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AHI moderate - sleep too short - feel tired
#1
AHI moderate - sleep too short - feel tired
Since 3 years I use a Dreamstation CPAP. Initial pressure was 6.5 CPAP and C-FLEX 3- AHI were between 5 and 15. The AHI increased over time, so did my weight (now 95 kg at 1.75m). The values were then at AHI 20 on average. I changed the therapy to APAP 8-13 and no FLEX. Now I have values of AHI 5-10.

Diseases:
Smoking 2000-2008. Since 2008 depression sertraline and opipramol. I am just reducing / discontinuing. 2016 in the sleep laboratory PLMS 90. I have now had RESTEX prescribed, but only take it when needed. I can sleep very well with it.

Do you still see optimization potential? I can sit the whole day at the PC but I have very little drive to be physically active. Surely one cause is sertrlalin as a side effect fatigue. Currently I don't drink alcohol and try Keto as a changeover.
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#2
RE: AHI moderate - sleep too short - feel tired
Have you had a recent physical and did they check your thyroid function and have you ever used an external pulse-oximeter to see if you are getting enough oxygen during the night -- both of which can manifest a additional fatigue issues? Your Sp02 looks good, but there is a drop for a period of time.

Have you eliminated any environmental issues like noise, light, pets, dust, etc.?

How about your bed? Too hard/soft/lumpy? Pillow not the right height?

I am sure someone in the community might have some settings suggestions. Be patient.

Best of luck.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#3
RE: AHI moderate - sleep too short - feel tired
I didn't have any other disease. My blood values this year are fine. I would be healthy. The SPO2 values are on the left and can be seen in the diagram. It's a little low. How could I get it higher? Would ASV make sense?

Environment is okay. I'm already looking at it. Maybe a little light. I have to use the eye mask again. The bed is fine. I just got myself a new mattress and pillow. With the pillow I can still optimize.

Thank you for your suggestions.
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#4
RE: AHI moderate - sleep too short - feel tired
Unfortunately, I have no experience with ASV devices so I cannot be of further assistance.
However, I was thinking:  are your sleep cycles regular or could this be a residual symptom of depression that is not fully controlled.
And, remember, it's not all about the device readings, the bottom line is how you are feeling.

Hang in there ... another forum member is bound to have some helpful suggestions.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#5
RE: AHI moderate - sleep too short - feel tired
On the SP02 levels, I think a machine with pressure support can manipulate SP02 levels some, so this could be where something like the ASV or other machines with PS may be considered.
Dave

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#6
RE: AHI moderate - sleep too short - feel tired
Your Philips Dreamstation Auto is set to 8-13 pressure. Your median pressure is 9.5 and the 95% pressure is 12.9. The Philips auto CPAP is slow to respond to event precursors like flow limitation and the minimum pressure needs to be set high enough to do that and avoid hypopnea. I think your optimim range is actually 11.0 to 13.0, and that will prevent at least 75% of these events. Less variation in pressure will also disturb your sleep less, and may reduce the CA events.

My recommendation is to change minimum pressure to 11.0, but if you find that uncomfortable, just go as high as you find tolerable.
Sleeprider
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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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#7
RE: AHI moderate - sleep too short - feel tired
(10-05-2019, 08:36 AM)SarcasticDave94 Wrote: On the SP02 levels, I think a machine with pressure support can manipulate SP02 levels some, so this could be where something like the ASV or other machines with PS may be considered.

(10-05-2019, 08:37 AM)Sleeprider Wrote: Your Philips Dreamstation Auto is set to 8-13 pressure. Your median pressure is 9.5 and the 95% pressure is 12.9.  The Philips auto CPAP is slow to respond to event precursors like flow limitation and the minimum pressure needs to be set high enough to do that and avoid hypopnea.  I think your optimim range is actually 11.0 to 13.0, and that will prevent at least 75% of these events. Less variation in pressure will also disturb your sleep less, and may reduce the CA events.  

My recommendation is to change minimum pressure to 11.0, but if you find that uncomfortable, just go as high as you find tolerable.

Thank you very much for your answers. I will test it tonight. Thanks Thanks
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#8
RE: AHI moderate - sleep too short - feel tired
One additional thought: can you try getting more sleep? Less than 7 hours is probably not enough.
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#9
RE: AHI moderate - sleep too short - feel tired
Thank you so much for the tip. I suspect that I can wake up because of the events and then no longer sleep. Maybe it's the nose pillows that bother me early. I will consider using my Mirage FX mask because it seems denser and more comfortable. I can also use Restex for 1-2 weeks. So I slept through the two nights in the hypnogram for more than 7 hours and I wasn't feeling too bad.
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#10
RE: AHI moderate - sleep too short - feel tired
I’m curious: what bothers you about the nose pillows? Sore skin? Mouth leaks? Or...?
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