Sleep Apnea/cpap help

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Question
"I had a sleep study which showed that I had 51 episodes per hour

I have been on cpap since the end of August.  I have he resmed auto with humidifier and heated hose.  I have tried several masks, amara,liberty,quattro fx, quattro and flexifit ff. The mask that seems best for me is the flexi-fit

I do not wake with headaches anymore and my blood pressure has come down but I am still exhausted.  I use the machine between
5-7 hours a night.


here are my 60 day average numbers

pressure median 12.5 95% 13.9 maximum 15.1
leak median 1.2 95% 24 maximum 15.1
ahi 3.2

single day read out is
pressure median 11 95% 13 maximum 18

My primary doctor ordered blood work (fatigue profile) which was normal.

When I address the concerns with the sleep doctor, she says that my AHI is good so the therapy is working. This response does not answer why I am so tired still

Since starting cpap, I remember bits and peices of lots of dreams for awhile. Could this be caused by the change in pressure waking me up and out of rem sleep? Could this explain why I am so waking up tired still?"

Answer
Amy:

"When I address the concerns with the sleep doctor, she says that my AHI is good so the therapy is working. This response does not answer why I am so tired still"

This sounds very much like when a mechanic works on your car but it still does not start up afterwards.  So what if the spark plugs got changed and are now firing right, the car still does not run!

Point is, sleep apnea is not the only cause of excessive sleepiness during the day and likewise sleep apnea does not necessarily present as a solo condition.  Case in point:  we recently had a young man referred to our program with classic symptoms of sleep apnea.  Testing revealed he did indeed have sleep apnea and he was subsequently treated for his condition.  But it turns out his sleep apnea was masking another sleep disorder and once we eliminated the sleep apnea, that other sleep disorder was able to rise to the top.  One cannot simply stop at the first treatment and walk away.

Perhaps you might want to seek a second opinion from another sleep specialist?

As for dreams, this can go either way on the spectrum when it comes to sleep apnea.  Some new CPAP users relate how they are now having vivid dreams and others say they now sleep the sleep of the dead.  Whether or not you recall dreams does not mean you have or have not experienced REM sleep.  Bear in mind that untreated sleep disordered breathing mostly fragments the sleep cycle so you have less restorative periods of REM.  Introduce successful CPAP therapy and the REM periods normalize resulting in you perhaps subjectively feeling you are dreaming more...

Hope this helps!

Sleep Apnea

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Dave Walsh RRT

Expertise

Registered Respiratory Therapist and Licensed Respiratory Care Practitioner (IL). Thirty-five years in the field of Respiratory Care with the last twenty-five years spent concentrating in the area of sleep disordered breathing. Established the first hospital based compact multiphysiologic recording program for the diagnosis and treatment of obstructive sleep apnea syndrome (OSAS).

Experience

I'm proud to have built a comprehensive sleep disorders center in Chicago during the '80s and to then go on and build the first hospital based home sleep testing (HST) program in the country. I now own and operate Sleep Case Management, a Division of DRW&Associates Inc, providing sleep disorders case management services to physicians and their patients in northern IL along with providing home sleep testing and arrangements for in-lab sleep testing.

Organizations
American Academy of Sleep Medicine, American Association for Respiratory Care

Education/Credentials
BSc (Biology), ASc (RT)

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