AHI of 1, but still sleepy, napping, dry mouth

[yngwiej]

Hi all, I need help getting my cpap therapy under control. My AHI is very low, usually around 1, and while I'm definitely feeling better compared to before using CPAP, I still wake up tired, have dry mouth, I usually crash after lunch and end up napping, either at work without cpap, or at home with cpap. I've tried taping my mouth the last two nights, but I don't think it's helping much. I don't really know much about reading the information in Oscar, so can anyone please help me out with understanding what I'm doing wrong? Thanks

[staceyburke]

I would suggest a couple of changes...

Min = 7
EPR full time

EPR = 3

Try; it a couple of nights and post to this one, tell us if the night was better or worse and why.

[yngwiej]

Thanks stacy, I'll try that and report back!

[yngwiej]

I tried your suggestions last night, but I didn't feel very good after I woke up. My flow limit looks a little worse. What do you think?

[SeePak]

welcome yng...

Your original post showed min max at 5 -8 with NO EPR

You have some obstructive apnea with these setting.

So, you need to get the min higher than 5 for sure.

But if you use EPR 3, that would mean you need to get your min. pressure up to 8 just to keep a min. pressure of 5 !

So,

If all else was decent before any adjustment, and no EPR i would suggest..

min. 6 max 8 and NO EPR , see how that goes first to get the OA under control

Keep taping your mouth as well, dont want too many changes here.

After that, you may want to play with EPR.

[yngwiej]

Thanks Seepak, I'll try your suggestion. Should I just keep bumping up the min pressure until my obstructive apneas are gone? 

What's an appropriate number of obstructive apneas? 0 per night? 1-2 per night?

Thanks again.

[Old Steve]

I would go to 8cm to start and bump your maximum pressure to perhaps 12cm.  Your flow limits are pretty high and you are already at 3 EPR so most likely you need more pressure.  If 8cm doesn't help go to 9cm.  Post some more charts in a few nights.

Good luck...

[SeePak]

Yes John that's how I would do it.

If you had a sleep study it would tell you what pressure the obstructive apnea would disappear this way if you don't have one we can quickly find out what pressure you need after 6 cm you could try 6.6 Maybe 7
But only adjust one pressure at a time.
Keep your max at 8 cm
I appreciate the fact that the flow limits look high especially to others on this forum.
 in my experience however I can have 0.2 for a flow limit and have an excellent sleep so not everybody's going to be the same and I'm not going to assume that you're the same as everybody else either.
I just probably looking to start you off closer to where you already are so that we don't run all over the place with settings.
And you got to keep taping your mouth I assume that it was taped when you gave us your other Oscar results.
Hope this helps!

[Old Steve]

If you look at your last chart your medium pressure is already running almost 8cm anyway and you are maxing out on your maximum pressure of 8cm.

[yngwiej]

Hi everyone, first I want to say thank you to all who've commented. I really appreciate that you are all willing to help!! 

To answer earlier questions, I did have a sleep study done, but it was about 3 years ago. My doctor at that time set my pressure at 5-8 and I haven't changed it at all since then. 

I have data from three nights with a pressure of 6-8 to share with you. I've also been taping my mouth every night. My mouth is not feeling quite so dry in the morning these days, so that's great. I also feel a little better in the morning, but still get sleepy in the afternoon unless I have some coffee. What would you suggest I change?