Need help reading flow charts. Very low AHI, still tired, algorithm wrong?
Hello everyone, I've been following this forum for a while but this is my first post. Thanks in advance for your help.
I am a 27yo man, very thin (BMI 19) with a healthy diet and lifestyle. I used to be physically active until apnea made it pretty much impossible to live a normal life.
First I'd like to tell you about my background: About 2 years ago I started having lots of breathing problems from my deviated septum and huge turbinates and I got a sleep study. The results were lots of hypopneas, loud snoring from mouth breathing and only 1 obstructive apnea. Most of the hypopneas were corrected at 8.0-12.0 with a Dreamstation One APAP. I used multiple FFMs that never really fit me well. At first I slept really well, but aerophagia started to make me wake up multiple times at night from the intense stomach pain and my sleep was getting worse anyway, so I got turbinate and septum surgery. I slept more or less well for a few months without the APAP after the surgery and I returned the APAP to the provider. I had 100% compliance because life pre-CPAP was hell, but I was happy to return it.
Then my sleep started getting really bad again. I suppose my surgery went badly or wasn't enough. I noticed my nasal valves were collapsing and bought a Mute nasal dilator. I kept opening my mouth and snoring anyway, and my sleep quality was going down again, so I decided to buy an Autoset 10 For Her with a nasal mask. I bought the FH model because I always had AHIs < 5.0 with the Dreamstation but never slept well. I also suspect I might have UARS.
Now I'm using the Autoset 10 FH, Airfit N30i, a Wellue Checkme O2 Max and taping my mouth. This has been my self-titration process:
So I would like to ask you guys in case you might have any ideas, and what you think is the next thing to try. More pressure? Different response mode? Different mask? Breathing exercises? I really don't know.
Sorry for the long post, and thank you so much for taking the time to read all this!
Uploading also a relatively normal looking flow chart rate for comparison.
PD: I can't say I'm satisfied with the SpO2 measurements from the Checkme O2. I haven't found any believable correlations with disturbed flows. I think it's because my fingers are thin and my hands are cold most of the time.
I am a 27yo man, very thin (BMI 19) with a healthy diet and lifestyle. I used to be physically active until apnea made it pretty much impossible to live a normal life.
First I'd like to tell you about my background: About 2 years ago I started having lots of breathing problems from my deviated septum and huge turbinates and I got a sleep study. The results were lots of hypopneas, loud snoring from mouth breathing and only 1 obstructive apnea. Most of the hypopneas were corrected at 8.0-12.0 with a Dreamstation One APAP. I used multiple FFMs that never really fit me well. At first I slept really well, but aerophagia started to make me wake up multiple times at night from the intense stomach pain and my sleep was getting worse anyway, so I got turbinate and septum surgery. I slept more or less well for a few months without the APAP after the surgery and I returned the APAP to the provider. I had 100% compliance because life pre-CPAP was hell, but I was happy to return it.
Then my sleep started getting really bad again. I suppose my surgery went badly or wasn't enough. I noticed my nasal valves were collapsing and bought a Mute nasal dilator. I kept opening my mouth and snoring anyway, and my sleep quality was going down again, so I decided to buy an Autoset 10 For Her with a nasal mask. I bought the FH model because I always had AHIs < 5.0 with the Dreamstation but never slept well. I also suspect I might have UARS.
Now I'm using the Autoset 10 FH, Airfit N30i, a Wellue Checkme O2 Max and taping my mouth. This has been my self-titration process:
- I started with fixed 7.0, EPR 0. That gave me some CAs (AHI 2.0) and aerophagia was killing me again, so I started decreasing the pressure until I reached 6.4. This almost eliminated the CAs, but not the aerophagia, and I got to AHI ~0.5. 3/10 sleep from waking up so many times with a stabbing pain in my stomach.
- Knowing EPR effectively decreases the overall pressure, I started introducing EPR slowly. EPR 1 and 2 improved my aerophagia, AHI still ~0.5. Not waking up as often, but sleep still 3/10.
- Decided to switch to APAP 6.4 - 8.0, EPR 3, Soft response mode, to avoid aerophagia while hopefully correcting some variable I'm not seeing yet. Aerophagia pretty much gone, AHI 1.7 (mostly CAs), sleep somehow 5/10.
- Tried switching to APAP For Her mode but the pressure changes always made me wake up heaving from how aggressive they were.
So I would like to ask you guys in case you might have any ideas, and what you think is the next thing to try. More pressure? Different response mode? Different mask? Breathing exercises? I really don't know.
Sorry for the long post, and thank you so much for taking the time to read all this!
Uploading also a relatively normal looking flow chart rate for comparison.
PD: I can't say I'm satisfied with the SpO2 measurements from the Checkme O2. I haven't found any believable correlations with disturbed flows. I think it's because my fingers are thin and my hands are cold most of the time.
