[Help Requested] How to improve?

[bigbiz]

Hi all,

Thanks in advance for taking the time to review my post. I'm not feeling much better after being on CPAP therapy since May. I'm due for a titration study in late October so hoping that may help clear things up. But in the meanwhile, hoping to gather opinions on my treatment / sleeping patterns.

Background: After a "take home" sleep study (AHI: 5.1), I was diagnosed with 'mild' Sleep Apnea earlier this year (~May timeframe) and was put on a CPAP (Resmed Autosense 10). I've tried a few different configurations (nasal mask -> nasal pillows, 5-6 variable pressure to 5.6 fixed), but I still find myself waking up exhausted in the mornings and feeling tired throughout the day, especially around 4-6PM. Example: it's 430PM PST and after getting at least 8 hours of sleep with a ~3 AHI, I'm tired. Didn't do much today besides go grocery shopping.

I also get wired at night, likely insomnia, and have at times suffered from what I think is restless leg syndrome. These latter symptoms have improved post-CPAP, but still occur at times.

Oscar data: I've noticed a few things. First, my AHI tends to fluctuate up and down, hitting 5 at times. Second, regardless of the AHI level, most of it is being driven by "Clear Airway" events. Is it possible that I have central sleep apnea or UARS?

Thanks again!

[OpalRose]

I don't see evidence of UARS. With a diagnosis of mild sleep apnea and AHI of 5.1, it's not likely you have central sleep apnea and that what you are seeing on your graphs above may be treatment emergent, and may settle down in time.

Do you have access to reports from your at home sleep study? If you do, post it here for review.

[bigbiz]

Hi thanks for the response. I don't have access, but can request. Is there anything in particular I should ask them for?

[Cpapian]

For your restless leg you can try taking iron and vitamin C (250) together.  I took it for a while on doctor's recommendation  and it did help.

[SarcasticDave94]

The sleep study report asked for should be a detailed multi-paged type not the summary only. Whatever you get is better than zero info though. The reason is you need these to put in your personal medical file. Here in the US it is yours to obtain legally per HIPAA.

I would suggest turning off Ramp. Your low therapy pressures do not dictate it is needed. It also adds pressure swings that can increase CA events including the treatment emergent variety. Consider bumping pressure to 6 and with EPR at 2. This may need to change with more data to base setting changes.