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1 month on CPAP, Still Tired
#1
1 month on CPAP, Still Tired
Past 6months to a year I have felt pretty fatigued. Have had bloodwork done, nothing abnormal with hormones (thyroid and testosterone ok). Very mild vitamin D deficiency which I am supplementing for. 

I used to (and still do) wake up at least 2-3 times a night so I pushed for a sleep study. Did that and had mild sleep apnea, AHI 7 (5 NREM, 22 REM), mostly hypopneas. Asked my doctor for CPAP because I didn't know what else to do to to try and improve sleep quality. I practice good sleep hygiene (no caffeine after 12pm, consistent sleep schedule, exercise most days, etc..).

Anyways, I am still feeling pretty tired and fatigued almost every day since I started CPAP. Attached a couple recent nights of OSCAR data. I would say these are mostly typical nights from the past month. I don't have any major comfort issues, mask gets a little irritating late into the night but usually fine. Anything look off here? Not sure what to do.


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#2
RE: 1 month on CPAP, Still Tired
Everything looks okay, although your AHI could stand some improvement...as a personal preference in my case.  I would want it to be as low as I can get it consistently, with minor range variance from night-to-night.

I see you have some open airway events, or what could be 'central apnea' events.  Could you place your cursor over the vertical purple indicators at the top chart and tell us their durations?  If they're over 14 seconds or so, they're starting to become a pain.

Your indexed data at left also says you have the odd largish leak here and there, maybe only for a few seconds.  They may be innocuous, but they may also arouse you due to both their severity and rarity.  That is, you sense them because they ARE salient.  If you do get dragged out of sleep, then between the large leak and the centrals, which can also drag you up out of the bliss, their aggregation can have a deleterious effect.

Please note that your AHI is nothing remotely close to 'bad', and the value suggests to the industry that your apnea is being controlled properly by your current settings and the machine.  But, you are the determinant in the final analysis of what really works, especially leaving you feeling secure and confident...and treated.  So, never stop being vigilant and questioning, and never stop feeling around in the dark for a better grip on your therapy or your experience with it.  You owe it to yourself to stay on top of it and to keep imagining ways to tweak it if you're not completely pleased. 

I wonder if it would be worth reducing your pressure relief by one unit for a few nights to see what effect that has.  Also, but later, try a reduction in top pressure by one full cm to see what that does.  Raising it beyond its current setting might just make things worse if you're having the odd leak, but only if it is NOT related to sleep position.
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#3
RE: 1 month on CPAP, Still Tired
It's puzzling to me (but bear in mind that I'm not an expert like some of the folks here). With an AHI of 7 you have mild sleep apnea. My AHI was over 50. Getting up twice a night is not strange at all. I sometimes got up five times or more a night. You sleep many hours a night. Did the sleep study flag any other problems with your sleep? Do you feel any better or less sleepy during the day when you use the cpap compared to not using it? If it doesn't make you feel better, it may be that you have a problem other than sleep apnea that is causing your problems.
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#4
RE: 1 month on CPAP, Still Tired
Sometimes setting a fixed pressure will help with fatigue. You are currently using 7-12 EPR 3 and a fixed pressure would be 10.0 with EPR 3 in either Autoset mode with the minimum and maximum set the same, or CPAP mode with EPR 3.
Sleeprider
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