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Sleepy for 11 months
Sleepy for 11 months
I have been receiving cpap treatment for over 20 years. I started out with a Bipap set at 10 after about 7 years that machine died on me, I was able to get a hold of my last cpap from a relative who had been diagnosed with OSA, but at a young age. He ended up having surgery done that solved his breathing issues.  

I have been happily using that Resmed S9 for about 13 years. but in the last year I started noticing that I have been feeling fatigued and sleepy during the day, a lot like I was before I started treatment. So early in 2020 I had a new sleep study done with the thought that my 13 year old machine was probably starting to fail me. It helped that my insurance deducible for the year was satisficed so the study didn't end up costing anything however It ended up taking me about 11 months to get a new cpap machine. My policy is high deductible and wouldn't pay a dime for the equipment. The best they would do is help set me up with a payment plan of nearly $100 a month for a year for the new machine. I ended up getting my new machine from [Commercial Link Removed] Supplier #1 with a coupon code for $499 after saving up the cash to outright buy the machine.

I am offering all this background because I am wondering if anyone has experienced a lag after starting with a new cpap machine before they started noticing that they are no longer tired everyday? 

My new machine seems great and as near as I can tell is working perfect. My setting from the Sleep study was supposed to be a cpap set at 12, but I got my doctor to write the prescription for and Auto Cpap. The Initial setting on the machine was 10 - 18. I found out about OSCAR and started using it at the same time I got my new machine, and I noticed that I was having a good number of events because the machine was trying to run at the lower setting and would only bump up when it detected a breathing issues. I have been changing settings to help improve my readings in OSCAR and I have what seems like a great readout from my most recent nights of sleep. The info has been looking good for around a week now, however I am still feeling like I have not had a good night sleep in a long time.

My new settings are 
Apap 14 - 20
EPR - Full Time
EPR - Level 3 cmH2O

I have seen information advising not to use EPR because it is thought that it can cause central apneas, I started out not using it, but the higher levels that I am running at make it difficult to use the machine without EPR. I have also noticed that since turning  EPR on my reports show much lower events overnight. I have also since starting to use OSCAR tried plugging in the memory card from my S9 and found that the EPR was running on it all along at the same 3 cmH2O setting.

Any input is appreciated, Thanks.

Attached a screenshot of last nights data.

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RE: Sleepy for 11 months
Your number are great. The high min might go down a little and make your night more restful. I read you raised the low number to stop events and that worked for you. But I would go down 2 and see if events go up. I don’t think they will.

Keep the EPR at 3. Don’t worry about centrals. The EPR effects people who are just starting pap therapy and once the body gets use to the therapy the centrals go away. You have been on pap therapy for a long time.
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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RE: Sleepy for 11 months
You did a great job self-titrating your machine, and results look outstanding. EPR serves as bilevel pressure up to 3-cm, and it is a defining feature of the Resmed. I guess if bilevel caused central apnea and had no other benefits, no one would use it or sell it, but of course, that's not the case. We have seen EPR has not only comfort benefits, but direct therapeutic effects on flow limits, RERA and hypopnea. It makes all the difference for some individuals; however a few will find that the increased ventilation of bilevel pressure reduces CO2 enough that CA events result. They often outgrow the events as they adapt to CPAP and increased ventilation. In your case, you found EPR caused pressure to be too low, and you raised your pressure to compensate, so that your starting pressure is now 14.0/11.0 (inhale/exhale), which is exactly where you were titrated. Great job, and a good deal. That is one of the best prices I have seen on a new Autoset.
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RE: Sleepy for 11 months
Great job on dialing in your settings! You asked this:

"I am wondering if anyone has experienced a lag after starting with a new cpap machine before they started noticing that they are no longer tired everyday?"

The short answer is "yes." Although there's some controversy about the concept, many sleep researchers would agree that there's such a thing as sleep debt. If it has built up over a long period of time, it can take a while to pay off -- possibly weeks. The experiences of people on this site often bear this out.

This is also a good time to review the basic guidelines for good sleep, even though you are a very experienced and savvy CPAPer.

• Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
• Set a bedtime that is early enough for you to get at least 7 hours of sleep.
• Don’t go to bed unless you are sleepy.
• If you don’t fall asleep after 20 minutes, get out of bed.
• Establish a relaxing bedtime routine.
• Use your bed only for sleep and sex.
• Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
• Limit exposure to bright light in the evenings.
• Turn off electronic devices at least 30 minutes before bedtime.
• Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
• Exercise regularly and maintain a healthy diet.
• Avoid consuming caffeine in the late afternoon or evening.
• Avoid consuming alcohol before bedtime.
• Reduce your fluid intake before bedtime.
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RE: Sleepy for 11 months

Are you on any other medication that may be affecting your tiredness ? It not all about sleep apnoea
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