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[Treatment] I've been using my CPAP for a few weeks, and I'm still exhausted. Looking for help.
#11
RE: I've been using my CPAP for a few weeks, and I'm still exhausted. Looking for help.
Given there weren't Centrals on the report, you're very likely dealing with the somewhat easier to deal with treatment emergent Centrals. You may need to lower EPR to 2 and see if it helps lower these CA. Unless another, better suggestion comes along, try out EPR 2 a night and post OSCAR tomorrow. Tell us how you feel then as well.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#12
RE: I've been using my CPAP for a few weeks, and I'm still exhausted. Looking for help.
Your flow limits were much better but centrals went up. That would indicate that your central very well go down as you get use to the therapy.

Until then it is a balancing act between moving the EPR down some to help with the centrals but in doing that your flow limit will increase. You need to see what level EPR makes you feel best. Something we can not “see” on the charts.
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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#13
RE: I've been using my CPAP for a few weeks, and I'm still exhausted. Looking for help.
I'll definitely bump it down, and see how I feel. From my limited understanding of xPAP therapy, especially in regards to UARS, if I'm unable to balance the two, would changing my machine to a BIPAP help? I tend to see it touted as the option for UARS if standard CPAP/APAP doesn't work.
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#14
RE: I've been using my CPAP for a few weeks, and I'm still exhausted. Looking for help.
The VAuto would be your next step up. It has advantages of wider range of pressure support versus the EPR 3, there's time controls as well that can be helpful if found to be needed.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#15
RE: I've been using my CPAP for a few weeks, and I'm still exhausted. Looking for help.
That might be the next step but if the centrals go down as they should as your body adjusts to therapy you can move the EPR up. That would mean you would not need to buy a more expensive machine. This wii take 2 to 4 weeks to adjust to the pap t.
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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#16
RE: I've been using my CPAP for a few weeks, and I'm still exhausted. Looking for help.
So after a few days of bumping my EPR to 2, the centrals went down. I did raise it back to 3, and I didn't have any increase in centrals, so success there! I'm still feeling tired, which I know can be an issue that could take a while to improve with. However, I do feel like my flow limits haven't really improved, and if anything, have gotten worse. Is this something where I should try bumping up my pressure to help? I've attached the last couple of nights data, and also just some of my breathing in one of the areas I had a bump in flow limit, and then also where my flow rate is kind of...sing songy if that makes sense lol.

Here's the other picture as well. Not sure if this is anything to look at, but I tend to have these flow rates that go up and down like this, and wasn't sure if it was worth looking into.


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#17
RE: I've been using my CPAP for a few weeks, and I'm still exhausted. Looking for help.
Hey guys, still having some of these flow limits, and I think odd breathing. It's about a month that I've been using PAP therapy. I will say I'm probably feeling better, although still kind of a mess. I figured I'd give myself another month before looking at a BIPAP if I'm still not feeling great.


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#18
RE: I've been using my CPAP for a few weeks, and I'm still exhausted. Looking for help.
it's the same for me man and it's been months. good luck
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#19
RE: I've been using my CPAP for a few weeks, and I'm still exhausted. Looking for help.
Hey guys, been a few weeks. So, I will say, overall I feel better than a when I started around 2 months ago. Definitely a learning curve for a few of the issues for me. What I'm dealing with now is really just my flow limits like before. However some good is that I don't have AS bad dark circles under my eyes, and I'm not as tired. However, I think changing how I sleep, along with getting a new mattress topper helped me get a little more comfortable, along with trying to use a flatter pillow set up. 

I have a few questions. First off, I have these flow limits in my chart. While they're not all night each night, they are, IMO, frequent enough to be causing a lot of my exhaustion. I talked to my doctor's respiratory therapist, and they were kind of clueless with UARS, telling me to just bump up my max pressure. To my understanding that won't really help in this case, although correct me if I'm wrong. 

Second, I have an appointment with an ENT to maybe look at doing a septoplasty/turbinate reduction. It's not major, but I think it may help with my therapy, and wanted insight if anyone else had good luck with it. I also wanted to maybe give the strips a shot, as it's not that bad anymore. As weird as it sounds, it feels like the therapy is helping open up my nose.

Third, I wanted to give a SCC a shot, and ordered one. I know it'll help with my chin tucking/fetal positions I get into for whatever reason. I may have missed it, but will I be able to not use my chinstrap anymore with it? Also, not sure if I saw any suggested SCCs, but if anyone has any, please throw in a recommendation.

Lastly, part of my "tiredness" is having to do with my thyroid I believe. Currently on Levo, and I plan on retesting, but has anyone had an experience where they need to lower any medication after successful therapy treatment? Personally I feel as though it's my lack of restful sleep that's caused my thyroid to act up, as it started within 6 months of a lot of my symptoms of SDB, but would be interested to hear from anyone else. 

Thanks, and for anyone still reading, sorry for the book haha.


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#20
RE: I've been using my CPAP for a few weeks, and I'm still exhausted. Looking for help.
Bumping your min Pressure up should help because you have a fair number of OA events. Increasing your min pressure should help with that.

Set Min Pressure = 11

You do have a good number of flow limitations going on and increasing EPR/PS is best for that but your EPR is maxed out. Thus raising min pressure is what you try.

Please let us know which settings "feel" better to you the new or the proposed, and be critical. Do this BEFORE looking at OSCAR. Keep a log.

It is possible, not making the call yet, but you may need a BiLevel for its higher levels of "EPR" (really PS), but let's wait a bit and see what we get first.
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