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[Treatment] Are there cases where CPAP doesn't help?
#1
Hi everyone! I’m a new member of the forum. Been having bad sleep for past couple years – lots of waking and low amount of time asleep. Although I am taking medication that can sometimes cause insomnia, I was also diagnosed with afib last year.  Many people with afib have sleep apnea, so I decided to first get a sleep study. Initial sleep study without a mask showed an overall AHI of 9.4 and a REM AHI of 35.2. Prescription is for CPAP pressure of 7. Tried a nasal mask, but air kept blowing in mouth so switched to a full face mask which I used the past two nights.  Last night I finally got it so that it stayed sealed all night and kept it on 7 hours.  Unfortunately I feel way worse this morning than I usually feel, and my fitbit sleep tracker shows my wake times are just as bad, if not worse, than when I don’t use the CPAP.  Also, I had a problem with acid reflux over a year ago which was resolved with medication and lifestyle changes, and this morning I’m feeling sick with some of those old acid reflux problems. I’ve been told that my AHI is mild, but the tech told me that during the sleep study in REM stages during the latter part of the night my oxygen dropped to 70%.

So, here are my questions:  are there cases for which CPAP doesn’t help someone like me, but in fact may cause sleep quality to be just as bad or even worse?  And, what are other avenues should I pursue in my case?

Thanks, Marie
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#2
Welcome to the forum.
Some people feel better at the start of treatment but many do not. Assuming your treatment pressure is correct, the treatment is helping your obstructive sleep apnea but it can also cause you discomfort (physical or emotional) which ruins your sleep. It took me 2 months before I enjoyed improved sleep.
Stay with it.
On another note, read about sleepyhead software.
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#3
Thanks.  Forgot to mention - my events per hour last night were 12.4 which is worse than during my sleep study.  So, aside from feeling horrible, I'm not sure it is even solving anything.
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#4
(05-25-2018, 07:06 AM)Marie Wrote: Thanks.  Forgot to mention - my events per hour last night were 12.4 which is worse than during my sleep study.  So, aside from feeling horrible, I'm not sure it is even solving anything.

What was the breakdown of events?
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#5
If you could, download the sleepyhead software and post some charts. Then we can see why your AHI is higher on the machine. It may take your body some time to adjust to the treatment but the data will help people here on the board see in detail what is going on with your events.
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#6
And as ted said, if you can look at the machine and see if the events were classified as obstructive or clear airway will be a good start.
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#7
(05-25-2018, 06:52 AM)Marie Wrote: ... Unfortunately I feel way worse this morning than I usually feel, and my fitbit sleep tracker shows my wake times are just as bad, if not worse, than when I don’t use the CPAP. 

Hi, Marie. CPAP works, but it doesn't have an immediate effect in the first night or two. The way I like to put it is that you can't expect miracles right away; those will happen later. It's far too early to judge what happens "when you use the CPAP" vs. "when you don't use the CPAP". It's absolutely necessary to give it time.

It might be useful to compare it to losing weight, which also doesn't happen overnight. It's a long slog and it takes weeks to see an effect and then many more weeks, likely months, to get to where you want to be. So just be a patient patient, and it'll all work out if you have a reasonable mask and reasonable machine settings, all of which can be determined, and even fine-tuned, with the help of the folks here on this board.

CPAP can, in fact, lessen gastric reflux. As just one data point, it did that for me, big-time. I can't say that it does that in all cases, but it is very likely in any given case because CPAP gets rid of the extreme CO2 buildup that poisons your cells & organs and gives you acid stomach.

In my opinion it's far too early to seriously look at alternatives, because, believe it or not, you haven't even tried CPAP yet!

Good luck, and hang in there: keep using the machine and the mask. The experience will get much better, and it's even likely that that'll happen soon. But just part of each night is not enough! To get the benefits, it has to be for the full sleep session.

As others have just said, you will need to use Sleepyhead to read the data from your A10 Elite's SD card and graph the results. That's the easiest and quickest way to figure out what's going on and tune your treatment.
"I wanted to be a Boy Scout, but I had all the wrong qualities.  They were looking for kids who were trustworthy, loyal, helpful, friendly, courteous, kind, obedient, cheerful, thrifty, brave, clean, and reverent.  Whereas I tended to be devious, fickle, obstructive, hostile, rude, mean, defiant, glum, extravagant, cowardly, dirty, and sacrilegious."  (George Carlin)
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#8
Hi Marie,
Welcome to Apnea Board!

Just be assured that most here have been through what you are experiencing now.
For some it is easy to adapt, but for others, it takes more time.

The real issue is having disrupted sleep.  You are using a straight pressure Cpap, so we can’t attribute that to pressure changes.  It’s probably the newness of it all, a combination of an ill fitting mask, and possibly the wrong pressure setting.

Do you know what your AHI reading is?  More important, a breakdown of AHI...Obstructives,
Hypopneas, Clear Airway events.

To answer your question...I believe Cpap will help you.  It is a matter of getting everything dialed in correctly.

We can better advise if we are able to see some data.  If you are able to download SleepyHead software, you can start to track your own therapy.  It will show you all Apnea events and help us figure out if your machine is set up properly.  The links in my signature line will help you after you set up SleepyHead.

Some of our members that use the Amara View can also advise you on fitting it properly.

As far as acid reflux, try to sleep a bit elevated, and refrain from eating too close to bed time.

If you haven’t ordered a Clinicians Manual for your machine yet, order here.
https://www.apneaboard.com/adjust-cpap-p...tup-manual
OpalRose
Apnea Board Moderator
www.ApneaBoard.com

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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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#9
P.S. to Marie: Just a detail, but an important one. If your A10 Elite came with an SD card, that's great, and keep it installed in the machine. (The slot is underneath a small plastic door that you have to pry open at the upper left of the machine as you're looking at it from the front. The card receptacle is spring-loaded: push the card all the way in and let it go, and it should stay there; to release, push the edge of it briefly, and it should pop out.) If you weren't given an SD card, you'll need to get one and install it before you can start collecting data for the Sleepyhead software. Just about any full-size SD card (not mini-SD or micro-SD) will work, and they're sold all over the place, but you don't need to go overboard with high-capacity, because all the extra gigabytes will never be used. I use 1-gigabyte cards in my A10, and the one that Resmed includes with a new machine is 4 gigs, and 4 is as big as you need to go. Even a 1-gig card will last for months before it needs to be erased and re-used. If you're buying, it's best to get at least two of 'em at first so you can simply swap the cards when necessary and take the one with the most recent data to your computer to have Sleepyhead read the files. That way there's always a card in the machine and you won't inadvertently miss logging any sleep data.
"I wanted to be a Boy Scout, but I had all the wrong qualities.  They were looking for kids who were trustworthy, loyal, helpful, friendly, courteous, kind, obedient, cheerful, thrifty, brave, clean, and reverent.  Whereas I tended to be devious, fickle, obstructive, hostile, rude, mean, defiant, glum, extravagant, cowardly, dirty, and sacrilegious."  (George Carlin)
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#10
You have received a lot of tremendously good and helpful advice above on what should be your next steps. Patience is by far the top virtue you will need to allow this to succeed for you.  I guess I should say patience plus Sleepyhead.  Your profile indicates you are using MyAir for software.  However, My Air is not software - it is just limited data in the cloud.  It provides very little useful information.  It is frequently referred to here as more akin to a cheering squad.

Lastly, please keep in mind that one night does not qualify as a sample size.  Be careful not to jump to any conclusions based upon one night of data.  So too, whenever you make changes make then subtle and not too many at the same time so you can keep track reliably of what worked and what didn't and then let those changes manifest themselves for 3-5 nights if tolerable.

Welcome to AB and looking forward to reading about your progress in the near future.
Coffee

Happy Pappin'
Never Give In, Never Give Up

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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. 
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