Free CPAP Advice and Sleep Apnea Treatment Help Board • View topic - Feeling Worse After 1 Month of Therapy - Any Thoughts?
FAQ
It is currently Tue Dec 01, 2020 11:17 am

As an Amazon Associate, I earn from qualifying purchases.
Please consider a small PayPal donation to FreeCPAPAdvice.com above.Thank you so much for your support!



Author Message
Wannarideagain
Unread post  Post subject: Feeling Worse After 1 Month of Therapy - Any Thoughts?  |  Posted: Sat Sep 19, 2020 10:23 am

Joined: Sat Aug 08, 2020 1:42 pm
Posts: 17
Location: Winchester, Virginia
PAP Mask: F&P Vitera
PAP Machine: ResMed AirSense 10
Humidifier: Built-in with heated tube
Pressure Setting: 9

Offline
I have CFS and the whole reason I got into CPAP therapy is for deeper, better quality sleep to hopefully help me with my quality of life.

After fighting masks all summer, I finally settled on the Vitera (with gel nasal pad + cloth cover & extra cloth for leaks).

After 2 weeks of consistent therapy, I was so wiped out I asked my doctor for Ambien to help me adjust. Now at the 1 month mark, I'm still significantly worse off energy-wise than I was before I started. I often feel wired when I wake up, but simultaneously exhausted, and after a couple of hours I'm only exhausted. Ambien has helped with the wired, but not the exhaustion. I've also started Yoga Nidra in the mornings to relax better.

I sleep about 7 hours, take the mask off and go back to sleep for 1-3 hours (despite the mild wired). I spend nearly or all of the rest of the day on the couch resting up for my next night's "sleep".

Any ideas on feeling better rather than worse?

Thank you


Attachments:
20200919_131121.jpg
20200919_131121.jpg [ 3.36 MiB | Viewed 649 times ]
Top
DeltaBravo3.8
Unread post  Post subject: Re: Feeling Worse After 1 Month of Therapy - Any Thoughts?  |  Posted: Sat Sep 19, 2020 11:44 am
User avatar

Joined: Sat Jul 04, 2020 8:38 am
Posts: 365
Location: Greencastle, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: New and old ResMed AirCurve 10 ASV for now, RT says I need NIV
Humidifier: HumidAir ResMed 10 series with ClimateLine heated hose
Pressure Setting: ASV Auto mode EPAP 4-15 PS 0-10 Odd pressures are OK but don't equate NIV

Offline
It doesn't show in that image, but I suspect your flow limits are high. If so, you need more pressure. Show the FL please. You can grab the chart borders in OSCAR and squish them so more charts show in a screenshot. I also think you're not doing yourself any favors by sleeping without the PAP therapy. I did that myself a long time ago, and I had to make myself sleep only with mask on because every mask off session tends to undo the therapy you just had. Recognizing that you like to sleep without the PAP and mask tends to highlight your therapy is not helping much despite low AHI. This means there's lots of work to be done yet. Despite the CA, I'd be of the mindset to run it in Auto with EPR instead of static pressure. You are not benefiting much as is. Something has to change for this to get you better sleep.

_________________
Dave K9DWB 73s

https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


Top
Wannarideagain
Unread post  Post subject: Re: Feeling Worse After 1 Month of Therapy - Any Thoughts?  |  Posted: Sun Sep 20, 2020 7:28 am

Joined: Sat Aug 08, 2020 1:42 pm
Posts: 17
Location: Winchester, Virginia
PAP Mask: F&P Vitera
PAP Machine: ResMed AirSense 10
Humidifier: Built-in with heated tube
Pressure Setting: 9

Offline
DeltaBravo3.8 wrote:
It doesn't show in that image, but I suspect your flow limits are high. If so, you need more pressure. Show the FL please. You can grab the chart borders in OSCAR and squish them so more charts show in a screenshot. I also think you're not doing yourself any favors by sleeping without the PAP therapy. I did that myself a long time ago, and I had to make myself sleep only with mask on because every mask off session tends to undo the therapy you just had. Recognizing that you like to sleep without the PAP and mask tends to highlight your therapy is not helping much despite low AHI. This means there's lots of work to be done yet. Despite the CA, I'd be of the mindset to run it in Auto with EPR instead of static pressure. You are not benefiting much as is. Something has to change for this to get you better sleep.



Thank you, DeltaBravo. I'll start easing upward on my pressure, and, sigh, use the mask my entire sleep time. I confess, though, I don't know how to change to auto. Could you tell me where that is? I may be looking right at it, but I don't see it on the basic screen or the clinical settings. I took a proper shot of today's data (electronically challenged), so you can see the flow limits.

I'm grateful for the idea of things to change to get better sleep!


Attachments:
Screenshot (1).png
Screenshot (1).png [ 208.08 KiB | Viewed 627 times ]
Top
DeltaBravo3.8
Unread post  Post subject: Re: Feeling Worse After 1 Month of Therapy - Any Thoughts?  |  Posted: Sun Sep 20, 2020 9:53 am
User avatar

Joined: Sat Jul 04, 2020 8:38 am
Posts: 365
Location: Greencastle, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: New and old ResMed AirCurve 10 ASV for now, RT says I need NIV
Humidifier: HumidAir ResMed 10 series with ClimateLine heated hose
Pressure Setting: ASV Auto mode EPAP 4-15 PS 0-10 Odd pressures are OK but don't equate NIV

Offline
OK sure, first you have to enter Clinical Mode/Menu. Hold the Home and push the Dial in together for about 5 seconds. You're then in Clinical Menu settings. You need to turn the dial to move to various areas and to edit values. Look for MODE, it should have CPAP and other options; look for something like AUTO. Use the dial to move to AUTO and click to select. Other settings should be available such as more pressure settings. It looks like you have CPAP pressure 8.4 now. It should give Min and Max or similar. I am guessing as I've never seen an APAP menu, so if I'm off just tell me what settings you see and we can fill in blanks for you.

Let's try to set it for Auto Mode and range of 8-12. You should see EPR an Exhale Pressure Relief of OFF then 1, 2, 3 and also Full Time or other settings. Make that Full time and 1, try it see if you like it. View OSCAR as well. You can try any of 1-3 but let's start on 1 and then you can edit up if the results are good.

_________________
Dave K9DWB 73s

https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


Top
VegasGMC62
Unread post  Post subject: Re: Feeling Worse After 1 Month of Therapy - Any Thoughts?  |  Posted: Mon Sep 21, 2020 8:25 am

Joined: Tue Aug 11, 2020 4:30 am
Posts: 3
PAP Mask: Resmed P10
PAP Machine: Resmed Airsense 10
Humidifier: yes
Pressure Setting: 10

Offline
I used Ambien for 5 years with no issues until I started on CPAP. Every time I've used it on CPAP I had a bad night and felt tired all day. The OTC sleep aid Doxylamine Succinate (Unisom) works good for me.


Top
DeltaBravo3.8
Unread post  Post subject: Re: Feeling Worse After 1 Month of Therapy - Any Thoughts?  |  Posted: Mon Sep 21, 2020 10:20 am
User avatar

Joined: Sat Jul 04, 2020 8:38 am
Posts: 365
Location: Greencastle, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: New and old ResMed AirCurve 10 ASV for now, RT says I need NIV
Humidifier: HumidAir ResMed 10 series with ClimateLine heated hose
Pressure Setting: ASV Auto mode EPAP 4-15 PS 0-10 Odd pressures are OK but don't equate NIV

Offline
FWIW I've been given feedback here and the AB forum that some sleep aids increase the probability of having more apnea events.

_________________
Dave K9DWB 73s

https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


Top
Pugsy
Unread post  Post subject: Re: Feeling Worse After 1 Month of Therapy - Any Thoughts?  |  Posted: Mon Sep 21, 2020 10:50 am
User avatar

Joined: Wed Aug 02, 2017 8:01 pm
Posts: 2028
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirCurve 10 VAuto

Offline
I was told by my sleep doctor that most sleep aids won't make OSA worse but any medication that causes an increase in relaxation of the tissues or muscles can. She was more worried about muscle relaxant meds than sleep aids...even RX sleep aids or even RX pain meds.

It depends on the working mechanism behind the medication and she told me that even if something makes the OSA slightly worse that it can be dealt with and we have to get sleep first and foremost because without sleep none of this matters much.

_________________
I may have to rise but I refuse to shine.


Top
Respirator99
Unread post  Post subject: Re: Feeling Worse After 1 Month of Therapy - Any Thoughts?  |  Posted: Mon Sep 21, 2020 10:21 pm
User avatar

Joined: Mon Apr 27, 2020 1:06 am
Posts: 155
Location: Australia
PAP Mask: Resmed Airtouch F20
PAP Machine: Resmed S9 VPAP Adapt
Humidifier: Resmed H5i
Pressure Setting: Min EPAP: 8.0 Max EPAP: 11.0 PS Min: 3.0 PS Max: 8.0

Offline
Looking at the last chart above, I see a persistent leak around 18 - 20 L/min for a large part of the night. Although this leak won't worry your machine at all, it could be disturbing your sleep. If it blows into your eyes or causes "face farts" or other noises it might be enough to prevent you getting fully rested.

_________________
Regards from Australia

* Download Oscar
* Oscar help
* Organise your Oscar charts


Top
Wannarideagain
Unread post  Post subject: Re: Feeling Worse After 1 Month of Therapy - Any Thoughts?  |  Posted: Tue Sep 22, 2020 6:48 am

Joined: Sat Aug 08, 2020 1:42 pm
Posts: 17
Location: Winchester, Virginia
PAP Mask: F&P Vitera
PAP Machine: ResMed AirSense 10
Humidifier: Built-in with heated tube
Pressure Setting: 9

Offline
VegasGMC62 wrote:
I used Ambien for 5 years with no issues until I started on CPAP. Every time I've used it on CPAP I had a bad night and felt tired all day. The OTC sleep aid Doxylamine Succinate (Unisom) works good for me.



Thanks, Vegas. I'll give it a try. Ambien has been helpful for me, but I think DeltaBravo is right about it increasing apnea. I know it did when I increased the dose for a couple of nights.


Top
Wannarideagain
Unread post  Post subject: Re: Feeling Worse After 1 Month of Therapy - Any Thoughts?  |  Posted: Tue Sep 22, 2020 6:51 am

Joined: Sat Aug 08, 2020 1:42 pm
Posts: 17
Location: Winchester, Virginia
PAP Mask: F&P Vitera
PAP Machine: ResMed AirSense 10
Humidifier: Built-in with heated tube
Pressure Setting: 9

Offline
DeltaBravo3.8 wrote:
FWIW I've been given feedback here and the AB forum that some sleep aids increase the probability of having more apnea events.


True - Ambien does. When I take 5mg it doesn't seem to matter, but when I went up to 7.5mg for a couple of nights, it did increase my events - especially the OA's. I went back down to 5mg after that. Haven't taken any the last couple of nights. Maybe shoulda last night ...


Top
Wannarideagain
Unread post  Post subject: Re: Feeling Worse After 1 Month of Therapy - Any Thoughts?  |  Posted: Tue Sep 22, 2020 7:04 am

Joined: Sat Aug 08, 2020 1:42 pm
Posts: 17
Location: Winchester, Virginia
PAP Mask: F&P Vitera
PAP Machine: ResMed AirSense 10
Humidifier: Built-in with heated tube
Pressure Setting: 9

Offline
Pugsy wrote:
I was told by my sleep doctor that most sleep aids won't make OSA worse but any medication that causes an increase in relaxation of the tissues or muscles can. She was more worried about muscle relaxant meds than sleep aids...even RX sleep aids or even RX pain meds.

It depends on the working mechanism behind the medication and she told me that even if something makes the OSA slightly worse that it can be dealt with and we have to get sleep first and foremost because without sleep none of this matters much.


Indeed! I have skipped the last 2 nights, trying to judge if going to APAP and increasing pressure helped as much as the Ambien. It's hard to say - my son visited Sunday, so I'm currently in my 5-day crash mode. Which will start all over again after Friday - my CPAP compliance visit :lol:

Do you have any further thoughts on adjustments or whatever for me to feel better rested? I'm going to ask the nurse practitioner on Friday, but I'm not optimistic on getting any help there.

Thanks


Top
Wannarideagain
Unread post  Post subject: Re: Feeling Worse After 1 Month of Therapy - Any Thoughts?  |  Posted: Tue Sep 22, 2020 7:15 am

Joined: Sat Aug 08, 2020 1:42 pm
Posts: 17
Location: Winchester, Virginia
PAP Mask: F&P Vitera
PAP Machine: ResMed AirSense 10
Humidifier: Built-in with heated tube
Pressure Setting: 9

Offline
Respirator99 wrote:
Looking at the last chart above, I see a persistent leak around 18 - 20 L/min for a large part of the night. Although this leak won't worry your machine at all, it could be disturbing your sleep. If it blows into your eyes or causes "face farts" or other noises it might be enough to prevent you getting fully rested.


Thanks, Respirator. With the cloth cover and some additional fabric sewn on, I don't feel any leaks that I'm aware of. How much of a leak I have seems to REALLY vary from night to night.

This is mask #4, and I'm not sure what else to do about leaks. When I tighten the straps it tends to get uncomfortable - and sometimes gives me more of a leak than I had before adjusting.

Any ideas?


Top
Wannarideagain
Unread post  Post subject: Re: Feeling Worse After 1 Month of Therapy - Any Thoughts?  |  Posted: Tue Sep 22, 2020 7:46 am

Joined: Sat Aug 08, 2020 1:42 pm
Posts: 17
Location: Winchester, Virginia
PAP Mask: F&P Vitera
PAP Machine: ResMed AirSense 10
Humidifier: Built-in with heated tube
Pressure Setting: 9

Offline
DeltaBravo3.8 wrote:
OK sure, first you have to enter Clinical Mode/Menu. Hold the Home and push the Dial in together for about 5 seconds. You're then in Clinical Menu settings. You need to turn the dial to move to various areas and to edit values. Look for MODE, it should have CPAP and other options; look for something like AUTO. Use the dial to move to AUTO and click to select. Other settings should be available such as more pressure settings. It looks like you have CPAP pressure 8.4 now. It should give Min and Max or similar. I am guessing as I've never seen an APAP menu, so if I'm off just tell me what settings you see and we can fill in blanks for you.

Let's try to set it for Auto Mode and range of 8-12. You should see EPR an Exhale Pressure Relief of OFF then 1, 2, 3 and also Full Time or other settings. Make that Full time and 1, try it see if you like it. View OSCAR as well. You can try any of 1-3 but let's start on 1 and then you can edit up if the results are good.


Thank you, DeltaBravo. Found the APAP from your instructions (Duh on me!). I was chicken to go to 12 on the upper end, so I did 9.6 one night, and 10 last night (when the pressure seemed to range ALL over the place, though I had almost no events. What's up with that?). I'm having some aerophagia, but it's not too bad, so I may keep going up every night until I do run into a problem with it.

I had a terrible time exhaling on a nasal pillow (my first mask), so I found EPR then and set it on 3 before I was done and have just left it there since. It's such a pleasure to be able to exhale when breathing, lol. Should I try backing it down?

I can't tell if I'm feeling better yet - but maybe it'll take a week or more. And I'm currently having a crash from my son visiting on Sunday. (Hence the gap in OSCAR last night. Have skipped Ambien last 2 nights and was too tired to sleep at first last night)

What exactly are flow limitations?? Is it measuring when your breathing is somewhat blocked - corresponds to events or is an almost-event? What are good numbers for flow limit.?

Thanks. OSCAR from last 2 nights:


Attachments:
9-21-20.png
9-21-20.png [ 207.02 KiB | Viewed 553 times ]
9-20-20.png
9-20-20.png [ 203.19 KiB | Viewed 553 times ]
Top
DeltaBravo3.8
Unread post  Post subject: Re: Feeling Worse After 1 Month of Therapy - Any Thoughts?  |  Posted: Tue Sep 22, 2020 9:25 am
User avatar

Joined: Sat Jul 04, 2020 8:38 am
Posts: 365
Location: Greencastle, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: New and old ResMed AirCurve 10 ASV for now, RT says I need NIV
Humidifier: HumidAir ResMed 10 series with ClimateLine heated hose
Pressure Setting: ASV Auto mode EPAP 4-15 PS 0-10 Odd pressures are OK but don't equate NIV

Offline
OK yes do as you say on a gradual upward adjustment in light of aerophagia being present. The chart is in an area where it is now adjust for comfort more than events. Leaks are still present, but it's not above 24 L/min and it's not consistently near that 24 either. Just keep an eye on it, FWIW leak rates do not need to be zero. There is some expected leaks as this encompasses exhale ventilation as well as I recall it. I typically suggest a relatively low fairly consistent without impacting mask comfort and low enough to reduce disturbances caused by the leaking. A reasonable leak rate is good, yours can be acceptable if it does not impact disturbances. At situations like yours, sometimes you have to pick which battles to take on and which to leave alone. So bottom line is if it's not impacting your sleep negatively, you may want to move on to other battles. It is your call though. I see it as the leak rate you post is fairly repeatable on various charts, so maybe this is your best on that. Priority is on comfort now.

_________________
Dave K9DWB 73s

https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


Top
Display posts from previous:  Sort by  
Print view

Who is online
Users browsing this forum: No registered users and 27 guests
You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum
Jump to:  


Delete all board cookies | The team | All times are UTC - 8 hours [ DST ]

Powered by phpBB © 2000, 2002, 2005, 2007 phpBB Group
DAJ Glass 2 template created by Dustin Baccetti
id="Mask Bright" style="width:728px;margin:auto;float:center";z-index:8">