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Need help. Fatigue/Daytime sleepiness even with low AHI
AHI less than 2 but excessive daytime sleepiness and fatigue. High flow limitation too.
Currently using resmed 10 with philips dreamwear nasal pillow. I mouthtape and use a nasal dilator at night. I try to sleep by my left side but I also move during sleep.
My left nostril is blocked a lot of times. My ENT told it is due to allergies and slight deviated septum. I also have a large tongue apparently. Can the tongue might be causing the flow limitation?
RE: Need help. Fatigue/Daytime sleepiness even with low AHI
Can you please explain why? I am having a hard time understanding all these.
The pressure levels reaches mostly 10 at maximum. Why is 7-12 better than 4-12?
Understand that increasing EPR will help with the flow limitation. But is it recommended to do just keep changing a lot on my own?
RE: Need help. Fatigue/Daytime sleepiness even with low AHI
At 4 you're not getting any treatment, as an adult needs something like 7 for there to be any effect at all. Actually, personally speaking, at 4, while wearing a mask, I feel like I'm suffocating.
Lowest I'm happy to use is 9 and then my night spends most of the time at pressure of 10 (ish).
RE: Need help. Fatigue/Daytime sleepiness even with low AHI
Okay. Will try using 7-12 and EPR at 3. Will report back.
Any advice on the tongue blocking my airway.
1) I tried using a SC collar but i woke up with neck pain the next day and haven't used it again. Does the pain mean it was too tight?
2) Is side sleeping better for mycase? I feel my nose is bit free when i sleep straight compared to side sleeping, but it was recommended to side sleep in the forums.
RE: Need help. Fatigue/Daytime sleepiness even with low AHI
I noticed your flow limits are quite high, so that could be something to explore.
Do you know for sure your tongue causing the problem? If so, I think side sleeping is supposed to help, also there are mouth/tongue guards that might be worth trying just to see if it helps you diagnose the problem.
In my case, I have flow limits when I allow my head to tilt forwards, it literally stops me from breathing (bad design there God!!), but now I sleep using a travel pillow in the C shape while I sleep on my back, and doing so I found I have more or less eliminated my flow limits. Which is weird because for most of my life I was a side sleeper but still had terrible apnea and snoring. In my case, during the sleep study they noted I had problems whether on side or back, I suspect chin tuck is a major cause of my problems.
I relate my story to show how I figured out what was causing flow limits, you'll have to experiment a bit I think for your own case.
I also tried a cervical collar and found it too hot and I felt like I would choke, so I gave the humble travel pillow a shot and works great for me... Also I no longer need a normal pillow at all.
RE: Need help. Fatigue/Daytime sleepiness even with low AHI
It could be that you are one of those whose sleep architecture gets screwed up due to pressure changes on APAP.
I would suggest you set the machine to your 99 percentile pressure = (9cm or 10cm) with EPR = 0. And evaluate for 7 days minimum. You can use APAP mode and set max=min.
And then see if you feel better during the day.
Source: Personal experience.
PRS1 Auto & Dreamstation Auto w/ P10 and straight pressure of 8cm
RE: Need help. Fatigue/Daytime sleepiness even with low AHI
This is Today's report after changing to 7-12 and EPR =3. I don't know why the leak was high as I used the same routine.
Notes : I used all the water in the humidity tank, probably due to leaks. The 99.5% EPAP is 7.62 while the pressure is 10.62. What can I infer from this.
@Dodies I honestly don't know how should i be feeling. I don't know whether this is helping me or not. So just changing the settings without knowing what to look out for seems to be not a good idea, lol
@AshSF Why do you say to turn off the EPR as opposed to other people's suggestion?
RE: Need help. Fatigue/Daytime sleepiness even with low AHI
EPR is ehale pressure relief. if your min is 7 and EPR 3 that would be 7-3=4, 4 is the exhale pressure and is as low as the machine can go. EPR helps with flow limits and FL are obstructive sleep apnea just not large enough to be considered a H event. (at least 10 Seconds in length) And they are not counted in the AHI. Although they are not counted they can stop you from getting into deep sleep or even wake you up.
Problem - in some people EPR causes central apnea. Central apnea is you holding your breath. That can of course happen when you turn over in bed or pull up the covers. But it also happens when the body has less CO2 in the blood. And this happens when the cpap machine is working well and your body need to get use to the therapy and adjust the the new normal. That takes 2 to 4 weeks.
If you have a lot of centrals then we back off the EPR and give the body a chance to adjust. You do not have a lot of centrals and I would just monitor them to see if they get worse and if so you would want to decrease the EPR until your body ajusts and move the EPR up 1 and get use to that level. Again, your last charts do a limited amount of centrals and I would leave the EPR where it is for now.
