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Why am I feeling worse using my CPAP machine, than without it?
#1
Why am I feeling worse using my CPAP machine, than without it?
It may sound strange, but that's what it is. My AHI numbers are great, usually below 1, and the only thing that looks bad are my flow limitations charts (as per this thread: http://www.apneaboard.com/forums/Thread-...mely-tired).

I tried sleeping without my machine, and while it hasn't been the greatest experience (waking up too many times), I still feel better in the morning, than when using my Resmed S9. Brain fog for sure, but not nearly as bad as after using the machine. I usually feel better within a few hours after waking up (with no CPAP), while it takes at least half a day after the treatment.

I have tried different settings, with pressures between 7.4 and 11.2 (EPR always at 3), and nothing seems to help. Lower pressures appear to be a bit better, but I cannot be absolutely certain about that. No CPAP still feels better, but far away from feeling good. I'm screwed, I suppose.
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#2
RE: Why am I feeling worse using my CPAP machine, than without it?
The only way to manage your flow limits is to use a BiLevel. The ResMed AirCurve 10 VAuto is recommended. This will allow the use of a higher pressure support than the 3 you are limited to with EPR. There is no guarantee. With your numbers I doubt your doctors would suggest it.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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#3
RE: Why am I feeling worse using my CPAP machine, than without it?
Have you had an oxygen study? I feel very poorly even on bipap without O2. I have been on O2 therapy for quite a few years but when I travel there is no concentrator and after a night or two I can really feel it. Your supplier will have a nighttime monitor you can use over night- no sleep study but the Dr will need to order it.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
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#4
RE: Why am I feeling worse using my CPAP machine, than without it?
(08-23-2020, 03:52 PM)staceyburke Wrote: Have you had an oxygen study?  I feel very poorly even on bipap without O2.  I have been on O2 therapy for quite a few years but when I travel there is no concentrator and after a night or two I can really feel it. Your supplier will have a nighttime monitor you can use over night- no sleep study but the Dr will need to order it.

I have never had an oxygen study, however I have an oximeter, and I monitor SpO2 (not every night though). Every time I do monitor it, it looks great. Other than a few very short dips below 90%, it looks the way it should be. Could an oxygen study be much more precise than what I'm already doing?

As for BiPAP, just as bonjour noticed, it is a very, very slim chance, probably no chance at all I could ever get a prescription for it. Getting a machine without a prescription in Canada is close to impossible, from what I know at least. Even if there is a way to get it without a prescription, spending $2,500 CAD, without any clue that it might help, is a gamble. Like I said, I'm afraid I may be screwed. I hate going to bed, since I know how I will feel in the morning.
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#5
RE: Why am I feeling worse using my CPAP machine, than without it?
Sounds like your O2 is fine, but it was just a thought. By the way I purchased a slightly used air curve VAUTO with 250 hours on it from Supplier #2 for 800 US. Great company and great machine. If it did not work you could sell it on eBay or craig’s list and not lose much on it
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
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#6
RE: Why am I feeling worse using my CPAP machine, than without it?
(08-23-2020, 03:22 PM)ppca Wrote: I have tried different settings, with pressures between 7.4 and 11.2 (EPR always at 3), and nothing seems to help. Lower pressures appear to be a bit better, but I cannot be absolutely certain about that. No CPAP still feels better, but far away from feeling good. I'm screwed, I suppose.

No, you're not screwed. You are just adapting. It takes time. You are feeling worse because the hose and the mask and the pressurized air are interfering with your sleep. Get some advice on the best pressure settings and stop making so many changes. Your body will adapt if you give it time.
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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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#7
RE: Why am I feeling worse using my CPAP machine, than without it?
(08-23-2020, 05:00 PM)Sleepster Wrote: No, you're not screwed. You are just adapting. It takes time. You are feeling worse because the hose and the mask and the pressurized air are interfering with your sleep. Get some advice on the best pressure settings and stop making so many changes. Your body will adapt if you give it time.

I have been using CPAP for about 5 years now, so unfortunately I can't blame it on adapting. Never felt any real improvement in sleep quality, but my AHI numbers have always been very low, and I did not feel terrible. Did a couple of sleep studies in the last few years too, and although I barely got any sleep in the lab, the doctor prescribed the machine and settings. If I recall it properly, I started with 8 or 9 cm H2O, and only made a few very minor changes within these several years.

The problem is that in the last few months I started feeling much worse than ever in the past. Dizzy and fatigued in the morning, and as I said, it takes at least half a day to feel close to normal. Following recommendations as per this thread: http://www.apneaboard.com/forums/Thread-...mely-tired, I started "experimenting", first with higher pressures for a few days, and then even lower pressures for another few days, to see if I can get better "flow limits" results, provided those are the culprit. So, all these many changes have only happened in the last 2 weeks, or so. Regardless, nothing's changing, before or after. Still feeling horrible, with the slight exception only when not using the machine at all. Less brain fog in the morning in that case, but a lot of waking up through the night. Not good either way.

Speaking of flow limits, I also tried something else. Used my machine while awake, watching TV before going to bed. I did it 2 or 3 times, using it for about 2 hours every time. The "flow limits" chart looks exactly the same as when I'm sleeping. I expected it to be better looking, but I guess I was wrong. For the record, I do not have any breathing issues...well, I may not be telling the truth. I do have some. My left nostril has always, as long as I can remember, been semi obstructed. It does not bother me too much during the day, and certainly not when my P10 pillows blast 9 cm H2O pressure. Gotta wonder though if that is what it is. Is that what possibly creates these flow limits and ultimately makes me feel so bad in the morning. In that scenario, how would even a BiPAP machine be of any help? My understanding is that they work with 2 separate pressures, one for inhale, the other for exhale, allowing for a wider gap between the two, than what EPR allows me now, with my CPAP machine (3 only or less). If it is the so called "flimsy nostrils" or deviated septum that is the root of my problem, could a BiPAP machine help at all?
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#8
RE: Why am I feeling worse using my CPAP machine, than without it?
I'm quickly closing in on two years of therapy. MY AHI #'s have been very good. Only one AHI higher than a 5 since having started. Most AHI's are 2-3 and under. 

Still waiting for that "feel good" train to pull into the station. I wake up and within a few hours, need to take a short nap to make it thru the rest of the day. 

I've had blood work done, had an oxygen level test as well, but nothing to be alarmed about. I'm thinking it's just getting older, more than anything else. Nothing, and I do mean nothing, gets better as we age. 

I'm going to keep hanging in there, but I just don't see myself doing this for the rest of my life.  Oh-jeez
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#9
RE: Why am I feeling worse using my CPAP machine, than without it?
I'm of the mindset that as others have mentioned, a VAuto is the tool of choice in your circumstance. You are in need of more PS and that is found in a BiLevel. PS/Pressure Support is the tool to get FL, etc. to fall in line. I do not know which machine you have had the past 5 or so years, but I do know the CPAP you're on now is not cutting mustard. If you want the therapy to change, the Elite needs to be retired and replaced with VAuto. Instead of finding new ways to smash your head into the brick wall, try changing the tools you use. I know it costs money, but isn't good restful sleep worth it?

You want to note the symptoms down on a notepad and take it to the doc. Here doc this is all the suffering I've been doing for X years with a CPAP. Are you on-board with getting me a VAuto? I realize it has a setting called Pressure Support, and I have read that it can help with my flow limits, etc.
How about it?
Dave

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