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Exhausted despite good numbers. Feeling discouraged. OSCAR report attached.
Exhausted despite good numbers. Feeling discouraged. OSCAR report attached.
Hey all, first post here. Glad to have this resource and community.

I've been using my CPAP for about 4 months now. I've adjusted to it well and can't sleep without it. Most nights, I'll get 7-8 hours of sleep, have an AHI under 3 and a leak rate under 5. I usually wake up 1-2 times every night (that I remember), but I don't have any trouble falling back asleep. My oxygen will get down to the low 90s during my apneas, but is mid-high 90s most of the night. My heart rate ranges from mid 30s - mid 40s while sleeping with spikes during my apneas. I'm seeing a cardiologist soon about my bradycardia. I did get a bunch of heart tests done a couple years ago (ECG, echocardiogram, halter monitor) and was told by my PCP at the time that everything looks good, but we'll see what the cardiologist has to say. I do have health anxiety over my bradycardia and can no longer wear my Apple Watch or my Wellue Checkme because when I do I wake up in the middle of the night in a panic attack with chest pain, which is very uncomfortable.

In May 2022, I was diagnosed with severe sleep apnea. My AHI during my sleep study was 78. I'm 5'9 and 200 lbs, so overweight. I have a deviated septum, environmental allergies, moderate-severe anxiety and mild depression. I take Lexapro 5mg and get allergy shots. Sometimes I use nasal sprays before bed. I workout 2-3 times a week. Mostly long-distance running but also some strength training here and there. I have a fairly healthy diet and am gluten-free. I drink a few cups of coffee every day and average about 10 drinks of alcohol per week (mostly on weekends).

I'll cut to the chase. Although my sleep data usually looks good and I usually get a full night's rest, I've only noticed a slight improvement in my symptoms of fatigue, dizziness, headache, and brain fog. I finally decided to post here today because I am completely exhausted. I've been useless today. My fatigue is so, so bad. I want to lay down and do nothing, but I have responsibilities. Unfortunately, days like this during the past 4 months have been all too common. I'm feeling really discouraged.

I've attached my OSCAR report. Is there anything I can do differently that might help? Perhaps a change in my CPAP settings?

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RE: Exhausted despite good numbers. Feeling discouraged. OSCAR report attached.
I will offer my own story:

I have fought Chronic Fatigue for a decade before a Quad Bypass.
Following the quad bypass surgery, this "Chronic Fatigue" seemed to go away for two/three years, then returned with a worrisome development: no longer confined to falls and spring it became year round.
The worst was the brain fog. I could get up in the morning and last only a couple of hours and the fog would happen, sometimes so bad I had a hard time watching old TV show reruns or following the plot of movies I had seen many times before.
Three years ago due to my wife, Jackie needing surgery, we were able to get on Access, and I also was given Access added to my Medicare. 
So over the next two years I tried to find treatment for my brain fogging. I could find no one to help me.
A couple of times I was rushed to the hospitable with reactions to well meaning Dr’s. Prescriptions…
It was hopeless. 
Then one Christmas Jackie received a Fitbit.  It could track many stages of sleep. I was gifted one too and made a significant discovery.
The poor quality APAP machine I was given when I asked for a replacement CPAP machine was over-reacting and waking me up nearly every time I would fall in a DEEP SLEEP CYCLE!  Or even REM.
It was destroying my sleep right at its most restorative phase, visible for the first time being tracked on the Fitbit. The APAP interfereing with my DEEP and REM sleep cycles.
I now use a ResMed Sleep Score Max system to monitor my sleep cycles.
I knew the APAP was not good for me even at the first few minutes of activation as every time I put it on I felt like I was suffocating for the first 5 to 10 minutes.
Out of storage I retrieved my older model, cranky ASV Bi-PAP machine and did a complete Titration again. I reset all the settings to the starting point and worked from there.
I learned that I needed 12 inch EPAP to completely stop Obstructive blockage and snoring, and 18 inches 17 IPAP pressure support to control my central apneas and hypopneas.
This worked miracles: I began to have much better days, I also began sleep much more fully a good night's sleep.
Before this change I would count only a few good days a month, now it is only a few bad days a month.
My AHI rating is now normally under 3 AHIs per night. Often under 2 AHIs.
The main problem is I cannot show these results in a sleep study, and as all the testing only shows that I can only be "Treated" by plan old CPAP so that is all they will authorize to give me.
I found they do NOT have any equipment to monitor the different dream states in use.
Without such specialized testing I cannot show the real need for an ASV system. 
So I buy them myself.
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