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2 month into CPAP Treatment, AHI is low but waking up frequently and still tired
Hey Guys,

I was diagnosed with mild obstructive sleep apnea about 2 months ago with an AHI of 8.1. I know it's considered very mild but I wouldn't describe the symptoms as such.

I was initially prescribed a Phillips DreamStation with ResMed AirFit P10 nasal pillows, and an APAP pressure of 5-10. After following some advice on here I boosted my pressure and was able to lower my AHI. I saw the doctor again about a month ago, he scolded me a bit for adjusting my pressure, and then agreed that it should be higher, and prescribed me at a fixed 10.0 pressure.

While my AHI has been low (30 day average at about 1.0), I find myself waking up 5-10 times throughout the course of the night. Usually I have no idea why I wake up, although there have been a few times where air escaping out of my mouth was definitely the culprit. Despite the wake ups, I feel like I am getting periods of good sleep, I am able to fall back asleep immediately, and I do feel less tired than before starting treatment. The wake ups seem to occur more frequently towards the end of my sleep, early in the morning before I wake up.

Suspecting mouth leaks as the cause of my wake ups, I got a chinstrap about 2 weeks ago which seems to have helped a little bit. I have attached a 1 day look at my sleepyhead data, along with a month long view of my leak rate.



Is my body still simply getting used to the CPAP, and the wake ups will go away on their own? Is it likely that mouth leaks are causing all of my wake ups? Is it too early to consider switching to a full face mask?

Any advice is greatly appreciated.

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I'm still learning so I won't make any suggestions on pressure. I would like to know what your flex settings are. I just got a DS.

Just my personal opinion. My posts are not medical advice or a statement of fact. Please consult a qualified physician or other qualified medical personnel. Please comply with all applicable laws, codes, regulations, and protocols.
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I keep my flex setting at the lowest setting: 1.0. When I first started I had it at 3.0 (highest) and it felt much more comfortable. However, after a week or so of experimenting I found that my AHI was a little bit lower at the lower setting so I kept it there. If you're able to tolerate it at 1.0, I would recommend keeping it there.
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Cflex, Aflex.. ?
Just my personal opinion. My posts are not medical advice or a statement of fact. Please consult a qualified physician or other qualified medical personnel. Please comply with all applicable laws, codes, regulations, and protocols.
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Give it some time you'll keep improving the benefits sometimes come slowly
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Your tidal volume is still low for a typical male. This suggests that you are still getting used to breathing out under pressure. It will improve over time as your body adapts.

One thing you may try is reduce your pressure by 1 and make it 9cm fixed. It will help with tidal volume and mouth leaks but may increase AHI a bit. That may be a worthwhile tradeoff.
PRS1 Auto & Dreamstation Auto w/ P10 and straight pressure of 7cm. 
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(04-15-2016, 08:23 PM)sdb7802 Wrote: Cflex, Aflex.. ?

It's a Respironics thing, like Resmed's EPR but a bit more complicated.

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I would recommend getting a full face mask. I tried nasal masks with chinstraps and it was not for me and had some nights the chin strap would move around and allow jaw drop. I would suggest the Simplus mask.
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+1 on the F&P Simplus.
I really like that one, after trying 3 full-face masks, (FFMs,) I never thought I would get to convert status, (from trying many different nasal masks and a few pillows,)but, sure enough, I have.
Good luck to you
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I'm in a similar boat. New to therapy as of 2 weeks ago. I started with AHI of 26, now i'm in frequently hitting 0 - .2 which I know is good. I still wake up 4-6 times a night, long enough to adjust mask and roll over for the most part (though remembering being awake and rolling over I will add), and it does not correlate with breath patterns (smooth) nor leak rate or other patterns in Sleepyhead. I used my pulse oximeter and that showed nothing either, o2 was solid in the 95-97% (sleep study showed drops into 7x% range!) and pulse rate stayed in the high 60's-low 70's, again nothing correlating with wake up events, enough that I stopped using it as it seems clear I have no o2 issues.

I will say though, I don't wake up to pee hardly at all now, maybe once a night now. Headaches are gone, but I too feel exhausted still (though comparatively better than before, that's for sure!).

I think mine has to do with leaks from the Simplus FFM hitting my eyes when I roll over on side. Eyes are constantly dry now like when you had a fan blowing on them or were awake all night. I move a lot and I think it has to do with new mattress (4 weeks ago, tried that as a solution right before they said sleep study showed OSA). Had a 10 year old one before (that was amazing when I bought it). New one isn't for me and my wife seems to toss and turn a lot too which doesn't help.

Using Benadryl helps, both with my constant stuffy nose/sinus (before I was using cpap I had this, and humidity on cpap seems to make things worse) and staying asleep. I think I back and bed problems combines with allergies messing with me right now.
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