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Fine tune APAP for possible UARS
#1
Fine tune APAP for possible UARS
Hi all, hope you're keeping (and sleeping) well. I've been a reader of the forum for a little while now but I'm at the point where I think I need some specific advice.

I've had sleep issues 2-3 years now but only been on APAP 6 months. I've stuck to it consistently with AHI between 0 and 2, sleeping 7+ hours a night, but still fatigued. I'm in my mid 20s and not overweight, but had a deviated septum I think might have been contributing. I did a home WatchPAT sleep study for my diagnosis and scored AHI of 6/hr but RDI of 22/hour, so I'm wondering now if it's UARS issues.

I had a septoplasty 2 months ago after having not being able to breath through my nose. It's still tender but mostly healed and I can breathe through it now. I've switched to the nasal mask the last week. I finally had a night without major leaks or abnormally high AHI so I thought I could post it here and maybe someone could give me advice on fine tuning to improve things, or can tell me where my issues are and why I'm not improving.

Before I used the default APAP settings, Autoset, 4-20 pressure, Full face mask, no ramp or EPR. I was waking up congested so turned up the humidity and tube temperature to max and that helped. To accommodate the FFM I switched from front to side sleeping and sleep on my side every night now.

When I switched to the nasal mask I tried some of the advice I read here about max and min pressures and adjusted the minimum to 8 and max to 15 based on my 95% pressures. I also saw some advice about EPR helping with UARS so set it to 3.

My apneas are generally 75% hypopneas and 25% clear airway with the FFM and standard settings, but this last night with the UARS specific settings they were all CA. My ENT said there was a chance I may not need the APAP after the septoplasty so I'm wondering if the APAP could be inducing CA and making my sleep worse than no machine. It's hard to tell since my machine doesn't detect RERAs and RDI. I slept with no machine the other day and didn't feel much different, but it's hard to tell without sleeping many nights with or without. I wanted to ask here first anyway.

Thanks in advance for any information anyone can give me, I really appreciate this site as a resource. I've attached my graphs, let me know if I need to reformat them. The snore graph had no data so I haven't included it. I also included a typical night from when I was using the FFM for comparison.
   
   
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