A doctor said I don't have sleep apnea but I am convinced I do

[dgcaste]

Hello everyone, I am a 45 year old male in decent shape (physically fit but perhaps 20 lbs overweight) and have always had a need for naps throughout the day and if I wake up at 6am I'm tired by 8am. I always wake up at midnight and 3am, my wife says I snore and chortle, so I got a sleep study... and the doctor said I don't have apnea.

So I went and bought myself an Resmed Airsense 10 and loaded up into Oscar with the following settings:

APAP 6-12
EPR 1
Humidifier 5
F30i mask
Ramp off
Soft response

Results graph below zoomed in to one of the most eventful parts of the night.

I've used the machine for about a week but only started taking SD card readings to Oscar last night. I wonder, should I drop the pressure to a constant 4 and turn off EPR so I can see the true extent of my events, should I turn off EPR and see if my CA gets better or worse, or should I do something else? I would hate to get another sleep study and get gaslighted into being told I don't have a sleep problem because it's clear that I do.

   

[Nightynite]

You need to post the chart details. Look at the OSCAR Chart Organization under the Wiki button.
You’re missing critical settings and that’s how people give recommendations.

[Old Steve]

It might also be helpful if you were to post a copy of your sleep study, with your name redacted.

[dgcaste]

You need to post the chart details.  Look at the OSCAR Chart Organization under the Wiki button.
You’re missing critical settings and that’s how people give recommendations.

Thank you for that. Here's a screenshot per the wiki page 

   

And here's one of my sleep study done by the VA, who I do not trust because once they had to do the same hydrocele surgery twice because they screwed up the first one and it became a hematocele.

   

[SarcasticDave94]

It might be the duration of the study, 56 minutes. It's expected to be an overnight study.

[dgcaste]

The VA is impossible and super stubborn. I don't expect to get another sleep study from them in the next 6 months. What can I do for now to further self-diagnose my base state so I can take some steps to mitigate?

[SarcasticDave94]

Unfortunately, the CPAP is a treatment device not a test device. It'll be somewhat difficult to diagnose this way, in my opinion.

However if you're determined to treat Apnea, and specifically Hypopnea from the short test, you will want to try new settings. I would start at standard response, min pressure 7, EPR 3 full time. Keep Ramp off. And for now keep Max 12.

Try it at least a full night.

[dgcaste]

Changes made. Will report tomorrow.

Thank you! :)

[dingdang5]

Only an hour of testing is silly. just get an at-home sleep test from one of the cheap online providers, can find for ~$100.

[Sleeprider]

I think you will do well with the settings suggested by SarcasticDave94. The problem with sleep medicine is that they have adopted standards that define the diagnosis of OSA that are well above what is tolerable for certain people, and they ignore the impacts of upper airway resistance syndrome (flow limitation) which can result in the snoring, respiratory effort related arousals and hypopnea that is likely the source of your ongoing problem. Your decision to self treat and pay attention to how you feel is the right one, and we should be able to help you optimize results. At the very least your wife will be happier with a quieter bed partner. It's a trial and error process and changes in settings, masks and comfort accessories like a hose cover can all add up to a better experience.