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AHI under 5, Good O2 level, still feel tired, sleepy in the morning
#1
AHI under 5, Good O2 level, still feel tired, sleepy in the morning
I've been on CPAP (Dreamstation Go with humidifier) now for over 6 months. I use a nasal pillow and I tape my mouth to prevent mouth leaks. 

During sleep, I alternate between sleeping on my back and on my side.

I still don't feel better in the morning. Still fatigued and sleepy during the day. The only thing better is no headache because I don't snore when wearing CPAP.

My AHI is usually under 5. I wear a Wellue Blood Oxygen monitor and my score is usually 9.7+.

Attached are screenshots of my sessions the past 2 nights from Oscar. I sleep around 4am since I work night shift. I have  I set my pressure to 5-6.5 range because sleep has been horrible lately. I wake up feeling I just went for a run. Before last week, my max range was 9.


Thanks.

   

   
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#2
RE: AHI under 5, Good O2 level, still feel tired, sleepy in the morning
To add, I went to my doctor about this issue and he prescribed blood tests (cortisol, testosterone, caclium, magnesium, etc.)

Everything is normal except for slight Vitamin D deficiency.

I'm in my 40s, pretty skinny (5'8", 140 lbs) and exercise regularly (except for days when I had awful sleep).
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#3
RE: AHI under 5, Good O2 level, still feel tired, sleepy in the morning
Your pressure is quite low and some obstructive apnea and hypopnea are getting through. You may be satisfied with less than 5 AHI but those events suggest a lot of potential for flow limitation and arousal. A good starting point might be an increase in pressure to a minimum 6.5 and maximum 8.0. Just give higher pressure a try and decide for yourself if you start feeling better.
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#4
RE: AHI under 5, Good O2 level, still feel tired, sleepy in the morning
Welcome

I would like to ask why you turned your max pressure down? The range you have now is very low, and for many people, they need at least 7, 8 or 9 to get the best results (especially if they feel like they're not getting enough air). To put it in perspective, If you half fill a glass of water and blow bubbles in it with a straw at the bottom, that's about the pressure you are using.

The fact that you're getting RERAS and hypopneas means that if you were on the Resmed, I would be suggesting you increase your minimum pressure to 7 and set EPR to 3, but you're using a DS, and I'm not exactly sure how Flex translates instead of EPR.

Out of curiosity, is your machine part of the big recall or not?
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#5
RE: AHI under 5, Good O2 level, still feel tired, sleepy in the morning
I was assuming that my difficulty breathing was because I can't take the pressure.

I'll try 6.5-8.0 tonight.

How about the Flex Mode? Should I be using C-Flex or something else?

Thanks a lot and I appreciate it.
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#6
RE: AHI under 5, Good O2 level, still feel tired, sleepy in the morning
Your pressure at 5.0 is nearly pediatric, and does not generate enough flow for comfort. I would personally feel suffocated at that pressure. Part of the reason CPAP works is that it increases airway pressure, expanding the airway space and helping increase respiratory flow. With a pressure of 5.0 you probably experience near zero pressure difference in the upper airway during inspiration which makes breathing harder compared to somewhat higher pressure. This respiratory effort created numerous micro-arousals that you are probably not aware of, but they add up to fatigue. Flex is a matter of comfort. The only way to figure it out is to try CFlex at 2 and compare to AFlex at 2.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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 under 5, Good O2 level, still feel tired, sleepy in the morning
(01-16-2022, 11:49 AM)Ratchick Wrote: Welcome

I would like to ask why you turned your max pressure down? The range you have now is very low, and for many people, they need at least 7, 8 or 9 to get the best results (especially if they feel like they're not getting enough air). To put it in perspective, If you half fill a glass of water and blow bubbles in it with a straw at the bottom, that's about the pressure you are using.

The fact that you're getting RERAS and hypopneas means that if you were on the Resmed, I would be suggesting you increase your minimum pressure to 7 and set EPR to 3, but you're using a DS, and I'm not exactly sure how Flex translates instead of EPR.

Out of curiosity, is your machine part of the big recall or not?


Yes, my machine is part of the recall and it hasn't been replaced yet. Unfortunately, I tried sleeping without CPAP and it's horrible. I get massive headache aside from the fatigue.
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#8
RE: AHI under 5, Good O2 level, still feel tired, sleepy in the morning
Work on that vitamin D deficiency too!
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#9
RE: AHI under 5, Good O2 level, still feel tired, sleepy in the morning
Update from me.

I set my AHI to 6.5-10.0. See screenshot from OSCAR from last night's session.

It doesn't feel as awful as before when I had the pressure on 5-6.5 range but I still don't feel refreshed.

I have 9.1 on 95%. Does it mean I should increase the pressure more to maybe 11?

I also notice that I have dry mouth when I wake up the past few sessions so I'm having a mouth leak. I think it's because the pressure is higher now.

I got a cervical collar but it's uncomfortable as it's a little bit hard so I ordered a different one hoping that it's softer.

I also had a consultation with my sleep doctor and she prescribed me Xanax to see if the issues I'm having is because of anxiety. It's only temporary just to narrow down the cause.

Thanks.

   
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