Need Help-AHI < 5 but still tired

[Thomas021923]

I have been using CPAP for more than a year now. I have now managed to get the AHI level to be consistently below 5 and Obstruction to be less than 0 but I am still tired during the day. I have tried different pressure settings using CPAP and also auto APAP but it doesn't really change how I feel. I have enclosed the last couple of nights using various auto and fixed pressure settings. Can some body please help point me in the right direction and what I should do? I am out of ideas.

Thanks in advance.

[Thomas021923]

I forgot the screenshots. Here they are.

[staceyburke]

Try these settings for a couple nights

Min 7
EPR full time 3
Max 20

EPR will help with your flow limits. FL are apnea also the same as O and H events. They stop you from getting deep sleep and can wake you up.

This setting will give you an inhale pressure 7 and exhale pressures of 4.

You need to give it a while and get better sleep for a few days to see any changes.

[racprops]

I will add my 2 Cents: I too fought with brain fogging and tiredness for two years after I was switched from a ASV machine to a APAP.

The problem was/is although like you I was able to get my AHIs below 5 per night I was NOT getting GOOD sleep.

Good sleep requires DEEP sleep cycles and REM sleep cycles. With out them I could sleep 10 hours and still be groggy all day.

In my case I got a ResMed Sleep Score Max system and saw that the simple APAP was cutting my DEEP sleep cycles and REM sleep cycles short.

And in my case switching back to a ASV machine solved my sleep cycle problem.

Rich

[CorruptAlligator]

Sorry, this had to be asked on my part

@racprops, do you have so many CAs that needs treating? Is that why you use and ASV? A person with so low levels of CAs shouldn't require an ASV, but maybe a BIPAP would be an improvement over a normal APAP that the PS is maxed out at 3.

[Thomas021923]

Thanks for the replies.

---

Try these settings for a couple nights

Min 7
EPR full time 3
Max 20

EPR will help with your flow limits. FL are apnea also the same as O and H events. They stop you from getting deep sleep and can wake you up.

This setting will give you an inhale pressure 7 and exhale pressures of 4.

You need to give it a while and get better sleep for a few days to see any changes.

Thanks very much for the suggested setting. I will try it out starting tonight and will report back.

[Thomas021923]

Reporting back after using EPR setting change since 2/20/2023. Feeling much better since the change until today. Even though the numbers look ok last night, see chart enclosed, I felt tired today. But I will continue on.

Also, seems to look like the Clear Airways numbers seems to have increased and also Obstructive numbers a little bit since the EPR change.

[Thomas021923]

It seems to improve the first couple of days but then it got back the usual tired feeling. Any other things I could change to help?

[Phaleronic]

You're using a Resmed device, you can try a remediated Phillips device, it will help you sleep better. I'm one of the few on here that has tried both and the Phillips allows me to sleep better, juxtaposed with a similar AHI on DreamStation.