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Diagnosed with moderate OSA (15.8), I've been using the ResMed AirSense 10 (8-10 pressure) with the nasal pillow mask (P10) for 3 weeks now, alongside mouth tape. The initial discomfort faded after the first few days. My nose gets itchy at nights by using the nasal pillow mask so I adjust it a little bit, but it doesn't really bother me.
While my AHI has dropped to below 1.8, I haven't noticed significant improvements in other aspects of my sleep.
I consistently wake up after about 3 hours of sleep, and thereafter, the quality of my sleep declines, leading to frequent tossing and turning. Consequently, I get out of bed feeling extremely fatigued, which affects my focus and energy. This was the primary reason for seeking help from a sleep doctor.
I maintain good sleep habits. I don't go to bed too late, avoid consuming caffeine close to bedtime, don't eat three hours before bed, and make sure I'm relaxed before bedtime. I got a vitamin D shot recently because I'm usually low on it, especially around this time of year.
I can't help you with regards to OSCAR reading but for sleep hygiene.
- Dim lights down 1 hour before bed
- No caffeine after midday. Caffeine half life is around 6 hours which means after 6 hours you still have 50% of the caffeine. Ideally you want no caffeine after 12 PM, no energy drinks, pre-workouts etc.
- No alcohol 3 hours before bed
- No work 2 hours before bed.
- Sleep with a cooler temperature, 18 degrees.
- Do your exercise in the morning if you can.
- Get light immediately in the morning.
On the supplement side Vitamin D is good but won't affect sleep directly.
1 hour before bed you could take
- Magnesium Threanate 300-400mg
- Teanine 100-300mg
- Apigenin - 50mg
- L-Tryptophan 1g > 15g grams
It could also be some other type of neurological problem. Undiagnosed ADHD, ASD?
You mentioned caffeine close to bed time, that would probably be the first thing I would change.
12-08-2023, 10:25 AM (This post was last modified: 12-08-2023, 10:26 AM by gainerfull.)
RE: Low AHI still tired
Welcome to the board - when you wake up do you have any sense for why you've woken up? How frequently are nights this fragmented? Your first arousal looks like it's smack dab in your first REM segment. How did you end up at your current settings?
To me, it looks like your minimum pressure minus EPR is too low. I have a hard time breathing out against anything less than 7cmH20 because it makes me feel like I'm suffocating so that's one thing to keep in mind. Your first awakening you were breathing out against only 5cmH20.
Tonight I'd recommend minimum pressure of 7cmH20, maximum of 12 and EPR off. After a night or two with those settings we can start to experiment with EPR should the data suggest you need it. Given that you're at such a low pressure, only using EPR 1 and have a 95% flow limit of .10 I'm not too worried about EPR at the moment.
Another alternative in our back pocket is to switch to constant pressure mode at 8cmH20 w/ EPR off. Perhaps less fluctuations in pressure give you more restful sleep.
Finally, looks like you went to bed around midnight - for the next 3-4 days try getting in bed no later than 10pm.
You need to resize your graphs by eliminating the calendar, so we can see the settings section in its entirety.
Alternatively you can reset to the standard view by- View > Reset Graphs > Standard Then take a screenshot of your Daily Screen. (For Windows or Linux, Use F12 key, or for a Mac Fn+F12 keys)
I would not like to comment on the potential settings changes to be made at this stage until you have reposted and we have a clearer view.
If you have a sleep study that can post (with your personal details redacted) this may give some key information. Always a good place to start.
You certainly have some violent pressure swings that must be causing you lots of discomfort. We need to try to establish the root cause.
As a footnote, the irritation of the pillows mask may be alleviated with a little lip salve around the edges of the nostrils, but not inside as could cause slippage of the prongs.
