1 Year of Therapy Still Dealing With Fatigue and Headaches

[Zzera]

Hello!

I was diagnosed with severe sleep apnea 40/AHI roughly a year ago. I was first put on a cpap machine but no matter what settings I used it was not lowering my AHI and I was having severe bloat issues with the higher pressures. I was switched over to a BiPap after about 4 months and have been on that since. I have noticed a slight difference in feeling better throughout the day but not much. I am still very fatigued and either wake up with headaches or get one later in the day.

Have been reading a ton on forums and online and have tried my best to mess with my settings myself but haven't had much luck in fixing my sleep. Was hoping somewhere here could guide me in the right direction to help get the full benefits from my therapy. 

Setting currently being used:
IPAP: 12.6
EPAP: 7.4
PS: 4
Trigger: High
Cycle: Med

I have attached my OSCAR data from last night's sleep below. Thank you in advance for any help

[PeaceLoveAndPizza]

Have you tried setting the trigger to very high? That should help some with the CA’s.

I would not change pressure at the moment. Let’s see how things respond to the trigger change and go from there.

[Zzera]

Thank you for the suggestion! I will change it tonight to "very high" and report back with the data.

[Zzera]

Results from last night with trigger set on "very high"

Woke up several times throughout the night turning the machine off then restarting it when I was ready to try and sleep again

O2 drops are my biggest concern, no matter what I try to do I can not stabilize it and there is always lots of fluctuation.

[PeaceLoveAndPizza]

Things look good from a settings perspective. Quite nice flow rate in fact. I do not think your wake-ups are related to the CPAP, at least as far as settings go.

Which O2 drops are you referring? The ones in the chart look quite good and well in the acceptable range.

[Zzera]

The spikes down where it gets to the low 90's. I had assumed one point of therapy was to stabilize oxygen sats and keep a consistent "flow".

I know some happened when I didn't have the mask on which makes sense but the drops around 11pm, 3am, 7am are all under cpap, which I had assumed would eliminate that from happening.

[Crimson Nape]

The low point are artifacts.  When a 4 sec point drops and then returns to your average value, you can disregard them.  SpO₂ levels do not fluctuate that rapidly. The body acts like a storage battery, so it will be a more graceful change.

Remember, when you go looking for problems, you will find them.  The main problems will find you.
- Red

[PeaceLoveAndPizza]

I do not think there is anything there to be concerned about as almost all are just a brief drop. You have excellent tidal volume, so plenty of O2 is getting into your lungs. Your median SpO2 is 97%, which is very good for being awake, let alone during sleep.

I suggest continuing with the current settings and looking at it again in a few days to a week or more. I do not see anything here to be tilting at windmills.