Too Sleepy's Therapy Thread | Apnea Board (2024)

Too Sleepy

Too Sleepy's Therapy Thread | Apnea Board (2)



Too Sleepy's Therapy Thread | Apnea Board (3)Posts: 45
Threads: 2
Joined: Jan 2023

Machine: ResMed AirCurve 10 VAuto
Mask Type: Nasal pillows
Mask Make & Model: ResMed P30i
Humidifier: Resmed Humidair
CPAP Pressure: 12/8
CPAP Software: OSCAR

Other Comments:

Sex: Male
Location: United Kingdom

#1

01-22-2023, 08:45 AM

Too Sleepy's Therapy Thread

Hello,

Thank you to whoever replies to this. I was diagnosed with an AHI of 11, purely hypopneas- no apneas or RERAs were noted during my in-lab sleep study. I have severe symptoms: drowsiness, sleepiness and general body fatigue. This all started about three years ago and has been progressively getting worse and worse. I started using APAP full-time from the 1st of January, before that I was getting acclimated and couldn't use the mask a full night. However, I progressed to now being able to fall asleep and wake up with the mask secure without any issues. I use P10 nasal pillows which I find comfortable.

Regarding APAP settings, my doctor hasn't helped me at all. I had no titration study done. When I was given my diagnosis near the end of last yearthe doctor simply said "try out a fixed pressure of 4" without any evidence as to why that would help- it didn't. I haven't been able to get an appointment with the sleep department since then (NHS).

I'm still very tired, and although it could be that my body is recovering from sleep debt, I have a feeling that something isn't quite right with my CPAP therapy. And I don't have the knowledge to be able to tell what's wrong. Could any of you please help me? OSCAR screenshots below.

Notes:
- Fall asleep and wake up fine with the P10 Nasal pillows
- I have woken up with a dry mouth for the last three days. All the othertimes I haven't noticed a dry mouth at all.
- I seem to still be waking up during or after dreams, as I have a vivid recall to my dreams.

Thanks!

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Too Sleepy

Too Sleepy's Therapy Thread | Apnea Board (11)



Too Sleepy's Therapy Thread | Apnea Board (12)Posts: 45
Threads: 2
Joined: Jan 2023

Machine: ResMed AirCurve 10 VAuto
Mask Type: Nasal pillows
Mask Make & Model: ResMed P30i
Humidifier: Resmed Humidair
CPAP Pressure: 12/8
CPAP Software: OSCAR

Other Comments:

Sex: Male
Location: United Kingdom

#2

01-22-2023, 09:02 AM

RE: I have been using APAP since New Year and still feel sleepy. Need help with settings

More zoomed in screenshots here.

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staceyburke



Too Sleepy's Therapy Thread | Apnea Board (20)Posts: 3,682
Threads: 15
Joined: Jun 2020

Machine: Resmed AirCurve VAUTO
Mask Type: Full face mask
Mask Make & Model: ResMed f30 & f30i
Humidifier: ResMed
CPAP Pressure: PS 5.6 over 6.2-19
CPAP Software: OSCARmyAir

Other Comments: O2 and pulse CMS 50F

Sex: Male
Location: colorado usa

RE: I have been using APAP since New Year and still feel sleepy. Need help with settings

Welcome, the only thing I see is that your min 4.6 and your EPR 3 can not work together. The absolute lowest the machine can go is 4. EPR (exhale pressure relief) is used to make breathing easier and help with flow limits (which are apnea also but not recorded in the AHI.

Simple fix is to raise the min to 7

That would make the inhale 7 the exhale 4.

Give it a try tonight and I think you will do better.

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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Too Sleepy

Too Sleepy's Therapy Thread | Apnea Board (24)



Too Sleepy's Therapy Thread | Apnea Board (25)Posts: 45
Threads: 2
Joined: Jan 2023

Machine: ResMed AirCurve 10 VAuto
Mask Type: Nasal pillows
Mask Make & Model: ResMed P30i
Humidifier: Resmed Humidair
CPAP Pressure: 12/8
CPAP Software: OSCAR

Other Comments:

Sex: Male
Location: United Kingdom

#4

01-22-2023, 09:57 AM

RE: I have been using APAP since New Year and still feel sleepy. Need help with settings

Thank you for your response. Could you expand on this to help me understand?

I use a minimum of 4.6 because any higher and I can't fall asleep with it. Do you see flow limits in my charts due to the minimum pressure being too low?

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OpalRose

Too Sleepy's Therapy Thread | Apnea Board (30)



Too Sleepy's Therapy Thread | Apnea Board (31)Posts: 13,269
Threads: 71
Joined: Nov 2014

Machine: ResMed AirCurve 10 VAuto
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: With ClimateLine hose
CPAP Pressure: EPAP 8.4 PS 3.4 Trigger-High
CPAP Software: ResScanOSCAR

Other Comments: Wellue O2Ring™ Oxygen Monitor

Sex: Female
Location: Ohio, USA

#5

01-22-2023, 10:05 AM

RE: I have been using APAP since New Year and still feel sleepy. Need help with settings

Welcome to ApneaBoard!

Your doctors recommendation of starting with a pressure of 4cm isn't doing you much good. The use of EPR 3 should be helping, except you are not receiving any benefit with a low minimum pressure. The machine can't go any lower than 4.

Let's raise the minimum pressure to 7cm with a maximum pressure set to 12cm. Keep EPR set at 3. Note that EPR can raise clear airway events, but I'm not too worried right now since they didn't show on your sleep study and will probably lessen in time.

Edit: I know you seem hesitant about raising your pressure, so take it slow. Try using your machine for an hour before bed, sitting up reading or watching TV. Turn the pressure up to 5, then 6 until you work up to 7. You won't notice this increase in pressure when you are distracted doing something else. In a couple days, you should be able to use the recommended setting of 7cm. You need to trust your machine and let it work.

OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer

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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Too Sleepy

Too Sleepy's Therapy Thread | Apnea Board (35)



Too Sleepy's Therapy Thread | Apnea Board (36)Posts: 45
Threads: 2
Joined: Jan 2023

Machine: ResMed AirCurve 10 VAuto
Mask Type: Nasal pillows
Mask Make & Model: ResMed P30i
Humidifier: Resmed Humidair
CPAP Pressure: 12/8
CPAP Software: OSCAR

Other Comments:

Sex: Male
Location: United Kingdom

#6

01-22-2023, 10:12 AM

RE: I have been using APAP since New Year and still feel sleepy. Need help with settings

Hello,

Sorry just to clarify. His idea was to do a fixedpressure of 4. My AHI with that setting was too high. So I changed it to APAP mode, 4.6 min to 8 max. My average pressure is 5.3.

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Too Sleepy

Too Sleepy's Therapy Thread | Apnea Board (40)



Too Sleepy's Therapy Thread | Apnea Board (41)Posts: 45
Threads: 2
Joined: Jan 2023

Machine: ResMed AirCurve 10 VAuto
Mask Type: Nasal pillows
Mask Make & Model: ResMed P30i
Humidifier: Resmed Humidair
CPAP Pressure: 12/8
CPAP Software: OSCAR

Other Comments:

Sex: Male
Location: United Kingdom

#7

01-22-2023, 10:33 AM

RE: I have been using APAP since New Year and still feel sleepy. Need help with settings

Are the leaks anything to worry about? As I said, recently I've had dry mouth. I wondered if the flow rate indicates that the therapy isn't working.

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OpalRose

Too Sleepy's Therapy Thread | Apnea Board (46)



Too Sleepy's Therapy Thread | Apnea Board (47)Posts: 13,269
Threads: 71
Joined: Nov 2014

Machine: ResMed AirCurve 10 VAuto
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: With ClimateLine hose
CPAP Pressure: EPAP 8.4 PS 3.4 Trigger-High
CPAP Software: ResScanOSCAR

Other Comments: Wellue O2Ring™ Oxygen Monitor

Sex: Female
Location: Ohio, USA

#8

01-22-2023, 11:15 AM

RE: I have been using APAP since New Year and still feel sleepy. Need help with settings

Your main complaint is:
"I have severe symptoms: drowsiness, sleepiness and general body fatigue."

There is more to sleep Therapy than just AHI numbers. Your numbers are low, but you're still struggling. Unless there are other reasons for the drowsiness like poor hygiene habits or other medical issues, then we look at Flow Limitation. The flat tops and areas where there is a dip in the top of the flow wave usually point to FL.

FL and Hypopnea cause sleep arousals that you may not be aware of.

As stated prior, you are not receiving the full benefit of EPR with a pressure set lower than 7cm. Your therapy isn't optimal if your tired all the time.

Also, dry mouth usually points to your mouth/jaw dropping open and allowing air to escape. Your leak rate isn't high, but even small leaks throughout the night can be disruptive.

OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer

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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Too Sleepy

Too Sleepy's Therapy Thread | Apnea Board (51)



Too Sleepy's Therapy Thread | Apnea Board (52)Posts: 45
Threads: 2
Joined: Jan 2023

Machine: ResMed AirCurve 10 VAuto
Mask Type: Nasal pillows
Mask Make & Model: ResMed P30i
Humidifier: Resmed Humidair
CPAP Pressure: 12/8
CPAP Software: OSCAR

Other Comments:

Sex: Male
Location: United Kingdom

#9

01-22-2023, 11:22 AM

RE: I have been using APAP since New Year and still feel sleepy. Need help with settings

Hmm okay. I will try mouth-taping and also adjusting the pressure. The thing is, I can't seem to tolerate anything higher than 4.6 while I'm awake otherwise I feel like I'm working too hard to inhale. Any tips on adjusting to higher pressures?

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OpalRose

Too Sleepy's Therapy Thread | Apnea Board (56)



Too Sleepy's Therapy Thread | Apnea Board (57)Posts: 13,269
Threads: 71
Joined: Nov 2014

Machine: ResMed AirCurve 10 VAuto
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: With ClimateLine hose
CPAP Pressure: EPAP 8.4 PS 3.4 Trigger-High
CPAP Software: ResScanOSCAR

Other Comments: Wellue O2Ring™ Oxygen Monitor

Sex: Female
Location: Ohio, USA

#10

01-22-2023, 01:03 PM

RE: I have been using APAP since New Year and still feel sleepy. Need help with settings

(01-22-2023, 11:22 AM)TooSleepy Wrote: Any tips on adjusting to higher pressures?

Did you read this suggestion that I posted above?

"I know you seem hesitant about raising your pressure, so take it slow. Try using your machine for an hour before bed, sitting up reading or watching TV. Turn the pressure up to 5, then 6 until you work up to 7. You won't notice this increase in pressure when you are distracted doing something else. In a couple days, you should be able to use the recommended setting of 7cm. You need to trust your machine and let it work."

OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer

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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