressure; that doesn't seem to be something the AirSense would be set up for.  (Is that what your Rx required?)  And I sure think OpalRose has the right idea of increasing the pressure.

Please update us on your progress!
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#5
RE: Sleep Hangover (Update - Round Two)
(06-28-2018, 05:16 PM)CPAPUserDave Wrote: sounds like an easy tweek to make. I'll give it a try

another thought I've Had:  Pressure at 8.0 now. EPR set at 3. if i understand correctly, that means my pressure when exhaling is 5.0   seems rather low. could this be causing issues?

I don’t think it’s causing issues, it if your feeling reluctant to raise your minimum pressure, then lower the EPR to 2. This will give you an exhale pressure of 6cm. Lowering the EPR may also help with the smattering of CA’s. They are not bad at all, and I think it will even itself out in time. It takes time to adjust.

Since you also state you are feeling foggy or light headed... have you ever tried an overnight recording oximeter to gauge your oxygen levels?

I know that most sleep doctors will look at your low AHI and say all is well. They don’t normally take into consideration how you feel. So it will be up to you to be a squeaky wheel so to speak. Ask about your oxygen levels at night.
OpalRose
Apnea Board Administrator
http://www.ApneaBoard.com


OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy





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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#6
RE: Sleep Hangover (Update - Round Two)
[attachment=7099][attachment=7098]

Update: raised pressure to 8.6  
left EPR at 3

no more RERA

Still waking up with hangover symptoms (no alcohol consumption)
do not feel overly tired, just hungover (anxiety???)

will give it time

measuring night time oxygen levels next step i guess

any other suggestions?
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#7
RE: Sleep Hangover (Update - Round Two)
ShaunBlake:

looks like my machine is set up for Fixed Pressure and Autoset

the settings (Fixed Pressure @ 8.0 and EPR @ 3 was set-up by my sleep doctor 
He used an overnight sleep study done in March 2005 (yes, 13 years ago) which indicated moderate obstructive sleep apnea.

also mild O2 desaturation, moderate snoring

complete resolution of apnea with CPAP at 5.0cm
(my doctor raised level to 8.0 so avoid starving effect for air)

tried CPAP back then, gave up. lived with apnea until symptoms got to point where I had to do something. 
(technology much better nowdays then back then by the way...)

i did not know I could change settings until i discovered this site. now I do!


seems like the settings are pretty close for what works for me. a little tweeking here and there maybe??

unless you have some other thoughts?
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#8
RE: Sleep Hangover (Update - Round Two)
This is how I would look at it in order to be pragmatic and hopefully effective in the tweaking in the least time possible:

I KNOW I have apnea, just not what it may be years later. 


I know that things change, especially after a decade, and that applies for all bodies at any stage of living.  If a sleep lab isn't in the offing any time within the next six months or so perforce, the machine still might get me to a satisfactory sleep state with some experimentation.  By making small adjustments to one of the modes offered by my machine, and then leaving my body to adjust over the next three to five nights, I hope to see a gradual improvement.  If things seem to be going the wrong direction, back off the last change(s), of which I have kept careful and complete records for refreshing my sleep-deprived memory, and consider what else to do next...not ruling out even a change of method of delivery of the PAP if the machine is capable of it and it seems to be the next logical step in the drive to get AHI consistently under 5/4/3...

Of course, there's more to this.  There's the mask choice, fit, state of repair, leakage, filters, sleep position, illness, seasonal disorders such as allergies, and so on.  Anything that is an uncontrolled 'confound' of the therapy, if only temporary, is something that might lead us in the wrong direction, even if it produces salutary results in the short-to-mid-term.  Two weeks later we might see our results spiraling downward once again, leaving us disheartened and mystified.
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#9
RE: Sleep Hangover (Update - Round Two)
(06-30-2018, 10:30 AM)CPAPUserDave Wrote: ShaunBlake:
looks like my machine is set up for Fixed Pressure and Autoset
the settings (Fixed Pressure @ 8.0 and EPR @ 3 was set-up by my sleep doctor 
He used an overnight sleep study done in March 2005 (yes, 13 years ago) which indicated moderate obstructive sleep apnea.

also mild O2 desaturation, moderate snoring

complete resolution of apnea with CPAP at 5.0cm
(my doctor raised level to 8.0 so avoid starving effect for air)

tried CPAP back then, gave up. lived with apnea until symptoms got to point where I had to do something. 
(technology much better nowdays then back then by the way...)
<snip>
seems like the settings are pretty close for what works for me. a little tweeking here and there maybe??

CPAPUserDave, your charts look fabulous; wish mine looked as good!

I'm confused: you tried PAP then gave it up – did you have another sleep study, or somehow currently working with a sleep doctor, or are these settings from your "back then" experience?

I don't have other suggestions than have been mentioned except this rule: make singular changes, and allow several days to collect data and determine if there is a trend (good or bad).  I'm also in favor of getting agreement from the gurus before making changes to my machine, but that's just me; you may be smarter or bolder, or both.

If you can, give your current settings some time to work on your body – it does take time, and sometimes a long time, to recover.  Ask me how I know!

And the oximonitors are fairly cheap now – $50-$80 <choke> so you may want to check your O₂ sat.  However, if you are currently in the care of the doctor who Dx'd you with mild O₂ sat, then that likely isn't the cause of your not feeling rested.  It may simply be because our bodies take time to recover.
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#10
RE: Sleep Hangover (Update - Round Two)
i agree. i think my charts look pretty damn good. do not know what else i can do to make 'better'
that's why i wonder why i still do not feel the greatest

this hangover feeling has been going on for a few months now
trying the 'giving it time' approach but wondering if something else going on (guess that's why I'm here)

anyhow...

the sleep doctor i went to last year to start this process used the old sleep study done 12 years ago.. no new study was done.
six months ago he said my numbers where good and referred me back to family doctor to explore other possibilities. had blood work done, all came back normal. waiting to see if any other symptoms popped up, but nothing. same old same old.

have pulse oximeter on the way to test out night time O2 levels.  things could have changed in past dozen years since last recorded so...
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