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Almost No OAs But Still Not Sleeping Well
#1
Question 
Almost No OAs But Still Not Sleeping Well
Hi All,

I'm two months into CPAP after a sleep test put me at 6 AHI. I now consistently get an AHI of around 2 every night. This is the lowest I have consistently gotten my AHI after doing a bunch of tweaks: mouth taping, sleep positions, masks, pressures, collar, etc. I have now settled into using a soft cervical collar and side sleeping (both I think have slightly helped).

Anyway, I would greatly appreciate any feedback on my results as I am unsure if I should be concerned about the hypopneas and CAs since I still feel exhausted (I know it's still early in the process) and they're the only thing left with my OAs averaging 1-2 a night total (at beginning of analyzing my CPAP data my OAs were 3-5). To note, my sleep doc says there were no signs of anything other than obstructive apnea on my sleep test (which I can't get the specific data on).

Attached is what an average night looks like for me. Thank you in advance so much!!


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#2
RE: Almost No OAs But Still Not Sleeping Well
Just to let you know, almost all of us have some centrals.  They can be caused by just holding our breath while turning over in bed or pulling up the covers.  A few each night is nothing to worry about.

There are several types of apnea we look at.  Central (clear airway), Obstructive (O), Hypopnea (H), Flow limits and throw into that positional apnea.  O, H, FL are all the same type of apnea - obstructions...  I have them listed in my signature telling how they are categorized. 

Flow limits are obstructions and some people are very sensitive to them.  They can stop you from falling into deep sleep or even wake you up.  They can and do in many people stop them from getting a good nights sleep.  But they are not included in in AHI.

We try to help flow limits using EPR (exhale pressure relief).  You have yours turned off.  I would suggest you try and see if this helps with your sleep.  It will of course take several nights sleep to see any difference.

To try set your EPR to FULL TIME set to 3
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Almost No OAs But Still Not Sleeping Well
Sometimes, it's not about the numbers. Try out different masks, work on sleep hygiene, be more active (if you are not) or exercise, eat right (do you have acid reflux?), see a therapist if there's something on your mind. I myself have issues with TMJ, and I use a splint, and if the splint isn't adjusted, I get bad sleep. There are many factors, and you know the best to narrow them down.

I mainly use the CPAP for the humidifier. I get nasal congestion here due to dry weather. Congestion will cause sleep issues, bad issues.

I've listed out several factors, so we have no way of knowing what is causing the issue without narrowing it down. You know best since you know yourself.
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#4
RE: Almost No OAs But Still Not Sleeping Well
Thank you both for the overview and advice! I appreciate it a lot - currently don't have time to research this all myself. I tried out full-time 3 EPR last night and will continue to do so and watch for any results. Also, you are right in that I this past week's stress is definitely adding to the poor sleep.
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