Limited knowledge on CPAP results and how to tinker with it

[hannahthefox]

I had a sleep study last year and was informed that due to braces when I was a teenager, it partially closed my airway. To fix it, I was told I needed an orthotic for sleeping, or braces to actually fix the problems that were created. I have had trouble with jaw pain and have been to a TMJ specialist. They gave me an orthodic to help while I sleep (only for the jaw, not for the apnea) It worked for a little while.

I opted for a CPAP to see if it would yield good results. They didn't recommend it because the orthotic was easier to them, but it seemed easy enough to try it out. also much cheaper! At first it seemed to be very nice, but now it does not appear to be helping much, or at all. Just last night was one of the worst nights I have had in a long time.

I just started looking at the charts created by my ResMed 10. But it appears that most of my incidents are within the first 2 hours when I sleep. I'll attach my sleep study and last night's reports. I was told that my sleep apnea was very mild. But it is really affecting me. I don't feel rested even with10 hours of sleep.

It is hard to get back out to the Dr due to the current pandemic. Any help anyone can provide would be greatly appreciated.

-Hannah

[Gideon]

You were likely tossing a bit at the start of the night so for now I'll skip that cluster. If it repeats regularly we will deal with it another night.
Based on your numbers the min of 4 is too low, it doesn't let EPR function fully so I'd normally set min to 6 , max to 10 to have some room though I doubt you will reach that and EPR = 2 but instead

Your EPR is set to 3 I think because of your nights troubles. I want to get max benefit from the EPR so set
Min = 7 to give the EPR room to work
Max = 10 and leave EPR alone.

[DeepBreathing]

G'day hannahthefox. Welcome to Apnea Board.

Your sleep study does indicate very mild apnea - pretty much sub-clinical. However there are obviously other respiratory events which are disturbing your sleep. You've given us one page of the report - could you post the other pages so we can get a full picture please? One thing to be aware of is that while the severity of apnea is based on the number of events per hour (AHI and RDI) that is a very crude measure. In particular it doesn't tell you how long each event was, or if the events were clustered.

Looking at your Oscar chart, we see a huge cluster for the first 40 minutes or so, then virtually nothing for the rest of the night. So my question is: what's happening during those 40 minutes? Are you still awake (or semi-awake) and fighting the machine? Is this a postural issue? Do you start out on your back then roll to the side (or vice versa). Or do you start out with your chin tucked to your chest? I find sometimes if I fall asleep while reading my chin drops down until SWMBO gives me the elbow.

You chart does show flow limitations most of the night - could you zoom in on a two or three minute segment so we can see in detail what's happening with the flow rate? I'd suggest one close-up in that big cluster and another at 03:32 am.

Finally, are there other conditions which could be causing your fatigue? Anaemia, vitamin deficiency (especially Vitamin D), thyroid insufficiency etc?

[Sleeprider]

Your doctors seem to really want a mandibular advancement device, and in my experience, they are expensive, relatively ineffective and can cause pain and badly affect the bite. It does not make sense that braces would have pulled your jaw back and your results on CPAP do not suggest very much upper airway restriction. CPAP can work well for you and be more comfortable.

Fred's suggestion for pressure looks very good to me. Either a minimum pressure of 6.0 with EPR 2 or a minimum pressure of 7 with EPR 3. You can try both and see which is most comfortable. I'm sure this will work well for you.