Still Tired - Examining OSCAR Data

[DKeranen]

Hi Everyone,

I was diagnosed with mild sleep apnea (AHI ~6.2) via an in-lab sleep study in early 2022. At the time, my doctor did not think that the mild sleep apnea could be the cause of my fatigue. However, in the fall of 2023, after many other specialist referrals and causes ruled out, a new respirologist said that it was very possible that the sleep apnea was causing my symptoms.

I started using a CPAP machine in early December 2023. My symptoms have improved a bit (no more brain fog), but I'm still so tired throughout the day, despite getting 9+ hours of sleep every night.

My AHI is consistently under 5 (typically around 2-2.5), and I'm wondering if it is still possible for the sleep apnea to be the cause of my ongoing fatigue. I have attached three screenshots of my OSCAR data - one from about a month ago, one from last night, and one that shows a closer look at a few minutes from last night. I included the zoomed in screenshot because I read a post that linked to an NHI article that described Flow Rate in sleep-disordered breathing (Fig. 5/Table 1 in "The role of flow limitation as an important diagnostic tool and clinical finding in mild sleep-disordered breathing" - unfortunately, I'm unable to link to it directly because this is my first post on this forum) and am curious if the pattern in my flow rate graph is something to be concerned about/considered or if it just shows a regular breathing pattern.

If anyone who is experienced in reading OSCAR data could help me interpret these graphs, it would be much appreciated! Are there any problems that you see? Or does it seem likely that the CPAP is doing what it needs to do, and I should continue investigating other possible causes for my fatigue? I think that movement in my sleep has caused some leaks (the hose pulls on my F&P Eson mask, causing it to shift on my face), and am planning on purchasing a mask with a top-of-the-head hose attachment to avoid this issue, but am not sure if there is more to be done.

Any/all advice is welcome! Thank you in advance.

[Sleeprider]

We need to get you to a bit higher minimum pressure to stabilize the changes in pressure and prevent more of the obstructive events. your current settings are 6-16 with EPR 2, I'd like to increase that to 8.0-16.0. If EPR 3 is available, use that as well. We will look for a reduction in obstructive events with the higher minimum pressure. Flow limits are periodic and may be associated with leaks or sleep position. We want to watch that to see if it is movement or sleep position causing leaks and flow limits, or how that might be happening. You may want to read the positional apnea wiki for some ideas. https://www.apneaboard.com/wiki/index.ph...onal_Apnea

[DKeranen]

I really appreciate the advice - thank you!

I've just adjusted the settings on my machine to up the minimum pressure to 8 and EPR set to 3. I'll give that a try tonight and am reading up on positional apnea now.

Are you able to comment on if the pattern show in the zoomed-in flow rate graph is cause for concern?

Thanks!