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[CPAP] Still tired after 4 months of CPAP
#1
Still tired after 4 months of CPAP
Hello everyone, 

Long time lurker on these threads and I've learnt so much about CPAP treatment and different thing to look for on my Oscar data on here. Finally decided I may need some help from the people here after 4 months of fiddling around with settings and different mask types and still being tired most days.

Brief history, I was diagnosed with moderate/severe sleep apnea early September with an AHI of 36 and have been using a CPAP ever since. Initially, the min pressure was set to 5 and max to 15. After the first month, I had a titration done and the doctor recommended I set my min pressure to 8 and max to 12. Since 8 felt like too much pressure for me, I changed it from 7 - 12 and after many days of tweaking I am currently at 7.4 minimum and 11 maximum (EPR: 2). I use a Resmed airsense 11 with an Airlift N30i mask and humidity usually set to auto. 

The issue is that after 4 months of usage I'm still tired. My AHI is usually between 2 and 3 and sometimes dip below 2. But I cannot find a relation between my AHI and how tired I am that day. Some days I have a high AHI but I am not too tired, and sometimes I have a low AHI and have to lie down several times a day to be able to keep going. Luckily I am still working from home. I use an Apple Watch to bed and have seen some dips in O2 levels but I am not too sure about the accuracy on this and have ordered a Lokee O2 ring for more data on my O2 levels. 

I was hooping the experts on this forum could shed some insight on why I would still be tired after 4 months use. I am usually fine when I wake up but get tired in a few hours. All the other posts I have seen on this forum, for most people they are tired as soon as they wake up and get better later, which is the opposite of how I seem to be functioning. I also feel better if I lie down for 10-15 mins with my CPAP on. All of this is so confusing, but as per my sleep doctor I am picture perfect and I should be tired any more seeing my AHI. 

Attaching screen from last night.

Thank you!


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#2
RE: Still tired after 4 months of CPAP
Just adding a couple of more days data. 

PS: I also use a wedge pillow when sleeping at night.


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#3
RE: Still tired after 4 months of CPAP
It would help if you would show the whole night in your OSCAR chart and also remove the calendar.
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#4
RE: Still tired after 4 months of CPAP
Hi @Old Steve

Thank you for the quick response. Please see attached whole night graph from last night and the night before. Please let me know if there is some part of this I should be zooming in on.

Thank you


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#5
RE: Still tired after 4 months of CPAP
Adding an additional chart with SpO2 data as well since my ring came in yesterday. I've been skipping on my afternoon naps past 2 days and have been feeling considerably better. I am not sure how it works but happy it does.


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#6
RE: Still tired after 4 months of CPAP
I would try raising your minimum pressure to 8.4cm and your EPR to 3cm.  I know you thought that 8cm was too high for you, but it is actually a lower than average pressure.  Try it for a few days and see if it helps with the way that you feel.  
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#7
RE: Still tired after 4 months of CPAP
Thank you!! Will try this during the weekend and report back :-)
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#8
RE: Still tired after 4 months of CPAP
Hi,

So it's been a month since I last posted and in that time, I've bought a pulse oximeter and have started adding that data to OSCAR as well. 
I also tried a full face mask (F30i) which I could not adjust to. Well, I just tried one night and had a lot of OAs and from the graphs it's apparent that I need to up the pressure levels to get it to work as it should. But I will leave that for a long weekend because I really cannot afford to be tired during work anymore. I moved to full face mask hoping to reduce leaks, but now instead, I am taping my mouth and the leaks seem to be mostly under control.
Reason it took me a while to post again is because I was increasing my pressure by 0.2 every week and I give myself time to adjust to the pressure gradually. I went up to 8.2 but that went pretty bad so I brought the pressure back to 8.0. I am fairly more energetic now and will keep using 8.0 for a while. My med pressure just keeps going up the more I increase my min pressure. 
I still have my headaches, but I am hoping it will go away in time. But, I will post my most recent graphs here for any helpful feedback. I am seeing my family doctor again today to discuss any more ideas he may have since my bloodwork came back pretty clean as well. 

Thank you


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#9
RE: Still tired after 4 months of CPAP
You are showing some improvement, but you are still having some OA's. Some of your charts appear to show some minor positional apneas (clusters of apneas).  If you sleep on your back you could try sleeping on your side.  Also, when you are in APAP mode your pressure will run up high and then down low.  As you are pressure sensitive you may want to try running in CPAP mode.  This would keep your inhale pressure at a constant 8cm and with your EPR set on 2 your exhale pressure would be at a constant 6cm.  This is how I run my machine and I find that I get fewer arousals and apneas this way.  I still think that you need a little more pressure, but running in CPAP mode may help too.
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#10
RE: Still tired after 4 months of CPAP
Thank you Old Steve! CPAP mode is something my doctor advised as well, but I have been worried I may not get enough pressure when needed. But I will give this a shot! Cheers!
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