Brand new to this

[Cheesedream]

And this one...

[Jay51]

Thank you for posting those charts.  Your charts look pretty good IMO.  Very clean and good stats.  I don't think you suffer from chin tucking as you don't have any clusters of events.  A couple of larger than normal height of the wave form tops could be arousal breathing; but yours doesn't even look bad IMO.  You may have changed position in bed for something right before that.  

It may just take some time to start feeling better and gaining energy.  There may be some other cause of your fatigue also that has not been identified yet.

[Cheesedream]

Thanks for the reply Jay!

I'm really happy with the fact that I've been able to lower the pressure so much because of the MAD. My respiratory rate and tidal volume looks alot better now too.
Do you think the flow limits are a bit high now? Would a soft cervical collar help that?

I feel like the mouth piece has helped so much with the oscar reports to a point where I may not need the cpap any more. I'm thinking of trying to set the pressure at 4cm and if there is still no apnea then try sleeping without the cpap and just wear the viatom checkme to keep an eye on spo2.
My worry is that the flow limits may go up even more

[BoxcarPete]

Unlower your pressure some. Flow limits are indicative of a partial blockage and can contribute to excess arousals. If you were having good results at your previous pressure with the MAD, you can try going back to that and seeing if it works. You may just be a little under-titrated right now, so I would go back up a little to something like 9 EPR 2 and see how you do.

[Cheesedream]

Thanks pete

I kept it for another night just to make sure and the flow limits were not great again. They do seem to get better and worse throughout the night and i did read that chin tucking can cause flow limitations?
Is it worth trying a soft cervical collar as they're fairly cheap?

In regards to other health issues, ive had bloods to check kidneys, liver, cholesterol, diabetes (hba1c), red blood  cells, white blood cells, thyroid, b12, vit D, Folate, potassium etc. I've also had an echocardiagram, a cardiac CT angiogram and a holter monitor and all has been good other than SVT that the holter monitor picked up. My platelet distribution width was in range but at the higher end and my dr seemed fine with it. i have read that blood markers like that have links to sleep apnea as well.

I haven't had my testosterone levels checked but i will get that done.


Here is last nights oscar report

[Cheesedream]

When I look at other people's oscar reports on this forum mine look brilliant but I feel absolutely exhausted. 
Its making me really wonder if there is something else wrong.
I know the flow limits aren't great, does that mean there is likely arousal? Could the lack of quality sleep due to the flow limits still be making me feel this rubbish even though the apnea events are under control?

[BoxcarPete]

It's certainly possible. I don't think your charts look brilliant, I think you look under-titrated at 6/4. The main reason to lower pressure is to avoid leaks, aerophagia, etc. but you were doing OK at 11 IIRC, so why not try bumping it up a little? 8 or 9 should be completely tolerable for you and I expect that you'll see some improvements in hypopnea and flow limitations with the combination of your MAD and a little more pressure.

FLs represent partial blockages, and are often the cause for arousals which can lead to non-restorative sleep in some people. Others it seems not to bother too badly. I see a fair number of flowrate spikes in your daily chart which could indicate either respiratory or spontaneous arousals. Get your FLs and hypopneas down, then we can see if any of the arousal spikes remain.

[Cheesedream]

i havent been on for a while as i've been giving things a good go for decent amount of time before making changes.
I've changed to a nasal mask with a cervical collar (to stop mouth leaks) because i was constantly waking up when a ffm was making me uncomfortable but i may change this back.

It started off with fairly high flow limits so i have slowly titrated the pressure up over a few weeks to 12cm epr 3cm. Now the flow limits are below 0.05 but their are still a lot spikes throughout the night. could this be waking me up? i still feel terrible whether i have 4 hours or 12 hours of sleep!
The other issue i am seeing is that my tidal volume and minute vent has come down as the pressure has gone up. is this because of exhaling against pressure? Im at maximum epr now so if that is the case the only resolve would be a bipap if im not mistaken?

i've attached the last 3 nights oscar reports and as you can see the flow limit numbers are great bet there are a good few spikes and the tidal volume on the 6th and 8th are pretty rubbish. this has been the case since upping the pressure.

Could i be feeling bad because of sleep interruptions due to flow limits or tidal volumes? high co2 because of tidal volumes?

These questions might seem stupid because i dont know too much but im trying my hardest to find the cause of the problem. Im only 38, i shouldnt be feeling this awful!


The dr is doing more tests fore coeliac and nutrient deficiencies as im having some digestive issues at the moment but everything else has come back clear (heart scans, chest xray, blood work etc)

[BoxcarPete]

Hate to tell you this, but I don't see anything in particular that's amiss in your sleep charts. You do have some spikes in flow rate which may be sighs or may be related to sleep arousals, but if they are, they're what we would refer to as idiopathic or spontaneous: without a clear indication of cause.

Keep looking for what's bothering you. Most/all autoimmune diseases start the same way with non-descript symptoms of fatigue and general malaise, and eventually declare themselves with more specific symptoms. Plenty of them affect your gut as well. Probably not what you'd like to hear, but at least it's a lead to follow and it sounds like your doc is already on that track with Celiac testing.

[Cheesedream]

I appreciate the help Pete.

You don't think the low tidal volumes are enough to be causing issues then?

If it all looks OK I'll just have to keep trying to find the issue elsewhere.
It's like you say, fatigue and malaise go hand in hand with alot of issues and I thought the sleep apnea was the cause rather than just one of the causes.
I self diagnosed this sleep apnea by wearing a recordable pulse oximeter and seeing huge spo2 drops during sleep (into the 70s). I might try and wear it throughout the day to see if I'm having daytime desaturations too. Maybe it's a lung issue or something