[Diagnosis] AHI ~10 with CPAP. Constant yawning and lack of focus. Tried nearly everything.

[Diagnosis] AHI ~10 with CPAP. Constant yawning and lack of focus. Tried nearly everything. - Printable Version

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AHI ~10 with CPAP. Constant yawning and lack of focus. Tried nearly everything. - gamedude07 - 09-08-2020

Hi everyone,

I desperately need help with my CPAP, and figuring out if my yawning, mental fatigue, and brain fog are even sleep apnea related. My ENT said that after seeing my AHI of ~8 using an oral appliance, he doesn't believe my mental fatigue is still caused by OSA. My AHI from my first sleep test was ~20, before I got a CPAP and oral appliance.

Whatever OSA-treating technique I try does not work for a more than a few days: CPAP (Philips Dreamstation Auto w/ full face mask from F&P), oral appliance for jaw advancement, mouth tape, nasal strip, angled pillow, side sleeping, nasal rinses, Flonase, nothing. I essentially feel the same daily whether I use CPAP, oral appliance, with or without mouth tape, etc. This makes me wonder if it's even an OSA problem.

About me:
I have a deviated septum and enlarged turbinates (considering septoplasty since breathing with Afrin is 10x better than my daily breathing.) I have enlarged tonsils (3/4 on Friedman scale) and have considered tonsillectomy but probably will not do it.
I'm 5'10, 165 lbs, pretty healthy weight and lifestyle.
No other medical conditions or meds.
All normal labs, including thyroid and iron, going to get tested for some vitamin deficiencies.

I've attached last night's OSCAR reading. Usually I've been ~ 7-10 AHI past few weeks. I sleep 8+ hours and still have consistent yawning, mental fatigue and brain fog throughout the day. It hurts my focus & motivation, all I want to do is close my eyes and rest, but I can't nap successfully most times anyways.

Any help or tips are appreciated!!

RE: AHI ~10 with CPAP. Constant yawning and lack of focus. Tried nearly everything. - factor - 07-02-2021

gamedude07 Wrote:yawning, mental fatigue, and brain fog are even sleep apnea related.

If you AHI is not less then 5 it is related

Quote:My AHI from my first sleep test was ~20, before I got a CPAP and oral appliance.

You have sleep apnea. Anything above 5 is Sleep Apnea.

Quote:Whatever OSA-treating technique I try does not work for a more than a few days: CPAP (Philips Dreamstation Auto w/ full face mask from F&P), oral appliance for jaw advancement, mouth tape, nasal strip, angled pillow, side sleeping, nasal rinses, Flonase, nothing. I essentially feel the same daily whether I use CPAP, oral appliance, with or without mouth tape, etc. This makes me wonder if it's even an OSA problem.

Post your sleep study and your OSCAR data. So someone can help you.

About me:

Quote:I have a deviated septum and enlarged turbinates

Known problem for folks with Sleep apnea. Follow you ENT advice here.

Quote:Afrin

Search Afrin addiction. Bad product used long term. Causes Insomnia.

Quote:I have enlarged tonsils (3/4 on Friedman scale) and have considered tonsillectomy but probably will not do it.

Follow ENTs advice here. A Tonsillectomy might help.

I'm 5'10, 165 lbs, pretty healthy weight and lifestyle.
No other medical conditions or meds.
All normal labs, including thyroid and iron, going to get tested for some

Quote:vitamin deficiencies.

Make sure they check D.

Quote:I've attached last night's OSCAR reading

Sleep Apnea for sure..

Usually I've been ~ 7-10 AHI past few weeks. I sleep 8+ hours and still have consistent yawning, mental fatigue and brain fog throughout the day. It hurts my focus & motivation, all I want to do is close my eyes and rest, but I can't nap successfully most times anyways.

Any help or tips are appreciated!!

Sorry this fell through the cracks... Comeback and give us an update.

I hope you switched resmed because of the recall.

RE: AHI ~10 with CPAP. Constant yawning and lack of focus. Tried nearly everything. - SarcasticDave94 - 07-02-2021

Welcome to Apnea Board,

A few actions that may help...

First the elephant in the room, DreamStation that's got an active recall, register and consider replacing with a ResMed AutoSet

Next, I'm seeing Apnea event clusters. Read up on soft cervical collar and positional Apnea. The basic thing is, seeing all those clusters of events, what's likely going on is your head and neck position is setting up an airway kink (like a garden hose) and the result is some to most of your Apnea. Check how many pillows you use. 2 or more? Go to 1. Very thick? Replace with a thinner one. If there's still positional clusters, get a collar.

More... Change settings with the DreamStation, there's some purple flags called CA this is Central Apnea, try dropping flex to 1 or off, also don't use Ramp. I know Ramp is a button on Respironics, but again don't push the Ramp button or edit the settings, 6 is too low for you so move it up. Your DreamStation is slow to respond, not just yours but all DreamStation's, your EPAP 95% is 8.2, so try starting at 8.

Try these things and see how much it helps.