Low AHI, tired foggy mind

[Artanox]

First of all, thanks to anyone who will take time to read and try to help me with my problem.
I've been using CPAP therapy for over 4 years now, i'm sharing data from the past 6 month from my new prescription.
I'm willing to share all the data i posses if needed.
Even if on average i have a low AHI i still feel very tired, confused, mind foggy ecc and i cant find the cause of it.
I got diagnosied with ADHD because the symptoms are pretty similiar but the meds are doing nothings, i think the cause is sleep apnea because sometimes i sleep better and feel better and i wanna address this problem but i dont know how.
I'm a side sleeper, i dont use a particular equipment, i have a sh**ty bed, sh**ty pillow, tried to use a chinstrap but i dont know if i need to use one, i have dry mouth.
I'm using an Airfit F20 medium and i think it's too large and ordered the small because i think it's too big, tried the foam one but it ruined pretty fast. 
Sorry for the bad english

I will share more data after work, thank to anyone who will take time into this.
           

[Plmnb]

Hi.

Are you able to post your OVERVIEW of the OSCAR chart?  The screenshot of your graphs for the night.  Advisors will want to see your wave forms and other data.

[Artanox]

Do you mean the daily?
   
   
   

[Plmnb]

Yes.

I'm interested because I am having some similar issues and wanted to see if your charts look anything like mine.

Thank you and I'm sure someone will be along soon to help you 

[Plmnb]

Welll, I am absolutely no advisor expert, but like I was, you are having a bad large leak problem.  I seem to have corrected that but I'm still having issues.  However, large leak correction is a place to start.

Mask size does play a role for sure but other factors may be contributing.  In my case I started to make sure I washed my face and mask seal every night, (my mask has a silicone seal).  I think I finally got the straps to fit well for my face.  This is when the large leaks started to go away.

Other than starting to use cannabis products around the same time my leaks got better, I have no clue what happened to make my large leaks go away.

Do you have zooms of your FLOW RATE that will show the waveforms more clearly?

[Expat31]

Several things you must do:-

1. Stop the leaks. 

2. Your machine is of little use in this situation. The algorithm cannot work properly, the graphs are basically of little value in your treatment.

3. When you get the smaller mask, experiment by sleeping on the edge of your pillow so the mask is not pushed too much during the night. Many people have 3 or 4 masks before getting the right one. It is very important, and much patience is needed.

4. Important the mask is not too tight. Best to adjust the tightness when you are in the sleeping position.

5. Buy a pillow that is quite thin.

6. Set EPR to 3 full time.

7. If you are taking any medicines that effect your nervous system, these may have an impact. Check with your doctor.

8. It is not clear if you have had a sleep study in order to get a prescription for a CPAP.  If you have had  one, details of AHI, obstructive, central, hypopneas, sleeping positions etc.

Several days of good data are needed (with leaks much reduced) in order to move ahead.

[Artanox]

Several things you must do:-

1. Stop the leaks. 

2. Your machine is of little use in this situation. The algorithm cannot work properly, the graphs are basically of little value in your treatment.

3. When you get the smaller mask, experiment by sleeping on the edge of your pillow so the mask is not pushed too much during the night. Many people have 3 or 4 masks before getting the right one. It is very important, and much patience is needed.

4. Important the mask is not too tight. Best to adjust the tightness when you are in the sleeping position.

5. Buy a pillow that is quite thin.

6. Set EPR to 3 full time.

7. If you are taking any medicines that effect your nervous system, these may have an impact. Check with your doctor.

8. It is not clear if you have had a sleep study in order to get a prescription for a CPAP.  If you have had  one, details of AHI, obstructive, central, hypopneas, sleeping positions etc.

Several days of good data are needed (with leaks much reduced) in order to move ahead.

Yes i have prescription for the CPAP, started by self diagnosing and then got a state prescription.
I drink a lot of coffee because i'm always tired, trying to cut on it. 
Will buy a cervical collar just to try if it can help with obstructive apneas.
I will dump more datas later, i dont know why i leak so much maybe i move too much during the night?
I had no problem with EPR to 3 and will set it again.
What do you mean with the algorithm cannot work properly?
anything else i can do? thank you guys

[Expat31]

I very simple terms, the CPAP is a machine delivering precise pressures to be able for open airways for the user.

The airflow is closely monitored with a series of sensors, second by second, so it can react in relation these changes, either increasing or decreasing pressure. 

With significant leaking, a chaotic airflow environment would be created. 

The machine's sensors would try to react to these "false" indicators, and especially the timings, and would not correspond to the parameters set in the algorithms. 

The result would be incorrect pressure therapy, and especially the graphical readouts used for clinical review.

From what I remember reading, the algorithm monitors the waveforms be be able to deliver correct pressures. If these waveforms are "artificially" distorted, well you can imagine the result.

This is purely my layman's understanding. 

Leaks in addition cause sleep arousals, disturbing quality of sleep.

I suggest you may want to do your own research if my explanations are insufficient.

[Artanox]

Feeling so stupid, the leak were caused from a broken L connector to the back of the cpap machine, now 2 nights with a new one
I already feel better and this is fucking amazing. havent feel this lucid in years and i'm so happy!

With cervical collar
   

Without cervical collar
   

Still something seems off, any advice? thanks. already very helpfull.

[staceyburke]

I'm glade you have found some answers to your problems. I still see a lot of flow limits. You could try some
EPR (exhale pressure relief) that would help with those. Flow limits are apnea just like O and H events - SAME thing only smaller. They can wake you up or stop you from getting a good nights sleep and they drive up pressure. Your most recent nights charts had lower flow limits but you could do better.

I would suggest these changes in your setting.

EPR on FULL TIME
EPR 3

That is the highest setting for EPR (1, 2 or 3) Give it a try I think you will like it better and have a more comfortable night.