[CPAP] Fyremaker - Therapy Analysis

[fyremaker]

Hello all!

First time poster but long time lurker.

I was diagnosed (using Lofta) with moderate sleep apnea in July of 2023 and was prescribed a CPAP machine, a Resmed Airsense 11.
(quick summary: ahi ~18, rdi ~35, lower ahi and higher rdi, not sure what to make of that)

45yo male, 5'9" 265lb (working on getting that weight down).

I've attached the first two pages of my sleep study results.

The prescription was 4-20 and to titrate.

I started July 3rd and have used it faithfully every night since then.  

But I didn't leave the settings there, I purchased an SD card and use OSCAR to view each night's outcome and to fine tune my values.  I'm currently 11.6-13.6 with my 6 month 95% pressure at 12.

But even after all this time and custom values I feel like I'm still tired during the day.  Now I'll say that it's a very different kind of tired than before I started CPAP but I feel like I'm 90% there with my therapy and that a solution is within grasp.

Please see attached OSCAR screenshot.

sleephq.com/public/e6b2c452-7cd6-4f9d-a980-571b307a8c74
for those who wish to zoom in/out on SleepHQ (sorry no links allowed for me yet).

I can post other OSCAR dates and at least 30 days of SleepHQ if needed.

If some kind souls would look over my data and give me your thought I'd be very appreciative. 

Thank you!

[fyremaker]

Another good night, slept right through.

But still fairly tired throughout the day, not fall asleep at my desk tired (like before cpap therapy), but rather just a general tiredness.  

Does anybody has any thoughts on my charts?

Thanks

[Deborah K.]

You are doing great! The only change I suggest is that you turn ramp off. You don't get any real therapy during ramp and you don't need it.

[HalfAsleep]

Maybe something else is going on. Perhaps check in with your PCP? Even something as apparently minor as low Vit D levels can wipe a person out. It's very easy to get the supply drained by the time spring rolls around, since we don't get much sunlight in winter.

[fyremaker]

Thank you guys for your replies!

[PeaceLoveAndPizza]

it is all about fine-tuning at this point. Even small incremental changes can make a big difference in how you feel.

One further thing to try is slowly bumping up your min pressure by 0.2 increments to see if the flow rate smooths out a bit. Leave the max pressure as is for now.

Another thing to give a go is a fixed pressure of 12 with EPR=3. Close to where you are now, but it would remove the pressure adjustments from the equation.

[UnicornRider]

I agree with Deborah and HalfAsleep

Along with the Vitamin D, tests that could aid in resolving excess tiredness include TSH (Thyroid Stimulating Hormone), Anemia, Iron Serum, and a CMP (Comprehensive Metabolic Panel), see if they have a recording Pulse/Oximeter you can borrow for a couple of days. There are some nasty respiratory illnesses that can cause you to desaturate SpO2, for a long time after you think you have recovered.

Then after you have had your Primary care Physician check all of that, remember that years of sleep deprivation is not going to be reversed for a very long time in most people.

 You are to be commended for the tuning parameters you have fine tuned your machine to, AHI is excellent.. Your Flow Limits is very respectable, and as for outside items you have control over, your leak rate is very good.

 As for the weight, keep working on it, get it off while you are still young. You have a lot of life in front of you, try to enjoy the journey, get outside and do stuff. Being in nature is healing for the mind and body. Memories are more precious than possessions.

Post back when you have some more to share or if you have any questions.

[UnicornRider]

Also everything PL&P recommends, he knows his stuff. The reasoning he gives is valid.