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[split] gadgetmaniah - Low AHI, but still tired
#1
[split] gadgetmaniah - Low AHI, but still tired
Hi, I hope it's ok for me to post here since I think my problem is relevant to the topic of this thread. 

So I've been having good AHIs (around 1) and leak rates since I started CPAP about two months ago, but I am still waking up feeling like I have not had a full night's sleep. My sleep has improved about 50-60% since I started CPAP though, so I am feeling its benefits. I don't feel as tired as I used to and my head feels much more clear. On some days I feel quite good actually, but I am still facing lingering sleepiness.

Anyways, the only thing that seems problematic to me while reviewing my data on OSCAR are a number of frequent arousals followed by mini apneas of less than ten seconds. These happen a number of times throughout my sleep and changing the pressure/EPR settings seems to have no effect on them. Is there a solution to tackling this problem? Could it be that I just need more time for my brain to get used to breathing with a CPAP?

I am using a Resmed Airsense 10 Autoset and my current pressure settings are 4-10 cm with EPR off.

I have attached an example of the mini arousals/mini apneas that I am talking about. My flow limits average was 0 by the way in this example. Sorry for the poor screenshot - I can post a better one once my laptop's internet starts working.


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#2
RE: AHI < 1.0 now, but still tired? Is it UARS, RERA, arousals or FL in your FR peaks?
Hello gadget mania,

Given the sleep questions you have its good to see you looking for help and even finding this thread off the beaten path. You will be far better served by posting your own separate therapy thread. 

There are two reasons. I know very little about Dreamstations, having used Resmed devices alone, and you won't get the benefit of great counsel from others who can help you fine tune your PAP device much better than I.

I'd suggest for your thread subject line something along this line, "Have low AHI, am still tired and have arousals". To speed matters up, I will request that your post be moved so help will come faster. You will speed things along the sooner you post your OSCAR charts as explained here 
http://www.apneaboard.com/wiki/index.php...ganization .

Feel free to come here and post if you have more questions on the overall topic of low-AHI tiredness. I may be able to point you to good sources of information.

2SB

Edit: Oops! Don't see why I didn't look carefully enough to see gadgetmania was using a Resmed Autoset. Still, it's best for him to have his own therapy thread.
I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  

Of my 3 once-needed, helpful, and adjunctive devices I have listed, only the accelerometer remains operative (but now idle). My second CMS50I died, too, of old age and the so-so Dreem 2 needs head-positioning band repair--if, indeed, Dreem even supports use of it now.



 
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#3
RE: [split] gadgetmaniah - Low AHI, but still tired
The posts, above, have been split off into their own thread in order to provide better help for gadgetmaniah.

- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
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#4
RE: [split] gadgetmaniah - Low AHI, but still tired
Hello, thanks very much for creating a new thread for me. 

I started CPAP about a couple of months ago and though I have seen improvement, I still do not wake up feeling completely fresh. I have noticed in my flow rate graph curves that seem flow limited and mini apneas that I think are being caused due to flow limitation. 

Below I am posting some images from last night's sleep where I kept a minimum pressure of 7 cm and EPR at 3. I am including pictures of both my flow rate curves and the mini apneas/arousals.

Note that I have tried various pressures up to 12 cm with no improvement - my flow rate curves still look irregular and I still experience the mini apneas/arousals. 

Please, any help would be much appreciated! I wonder if I need a new machine such as BiPAP to fix this (perceived) problem.


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#5
RE: [split] gadgetmaniah - Low AHI, but still tired
(08-13-2021, 03:44 AM)gadgetmaniah Wrote: Hello, thanks very much for creating a new thread for me. 

I started CPAP about a couple of months ago and though I have seen improvement, I still do not wake up feeling completely fresh. I have noticed in my flow rate graph curves that seem flow limited and mini apneas that I think are being caused due to flow limitation. 

Below I am posting some images from last night's sleep where I kept a minimum pressure of 7 cm and EPR at 3. I am including pictures of both my flow rate curves and the mini apneas/arousals.

Note that I have tried various pressures up to 12 cm with no improvement - my flow rate curves still look irregular and I still experience the mini apneas/arousals. 

Please, any help would be much appreciated! I wonder if I need a new machine such as BiPAP to fix this (perceived) problem.


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#6
RE: [split] gadgetmaniah - Low AHI, but still tired
Some more pictures.


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#7
RE: [split] gadgetmaniah - Low AHI, but still tired
(08-13-2021, 03:48 AM)gadgetmaniah Wrote: Some more pictures.

I am note sure if my flow rate curves indicate flow limitation but they do have two small peaks (or irregular peaks) a lot of times which I wonder has to do with flow limitation.


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#8
RE: [split] gadgetmaniah - Low AHI, but still tired
Also, here are screenshots including respiratory rates for a few of my previous full night sleeps. Sorry for posting so many pictures but I thought it would be helpful to share as much potentially useful information as I can.

I read that a fluctuation in respiratory rate together with flow limitations can indicate RERAs.


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#9
RE: [split] gadgetmaniah - Low AHI, but still tired
(08-13-2021, 05:33 AM)gadgetmaniah Wrote: Also, here are screenshots including respiratory rates for a few of my previous full night sleeps. Sorry for posting so many pictures but I thought it would be helpful to share as much potentially useful information as I can.

I read that a fluctuation in respiratory rate together with flow limitations can indicate RERAs.

And this is from today's sleep. I think there is a clear fluctuation in the respiratory rate that coincides with the flow limitations.

Also, by the way, the custom UF1 and UF2 flags are for events of minimum duration of 5 seconds (not for the default 8 seconds) and flow restriction of either 20% or 50%.


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#10
RE: [split] gadgetmaniah - Low AHI, but still tired
I wonder if there are any suggestions from anyone? I woke up really tired today too, it feels like the sleep I would have pre-CPAP. I should say however that my CPAP experience was not going bad - I was waking up fairly refreshed even though a bit sleep deprived and I had a lot more energy. This went on for about a couple of months until about a week or so ago. Now for some reason I'm waking up mostly like I would without a CPAP - very fatigued with sleep deprived eyes. However, even in my older data I can see evidence of flow limitation, so I wonder if this is the main problem that I have had all along.
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