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Tired after waking up
#1
Hi,

I was recently diagnosed with Sleep Apnea. I had a sleep study and was diagnosed in late February with an AHI of 74.1 when on my back and 32 when on my side. Then there was a followup study for pressure titration which determined that I needed a pressure of 13 on my back and 8 on my side, after which the doctor prescribed an APAP device. Also, during the titration, they tried different masks but only the full face Fisher and Paykel Simplus worked.

I finally got the prescription and got it filled last week. I tried the Mirage Quattro for the first two days as the Simplus was uncomfortable for me during the titration, but the result was an AHI between 10 and 11 during the first 2 days with leaks between 35 and 45.

My provider recommended the P10 nasal pillow and then I tried it with more success. Two nights ago, my AHI was 3.29 and my 95% leak rate was 0, with one peak of 15. Last night, my AHI was 1.56 and my 95% leak rate was 8.4, with a peak of 16.

Sleepyhead Graphs from last night are:
   
   

There are 2 sessions because I woke up to go to the washroom. In the first session I was sleeping on my back and in the next, I was sleeping on my side. The numbers for the second session seem much better.

Overall though, Im still feeling tired in the morning. Is there anything blatantly obvious in my graphs that some experienced members can point out? Or do I just have to wait it out?


Ill post more graphs when my post count increases Smile
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#2
Your user name is awesome!
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#3
How long have you been on the CPAP therapy? Any thing below a 5 AHI is considered treated. The simple act of washing your face before bed can have an effect on your AHI numbers.

There are 2 sides to CPAP therapy, the first is getting the mechanics correct(e.g.: mask, humidity, pressure, pressure range(if auto), epr, ramp). The second becomes an art form; hygiene, mattress, pillow type, sleeping position, CPAP placement, hose placement, humidity level, and to use or not to use a heated hose (I know I'm forgetting some). The list is almost endless and it seems that no 2 people have the same combination. Obtaining the proper therapy is a long and slow process and if VERY odd to occur overnight.

Hang in there and prepare to have plenty of patience.

Good luck and welcome to the forum.
______________________
Useful Links -or- When All Else Fails:
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#4
darth_vapor,
Your numbers look good considering you just started therapy. The only thing I see is that your starting pressure of 5 is too low. For 95% of the night, your pressure was at 14 and under, and your medium pressure was almost at 10.
It would be best if your starting pressure was slightly under your medium pressure.
I would raise your pressure settings at 8-16, turn off ramp if you are using it, and set EPR to 2.
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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#5
Hi darth_vapor,
WELCOME! to the forum.!
What OpalRose said about your pressure settings.
Hang in there for more responses to your post and much success to you as you continue and fine tune your CPAP therapy.
trish6hundred
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#6
(04-26-2015, 02:53 PM)JVinNE Wrote: Your user name is awesome!

Huge star wars fan... it just clicked Smile
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#7
(04-26-2015, 03:19 PM)sgearhart Wrote: How long have you been on the CPAP therapy? Any thing below a 5 AHI is considered treated. The simple act of washing your face before bed can have an effect on your AHI numbers.

Yesterday was my 6th day

Quote:There are 2 sides to CPAP therapy, the first is getting the mechanics correct(e.g.: mask, humidity, pressure, pressure range(if auto), epr, ramp).
[\quote]

Im in Canada and humidifiers are mandatory here. I think the resmed airfit p10 seems to be working for me, especially when I use Lasinoh around my nostrils for a seal.

[quote]
The second becomes an art form; hygiene, mattress, pillow type, sleeping position, CPAP placement, hose placement, humidity level, and to use or not to use a heated hose (I know I'm forgetting some). The list is almost endless and it seems that no 2 people have the same combination. Obtaining the proper therapy is a long and slow process and if VERY odd to occur overnight.

Hang in there and prepare to have plenty of patience.

Good luck and welcome to the forum.

Thanks. Will try looking at these factors
(04-26-2015, 03:37 PM)OpalRose Wrote: darth_vapor,
Your numbers look good considering you just started therapy. The only thing I see is that your starting pressure of 5 is too low. For 95% of the night, your pressure was at 14 and under, and your medium pressure was almost at 10.
It would be best if your starting pressure was slightly under your medium pressure.
I would raise your pressure settings at 8-16, turn off ramp if you are using it, and set EPR to 2.

I think the reason was that when I am on my side, the pressure needed was 7-8 in the titration study and on my back it was 11-13. Ill turn off ramp. What is EPR?
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#8
(04-26-2015, 03:59 PM)trish6hundred Wrote: Hi darth_vapor,
WELCOME! to the forum.!
What OpalRose said about your pressure settings.
Hang in there for more responses to your post and much success to you as you continue and fine tune your CPAP therapy.

Thanks!
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#9
The EPR is a pressure relief setting when exhaling. The settings are 1,2, and 3.
An example... A starting pressure of 10 with an EPR setting of 2 would drop your pressure to 8 when exhaling. This is a comfort feature, as some find it hard to breath out against higher pressures. It is probably not set up on your machine, and you may not need it.

You should request the Clinical manual for your machine. See top of page.
Then if and when you need to change settings, this will explain how to do so.


OpalRose
Apnea Board Moderator
www.ApneaBoard.com

How to Organize and Post ScreenShots

http://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur

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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#10
Darth, congrats on your great numbers! Many others take a while to reach those! You may continue to feel tired for some time though. Your body will like this new oxygenation and simply decide it wants more. Your job is to keep this up and keep your body, brain, and organs with their oxygen. The tired feeling will pass, and one day you will realize you have way more energy than before.

Download Sleepy head to watch your own stats, but use them as an indicator, not a report card.
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