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AHI at 1, still very tired, OSCAR results
#1
AHI at 1, still very tired, OSCAR results
Hello everyone, I have been using CPAP for a while now but am still feeling very tired, OSCAR data inserted. Please let me know if any other data is needed for better interpretation


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#2
RE: AHI at 1, still very tired, OSCAR results
welcome to the board...  It looks to me that your flow limits are causing the problems.  BUT it also looks like you are using EPR at 3.  I can't see it on the left hand column so I would ask you to check that EPR is set to 3 FULL time.  Other than that you can try raising the min by 1 to 9.
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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#3
RE: AHI at 1, still very tired, OSCAR results
Yes EPR is at 3 Full time, I will bump up the pressure tonight and see if I get better results. Another question I have is it reasnoable to obtain an AHI of 0?
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#4
RE: AHI at 1, still very tired, OSCAR results
An AHI of 0.0 can happen, but it is only occasionally. For some, not at all. The object of the therapy is to get as close to 0.0 and feel good. Do not become obsessed in trying to achieve this. Many become number fixated and forget about comfort.

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#5
RE: AHI at 1, still very tired, OSCAR results
Also in addition to raising your min by 1 as Staceyburke recommended, I would recommend raising your maximum from 14 as you are hitting and thereby limiting your AS10 response to events.
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#6
RE: AHI at 1, still very tired, OSCAR results
On the other hand, flow limits are high and may be causing events. The usual strategy is EPR 3 full time, which OP is already doing.

In my case, it took a couple-three months to see improvement I would describe as significant. Stay the course.

Not to be hyper-critical of the OP, equipment profile says "Resmed Autosense 10." There is no such machine. should say "Resmed AirSense 10 AutoSset." Experts need the right info to be able to help.
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#7
RE: AHI at 1, still very tired, OSCAR results
How long is "a while now?" because if you are accustom to getting minimal sleep due to the apneas and get the apneas under control you might still just be getting minimal sleep due to your body going "ok I got as much sleep as I am use to getting must mean that it is time to wake up". I know for me personally I was use to waking up like every 30-40 minutes every night getting terrible sleep, now the apneas are under control but because I am so use to so little sleep I can sleep about 4 hours before I start waking up every half hour not because of any apnea but just because I have already hit as much sleep as I am use to and have not adjusted to actually being able to sleep longer.

While you can adjust some settings on the machine to try to help, the first question I would have is "Do you think you are waking up tired because of the machine, the apneas, or because your body has not had time to adjust to being "allowed" to sleep a proper amount of time?" Tinkering with the settings if it is just you have not acclimated to being able to sleep yet would be the equivalent of adding gas to an already full gas tank when the issue of the car not starting is because the battery is not connected, both gas and battery are vital to starting a car but you may be trying to fix one when the other is the issue.

I am not saying your settings are or are not correct, I am just saying that sometimes the simplest solutions are the correct answers. The first question should not be "what do I need to adjust?" but rather "what feels like it might be what is causing the issue? Then from there you can ask what to tweak" but you can rebuild the entire engine of the car and see no results if you never plug in the battery.
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#8
RE: AHI at 1, still very tired, OSCAR results
The length and timing of your FLs, breathing patterns and machine responses suggests your Apnea is at it's most severe during REM. What does your sleep study say about REM?

Assuming your Apnea is especially problematic during REM: 

The machine flat lining at at your minimum pressure and then rapidly descending back down to the minimum suggests that 8 treats your apnea, *while not in REM*.  But the severe and abrupt increases in a pattern that aligns with REM, suggests it's not nearly enough to treat your events during REM, and can't get there fast enough. The capping at your maximum pressure prevents your machine from getting to the pressure it needs to get to.

Your device is a ResMed, but your profile is Respironics, this suggests you've been on CPAP since at least the recall at least a year. So your sleep maintenance isn't because you're new to CPAP and we can get away with more pressure. 

Increase your minimum press, go from 8 to 9, if you're comfortable go a little higher, say 10. I'd also increase your maximum pressure, I just set mine to the machine max of 20 and let the machine go where it needs to go. Normally, I don't like to adjust two items at once but increasing both the minimum and maximum pressures aren't conflicting and the responses show up distinctly different on the graphs.

Leave the settings alone a few days, then increase again. 

This is where we take advantage of the OSCAR statistics page. Providing we make changes, leave a few days so that the changes are more significant we should see the AHI come down. We should also see the pressure graph flatten.

Keep increasing the minimum, as we approach the more optimal minimum, the increase amount should be less and less and the time at that range longer to see any change.

During this time also consider improving your sleep hygiene (I hate that term). Google "Sleep Hygiene" and "Sleep Maintenance" start applying some of the things that you might not be doing a good job at.
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