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andielv's Therapy Thread - Daytime Drowsiness
andielv's Therapy Thread - Daytime Drowsiness
Hi all,

I've been on APAP (I think you can see my info with my username in this post?) since summer 2021, and while it has definitely been helpful overall, I have recently been experiencing a lot of daytime drowsiness. I am wondering if my machine settings are the best they could be, or if there are changes I could/should make to help with my sleep quality. I've included three screenshots from OSCAR - from the last three nights - but am happy to include additional screenshots or provide additional information.

Since this isn't in the screenshots:
Ramp: Auto
Ramp Pressure: 4 cmH2O
Response: Standard
Smart Start: On
Temperature: 27 ºC
Temperature Enable: On

Thanks in advance!

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RE: andielv's Therapy Thread - Daytime Drowsiness
I definitely don't know what I'm talking about, but I have read that making your minimum pressure closer to the therapeutic range can be helpful.

From "Optimizing therapy" in the wiki (I can't post links since I am new):

"A good rule of thumb is to keep your minimum pressure setting about 2-cm below your 90% pressure (PR) or Med Pressure (ResMed) or near the average if they are close."

Maybe try setting the minimum to 6 or 7?
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RE: andielv's Therapy Thread - Daytime Drowsiness

Welcome to the board, good job on getting those charts arranged so folks can get the most data from a glance. Those far more skilled at analysis than I are sure to turn up fairly soon. Quartet is right on, you should bump your minimum up to 7, considering you are already running EPR full at 3. I would ditch the ramp, zero therapy happens during ramp and its valuable sleep time wasted.

Over all you look pretty good, Flow Limitations will further decrease once you bump the min up. Once you get dialed in tight with the help of our more skilled members it will be time to look closer at the persistent daytime drowsiness, it can be from many causes, but till therapy is dialed in it's like tilting at windmills to try and figure out.

Good luck, keep at it, its how we get good at it!
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RE: andielv's Therapy Thread - Daytime Drowsiness
As some have pointed out you need to increase the min for your EPR to work. EPR is exhale pressure relief. If EPR is off then the inhale is your min pressure which is 4. The EPR is subtracted from the min to get the exhale pressure BUT the lowest any cpap goes is 4 so min 4 - EPR 3 is still 4 because that is as low as it can go.\

I would leave everything else alone and move the Min to 7. That would give you an inhale pressure of 7 and an exhale pressure of 4. That would help your flow limits (flow limits ARE apnea just like O and H events, but not counted in the AHI) and that will actually keep your pressures down. Pressures go up when the cpap finds flow limits and it does that to stop flow limits from becoming larger O and H events.
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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RE: andielv's Therapy Thread - Daytime Drowsiness
Thanks everyone! I appreciate the guidance. I had anticipated that your advice might include changing the minimum pressure so I did that a few nights ago. Here are a couple nights of results from that change. Yes, for that one night I did remove my mask in my sleep and then sleep without it for awhile. That doesn't happen very often.

I'm not feeling a difference in my fatigue, sadly. Sad

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RE: andielv's Therapy Thread - Daytime Drowsiness
Any thoughts?
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