Another low (really low) AHI but tired - first time OSCAR user

[xtracheese]

    Hi everyone - I've been a CPAP user for about 5 years and had pretty good success until the past year.  Started waking up tired sometimes, and then more often than before so I went digging for answers.  I have realized that the sleep clinics, Drs, NPRs, etc. aren't experts in how these work and just so your numbers are low, they don't really care to help.  The equipment supplier has been better but still they're not gurus in fine detail.  

I have been reading over anything I can find on reddit and here and have realized y'all are the experts and OSCAR data is my best shot to figure this out.  I would greatly appreciate your help.  I am where I can't function the 2nd half of the day.

At diagnosis:  6-8 pressure range, P10 pillow mask, Resmed 10 APAP.  The humidifier makes my nose clog up so I adjusted it to 82 degrees and level 1.  Turned off EPR and turned off ramp

Now:  7-15 pressure range (supplier suggested I go high on the range b/c the "machine would figure it out" so I did), tried other masks (Resmed N20, Philips Dreamwear), Resmed 11 b/c the Soclean I was using eventually wrecked my 10 (it started whistling)

Worth mentioning:  I am a back sleeper and always have been.  Tried sleeping on my left side and that did help when I could stay asleep, but I can't stay asleep/consistently in that position.  I've had neck surgery before and am broadshouldered...just can't get comfortable no matter what I try.  Noticed I tuck my chin sometimes when I sleep so I've been experimenting with a cervical collar (not reflected in the days I uploaded tho).  I use mouth tape sometimes but actually noticed a few times it seemed worse when I taped as to when I didn't.  I've also put on about 20 more pounds unfortunately in that 5 years.  I'm not obsese but I'm not in prime shape either.

Here are two days this week, two screencaps per day.  One captures all the recommended graphs but snore, and the other one captures snore. 

Grateful for any help.

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Here are the other two screencaps.

[staceyburke]

Your pressures are fine but you should try EPR.   Set EPR full time and EPR 3.  That will help with your flow limits. Fl are what drives up your pressure and they are apnea just like O and H events.  FL are shorter and not counted in the AHI.

[xtracheese]

Your pressures are fine but you should try EPR.   Set EPR full time and EPR 3.  That will help with your flow limits. Fl are what drives up your pressure and they are apnea just like O and H events.  FL are shorter and not counted in the AHI.

Thank you Stacey.  I would have never considered changing that as I thought it was a comfort-for-new-users setting that needed to be disabled as soon as possible.  I’ll try that tonight.

[Phaleronic]

Welcome to the forum xtracheese

I'm not a believer of EPR being a fix all for flow limits, and since you're not having any clear airway events you may have some crop up when turning on EPR straight to 3, with your minimum pressure at 7cm if you turn EPR on to 3 you will lose some apnea control so I don't think turning it on is the right path here, if you really want to try EPR to see if it mitigates the fairly low FL peaks I would try it on 1 for a few nights. I was going to suggest just bumping up your minimum pressure to 8cm to see if it takes care of the sporadic hypopneas and somewhat normal FL spikes. Your charts look pretty darn good, how are you feeling with these settings and decent charts?

[xtracheese]

Welcome to the forum xtracheese

I'm not a believer of EPR being a fix all for flow limits, and since you're not having any clear airway events you may have some crop up when turning on EPR straight to 3, with your minimum pressure at 7cm if you turn EPR on to 3 you will lose some apnea control so I don't think turning it on is the right path here, if you really want to try EPR to see if it mitigates the fairly low FL peaks I would try it on 1 for a few nights.   I was going to suggest just bumping up your minimum pressure to 8cm to see if it takes care of the sporadic hypopneas and somewhat normal FL spikes.  Your charts look pretty darn good, how are you feeling with these settings and decent charts?  

Thank you!  I appreciate all input.  I’m feeling groggy and tired, not quite as bad as before I was diagnosed, but enough to know something needs to change.  When I can sleep on my side things are better, but I can’t seem to do that without pain and discomfort.  I just need to lose this fuel tank I gained.