Lower AHI after machine, still tired. Settings?

[btuger]

Hello, hope you're all doing well!

After a sleep study, I was diagnosed with a 5.2 AHI, with a 17.6 RDI. Not necessarily too high, but constantly tired, constantly waking up. For this, I was given a Resmed Autosense 11.
These were the following settings that were given to me at first:
MIN: 4
MAX: 12
Ramp with EPR on Ramp Only.

I turned off Ramp, it didn't feel right. In terms of AHI, it does seem there's an improvement. However, I still feel quite tired and more importantly, I'm constantly waking up at around the same time as there's an event. These are these past two days. I believe I could increase min pressure to around 7 but I'm not sure it'd be correct.

Could you please advise me? Thank you

[staceyburke]

Welcome to the board... It looks like pressure changes are waking you up.  Look at the pressure chart, it looks like a rollercoaster.  Swings like that will not allow you to get into deep sleep and can wake you up.


The reason the pressure is going up are Flow Limits.  Compare the FL chart to your pressure chart, you can see a direct correlation.  Each time you start to have a group of FL your pressure goes up.

To help with that we need to make a couple of changes to your settings.

Min 7
EPR Full time
EPR 3

Leave other settings alone.  Give it a try tonight, I think that will help.

[btuger]

Thank you and thank you for the reply as well. Indeed, those do seem to quite linked in the graphs above. I'll give it a try for a couple of nights, see if it helps and post the results here.
I did read though that EPR 3 can increase CAs? I'll keep an eye on that as welll.

[Deborah K.]

You don't have enough CAs to worry about.  Set EPR at 3 and leave it there, even if the CAs increase some.

[btuger]

Ok, so I won't worry about CA at this level. I increased the minimum frequency and left EPR 3 Fulltime. Feeling-wise, it's the same though. Tired, slight headache.

Seems like I woke up less, once at 1:50 and then around my usual wake up time. The large leak around 2 is me adjusting the mask and the flow limits seem to be smaller but still impacting the pressure graph. The max pressure seems to have reduced as well.

Should I continue with these settings for a couple more days?
Min: 7
Max: 12
EPR: 3 Full-time


Thanks

[Deborah K.]

I think you would sleep better with a minimum pressure of 8.4. Switch to that.

[Dormeo]

Most people need at least 7-8 hours of actual sleep, which means, for most of us, 7.5-8.5 hours in bed. Give it a try!

[btuger]

So I did increase to 8 (I'm not sure I can set it to 8.4) but tonight it sucked. Extremely fragmented sleep, with added insomnia, the mask was bothering me a lot (AirFit P10) to the point I had to take it out. At some point, put it back on but changed it to the AirFit N30.

I don't think it's due to the pressure though, it was just a rough night. I'll see tonight.


Concerning the sleep hours @Dormeo, I wish I could. I was never able to sleep that many hours, not even as a teenager. When I wake up towards the 5h30/ 6h, I can't fall back asleep. If I go to bed around 22h, I keep waking up, even if I do have a good sleep hygiene I believe.