AHI looks good, but still feeling bad

[nh00]

Hi everyone, I started CPAP therapy about a month ago. I've finally gotten a mask that works for me comfortably, and my AHI is looking quite good, but I'm still feeling generally awful. I'm hoping there's something in my data that reveals a problem. Here are some details:

- Machine: AirSense 11 AutoSet
- Mask: ResMed F40
- Pressure Range: 6-16
- Ramp settings: Auto
- Sleeping: I generally sleep on my side

I'm happy to post any other details needed, including the full data files if it's helpful. Thank you.

[staceyburke]

Welcome to the board.

The change i would make is raising the min from 6

I would start at 8  and would try 9 if the night goes well.

Your pressures look like a mountain range, it should be much more level and with the change in min should help and let you sleep better.

[nh00]

Thanks for your reply! I'll raise it to 8 tonight and see how I feel. I appreciate your advice.

[nh00]

I've made a few changes over the last few nights: I switched the "starting pressure" to 6 from 5, and the "minimum" pressure up to 8. I tried that minimum pressure for two nights, but I felt like I was having trouble tolerating it, so I went down to 7. I'm starting to suffer much more aerophagia. Here is the first night at 8.0:




After which, I switched the mask type to pillow. Note this night I only had 4 hours of use, as I felt like I couldn't handle the pressure, along with other emotional fatigue from trying to get this working:



And then went back to 7.0 last night:



One night is certainly not enough data, but the 7.0 did look much worse than the nights with 8.0. Hopefully I can work up to it. I'm still having moments that are awfully concerning:

[staceyburke]

I would try a straight Cpap pressur and see how you feel. 

Set min7
Max7

Leave all the rest alone.

[nh00]

Here's a single night of a static 7 pressure. I'll try for another night or two to see how I feel, as long as there are no red flags here.

[nh00]

Here is last night. I feel tired today (I did make the mistake of going back to sleep afterwards without my CPAP). I'm starting to have this terrible feeling that there's nothing seriously wrong with my sleep. Some kind of apnea imposter syndrome. Let me know if I should post other charts or any zoomed in sections.

I know sleep tracking devices aren't totally accurate, but my Fitbit says I got 11% deep sleep and 16% REM, which is quite bad. So maybe I'm still not having healthy sleep stages.

[SarcasticDave94]

I would say that there's a few things to consider changing: Ramp although on Auto for timing it's not ideal due to preventing actual therapy during its use.

You will need more pressure to reduce the flow limits. Since you're on EPR 3 full time already, which does help with the FL, but you need to get these reduced, which will now call for pressure increase. On ResMed machines, FL would call for pressure increases if you had a range of pressures. Are your FL terrible? Maybe not, but you'll likely want to address to maximize therapy effectiveness.

[staceyburke]

As dave said we need to move both to max to 8 and see if you  feel better.

[nh00]

Dave, thanks for your response. I assume ramp doesn't make a huge difference at static pressure, but I can turn it off. Last night, I had pressure on 8 all the way through. I feel terrible.