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Mild Case But Still Tired!
#1
Mild Case But Still Tired!
I have a mild case of OSA (5.8 AHI) and have been struggling with my APAP since March of last year.  I was really bad at wearing it in the beginning but I've been much more committed lately and really want to make it work.  Even though my AHI has been below 1, I'm still always tired and don't feel like I ever get deep sleep.  I had a lot of issues with rainout but feel like I've finally got that under control.  I use a nasal mask and mouth breathing has always been an issue.  I've tried several chin straps and dual chin straps but they prevented me from sleeping though the night.  Recently I've been mouth taping but am a little nervous about that.  

I've never been confident in my settings as sometimes i feel out of breath or like i can't exhale.  I've tried raising the min, increasing the EPR and most recently I watched a video where a guy recommended using the lowest possible settings.  He said to go into the stats and see what your 95% pressure was and set your max at that level.  My 95% pressure was 7.5 so i set the max at 8, min at 4.  I had one great night sleep but then back to normal (waking up exhausted even thought my score is 100 and AHI below 1).

I spent about 8 hours reading posts on this forum (you guys know your stuff!) and it seems like the consensus is to keep the min at 6-8.  I'm feeling completely confused now and hoping you could take a look at some of my charts to see if anything jumps out.  I wasn't sure which ones to include since I've tweaked the numbers a lot lately.  I do have a pulmonologist appointment in 2 weeks but I'm not sure what to do with the settings in the meantime.  I'm extra nervous about mouth taping and potentially having too low of settings.  

I appreciate any advice you can offer!  Thank you!


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#2
RE: Mild Case But Still Tired!
Usually when people have this type of complaint they have a high number of flow limits. They are apnea also just smaller but if they are numerous they will disrup sleep - waking you up or not allowing deep sleep. You cut off the flow limits chart. Take a look at it. IF you have a lot they are treated by PS (epr). You need to raise the lower number high enough for the ps can work. 4 is as low as the machine goes so the lowest you could set it would be 7.  Take a look and give it a try.
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: Mild Case But Still Tired!
Thank you for the quick reply!  Interesting!  This is the first time I've heard about flow limits.  I've resized the charts and included the flow limits but dont have anything to compare them to.  There are a handlful, even on the 1/8 chart where the min was set at 7.  They look small in magnitude.  Do you think they are large enough to prevent me from getting a deep, restful sleep?


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#4
RE: Mild Case But Still Tired!
There are a lot but small, frankly I thought there would be more. The bottom graph shows min of 4 and epr of 2.  That night you had no epr because 4 is as low as the machine can go. Try min 7 and epr 3. See if that makes any difference in how you feel in the morning. Your events as low so the main thing we want is how you feel. Give 3 nights to give it a little time to recover   Hope it helps
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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#5
RE: Mild Case But Still Tired!
I'll give that a shot a few nights.  Epr 3 w/ min 7.  Any suggestion on MAX?  

I feel like I'm just throwing darts at this point, probably not the best approach when my life literally depends on it!
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#6
RE: Mild Case But Still Tired!
Don’t worry your numbers are good, you will be fine. As far as the max is not that important in auto mode - it will go up as far as it needs to go set at 20 as your top chart showed. but if you want to cut it down your high was 9 so you can set it to 10
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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#7
RE: Mild Case But Still Tired!
Thank you staceyburke!  I appreciate it!  Smile
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#8
RE: Mild Case But Still Tired!
Just one thing to add. You may want to turn off the ramp. Your pressure is already low and you have a ramp starting from 4-cm for 20 minutes. During that time, the EPR is not present or just gradually increases until you reach therapy pressure. Most of us abandon ramp once we tolerate the machine pressure, and it is an unnecessary feature. Your results look great, and they looked better in your 1/8/21 chart before you reduced pressure. I agree with the direction you are going with minimum 7 and epr 3.
Sleeprider
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#9
RE: Mild Case But Still Tired!
Keep in mind there are causes of fatigue that are not sleep apnea related.
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#10
RE: Mild Case But Still Tired!
As in getting older? Yeah, I'm well on my way.  Oh-jeez
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