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Worsening of the cpap-therapy
#1
Question 
Worsening of the cpap-therapy
In 2014 I was diagnosed with a mild OSA in a sleep laboratory. 
At the second visit to the sleep laboratory, they tested the use of a cpap-device with success on me.
My therapy is routinely checked from a "sleepcenter", including checking the device and getting new supplies.

After 2.5 years of steady cpap use, the symptoms of day fatigues intensify, alternate words in sentence when speaking, to be upset, etc.
Noticed also that the humidifier needs more water.

I went to the sleepcenter, the checked the graphs from resscan with 4 eyes! and did a device pressure test.
They said: All data from resscan looks flawless, I should do a visit to my general practitioner.
(Got also a new mask, no improvement.)


I certainly think, he can't help me with this topic.


Could someone do a advice from the sleepyhead-printscreen?

Printscreen from my last sleep:
[attachment=3431]

I did a 6 month statistic with the average pressure from sleepyhead. I see a slight increased pressure:
   
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#2
RE: Worsening of the cpap-therapy
That's the purpose of the Autoset. Your numbers look great.

Can you be specific on how you feel and when? Let's see what can be done with your comfort.
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#3
RE: Worsening of the cpap-therapy
Welcome to the forum. Your AHI is excellent. It appears your min pressure is too low and should probably be increased to about 6 but wait for some more feedback from other members before making a change. I see nothing in your data that would explain the fatigue. Others with more expertise may have some advice. I do suggest that you organize your sleepyhead charts as shown in the link below and repost. It will provide more useful data.
Download OSCAR

Organize Charts
Attaching Charts

Mask Primer
Soft Cervical Collar

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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#4
RE: Worsening of the cpap-therapy
Generel I feel the same signs of fatigue symptoms before I startet with CPAP.
After get up, I need a couple of hours "to wake up". (I was never a morning person, but I feel now, that it takes more time.)
During the whole day, I feel sleepy, but I never fall asleep.
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#5
RE: Worsening of the cpap-therapy
A possibility just occurred to me. I also noticed increased fatigue a little over a year ago and was diagnosed with a hypoyhyroid condition. You may want to have your thyroid stimulating hormone levels checked. I'm now taking synthetic thyroxin and my symptoms have improved greatly. The condition is very common, especially as we age. I have learned that several of my friends and relatives and even my Dr. have it.
Download OSCAR

Organize Charts
Attaching Charts

Mask Primer
Soft Cervical Collar

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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#6
RE: Worsening of the cpap-therapy
6.5 hrs of sleep?
no wonder you're tired and fatigued.


go to bed earlier. Get more sleep.
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#7
RE: Worsening of the cpap-therapy
The machine is obviously flittering about, reacting to some precursor breathing, maybe flow limitations. If this we mine, since my median pressure is 6.8, and max is 9 (and I hit 9 several times for a short period), I would set my minimum at 6.5 or 7, maybe raise the maximum to 9.5 or 10.

Hope you start feeling more rested.

QAL
Dedicated to QALity sleep.
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#8
RE: Worsening of the cpap-therapy
(05-03-2017, 11:57 AM)zelda Wrote: In 2014 I was diagnosed with a mild OSA in a sleep laboratory. 
At the second visit to the sleep laboratory, they tested the use of a cpap-device with success on me.
My therapy is routinely checked from a "sleepcenter", including checking the device and getting new supplies.

After 2.5 years of steady cpap use, the symptoms of day fatigues intensify, alternate words in sentence when speaking, to be upset, etc.
Noticed also that the humidifier needs more water.

I went to the sleepcenter, the checked the graphs from resscan with 4 eyes! and did a device pressure test.
They said: All data from resscan looks flawless, I should do a visit to my general practitioner.
(Got also a new mask, no improvement.)


I certainly think, he can't help me with this topic.


Could someone do a advice from the sleepyhead-printscreen?

Printscreen from my last sleep:


I did a 6 month statistic with the average pressure from sleepyhead. I see a slight increased pressure:

many things can make you tired
not just apnea

like sherlock holmes said
when you have ruled out everything else then whatever is left is the answer no matter how improbable

if the numbers are good and the machine is working
then look for something else that is the cause
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#9
RE: Worsening of the cpap-therapy
I think your minimum pressure is not doing you any favors here. it's clear that your pressure remains near 7.0, most of the night, and that is what I'd recommend as a minimum. The variation in pressure can be disruptive, even if you're not aware of it. Keeping pressure in a narrower range will help a lot.

Leaks are significant and those also add to disruptive sleep. These are all leaks of pressure through your mouth, so you have options of chinstraps, soft cervical collar or switching to a mask that also covers the mouth. Finally, I agree you should try to get 7-i
8 hours of sleep.

I am certain that implementing any or all of these three suggestions will make a noticeable difference.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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
RE: Worsening of the cpap-therapy
Thanks for all the replys!

One observation with the nearly empty water tank from humidifier is still a mistery for me. 
Normally, there is at least 1/3 to 1/2 water left after usage.


Conclusion:
First: More sleeptime, try a chin strap, checking the thyroid.

If no positiv change:
Increase the pressure from 4/9 to 6/10 or 7/10.
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