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Still Feel Tired After all This Time
#11
RE: Still Feel Tired After all This Time
70sSanO

I can sure relate to no data.  As to the mask seal issue, I started CPAP 22 years ago with a full face mask that leaked like a sieve unless tighten so much I could hardly stand it.  The new masks seem much better at sealing than my old ones did. My pressure was originally 

set at 11 or 12 cm pressure all the time.  If I remember correctly my original sleep test showed 107 apneas, so what I have now is really quite an improvement.  You are right about the data.  There was none.  I couldn't change the pressure with out going to my sleep Doctor and he gave the the OK to my Respiratory Therapist to reset the CPAP.  I am sure the sleep Doctor was just making an educated guess as to the raising or lowering my pressure.   I was never told of RERA, Central Apneas or Hypopnea.   Even today my Respiratory Therapist thinks that as long as I am under five AHI that I am doing great.   I have only been using the soft collar for about a month, I agree that you really need to hit the sweet spot for them to help,  if it is too tight it can cause more problems.  I usually start on my side when I go to sleep, but I usually wake up on my back.  Since going to the FF mask I have been using a really low pillow that seems to help most nights.  

I just got OSCAR about 6 weeks ago and <5 doesn't look so good anymore.


Since using the full face mask, using various pressure settings, 90% of the time I am under 5 AHI, in fact usually below 3.5, but I still do not really feel refreshed.  I wonder if I should be looking into an ASV machine, perhaps that is what I have needed 22 years ago, but I am sure they didn't have them then... 

Thanks for your help.

Steve
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#12
RE: Still Feel Tired After all This Time
Now that you have OSCAR, and before you think about an expensive ASV machine, post a Daily screenshot. Use the F12 key (Fn + F12 on a Mac). Make sure we can see the Settings at the bottom of the Left column - take two shots if necessary. We have several members here who can look at those and make suggestions that will probably improve your therapy.
Apnea Board Monitors are members who help oversee the smooth functioning of the Board. They are also members of the Advisory Committee which helps shape Apnea Board's rules & policies. Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#13
RE: Still Feel Tired After all This Time
Here you go...







   
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#14
RE: Still Feel Tired After all This Time
Steve,

May I suggest upping the minimum by 2 cm and the EPR to 3. In reality the EPR pressure will increase by 1 cm.

Just because your numbers good, I can understand why you get aroused and feel tired.
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#15
RE: Still Feel Tired After all This Time
I’m not suggesting you get an ASV, I was able to get one because my centrals spiked.

I only mention it because I think the only difference is the software, maybe a different board, but nothing that should command the excessive cost.

At any rate, I”ll keep harping on your “current” great FFM leak rate. If you can keep the leaks down, others here can help get you where you want to go.

John
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#16
RE: Still Feel Tired After all This Time
I see an area where your flow limitations have increased, causing an increase in pressure, perhaps giving some discomfort. If it was me, I probably changed sides, rolled over, pulled my knees up, and tucked my head and chin down as close to my chest as I could get it. This, of course, likely kinks my throat, restricting the air flow... (That's my theory anyway)

Given that your EPR is set at 2, and EPR is our weapon against flow limitations, I's suggest that you increase your EPR to 3, and also increase your minimum pressure by 1, to 9. This will maintain your minimum EPAP at 6, so that your OA index should remain the same. Try that for a few days, to see how it works for you.
Apnea Board Monitors are members who help oversee the smooth functioning of the Board. They are also members of the Advisory Committee which helps shape Apnea Board's rules & policies. Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#17
RE: Still Feel Tired After all This Time
This was from last night, I had already set my pressure a bit lower prior to seeing your suggestions.  Last night it appears that I had positional apneas.  I actually do not feel as bad as usual this AM.

I have been using a soft collar for about three weeks.

I have sinus problems and use Breath Right strips at night.

I have also started using a cheap mouth guard for about a week and it seems to help.

I am 75 years old and have been using CPAP since I was 53.

My original sleep study showed me with 107 apneas, so the CPAP has made quite an improvement.  Although, I have rarely felt rested all this time.  




   
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#18
RE: Still Feel Tired After all This Time
Sorry, I forgot to show this OSCAR chart in my last post, it is from a few days ago where I had upped my pressure to 9cm and I think I set the EPR at 3







   
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#19
RE: Still Feel Tired After all This Time
More positional apneas last night.  Do I just need to find a way to stay off my back?




   
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#20
RE: Still Feel Tired After all This Time
I would say yes, it will stop most clusters, and on addition "clean up" quite a few individual OAs.
(Personal experience, learned by trial and error)
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