06-10-2021, 01:08 PM
RE: Oscar data help bipap
I don't 'know' the answers but will give my thoughts about your questions.
sometimes I feel fine with 0.0 ahi compared to higher ahi's under 5. maybe more often I don't. for me, sleeping longer than 2.5 hours without masking off is the exception rather than the rule. I think my 0.0's tend to occur when I don't sleep long enough to get into deeper levels, during which I'm more apt to obstruct. in this case, 0.0 isn't a good thing.
regarding 5 hours vs 8 or 9, I've experienced the same thing, but I doubt feeling good on 5 hours is sustainable for most people. I know we sleep in cycles and there are apps that attempt to monitor these in order to wake us at some optimum time determined by what part of the cycle we're in. unfortunately I haven't slept too long in years but I remember feeling groggy if I did so in the past. my guess is there's a happy medium in there someplace and if you pay attention, your body will tell you what it is.
I also wonder: if our pre-cpap bodies are used to x hours of apnea interrupted sleep, it's possible that having few to no apnea with cpap leaves us feeling much better, even if fewer hours. intuitively I suspect this is a temporary thing and we're likely to sleep longer as we grow used to few to no apnea and as we tire ourselves less destructively with more physical activity as our energy levels increase.
I think only you can answer #2 depending on how you feel.
as you know, the medical / insurance folks say ahi under 5 is treated. that's the only reason I said you might lower epap until ahi rises to 4.9. otherwise it depends on how you feel. your charts look good so tweaking settings is for comfort. it's not clear what's leaving you feeling less energetic than you'd like. it's a longshot but if it's related to pressure or leaks, you seem to have room to reduce epap. no harm in experimenting; if/as/when ahi increases to the point you can feel the difference in how you feel, stop reducing epap and maybe nudge it back up until you find the setting at which you feel best.
the point is, as you know, ahi is one measure; how you feel is as- or more- important than ahi, especially when below 5. sometimes we are better off sacrificing ahi a bit for other benefits like fewer leaks, avoiding aerophagia, or in my case with asv, avoiding actively swinging pressure support.
like I said, we don't know why you feel less than rested so any further setting tweaks may or may not solve the problem. you can experiment and see. it could simply be a matter of time.
meanwhile, pay attention to things other than sdb and pap. journaling and video may be useful next steps.
sometimes I feel fine with 0.0 ahi compared to higher ahi's under 5. maybe more often I don't. for me, sleeping longer than 2.5 hours without masking off is the exception rather than the rule. I think my 0.0's tend to occur when I don't sleep long enough to get into deeper levels, during which I'm more apt to obstruct. in this case, 0.0 isn't a good thing.
regarding 5 hours vs 8 or 9, I've experienced the same thing, but I doubt feeling good on 5 hours is sustainable for most people. I know we sleep in cycles and there are apps that attempt to monitor these in order to wake us at some optimum time determined by what part of the cycle we're in. unfortunately I haven't slept too long in years but I remember feeling groggy if I did so in the past. my guess is there's a happy medium in there someplace and if you pay attention, your body will tell you what it is.
I also wonder: if our pre-cpap bodies are used to x hours of apnea interrupted sleep, it's possible that having few to no apnea with cpap leaves us feeling much better, even if fewer hours. intuitively I suspect this is a temporary thing and we're likely to sleep longer as we grow used to few to no apnea and as we tire ourselves less destructively with more physical activity as our energy levels increase.
I think only you can answer #2 depending on how you feel.
as you know, the medical / insurance folks say ahi under 5 is treated. that's the only reason I said you might lower epap until ahi rises to 4.9. otherwise it depends on how you feel. your charts look good so tweaking settings is for comfort. it's not clear what's leaving you feeling less energetic than you'd like. it's a longshot but if it's related to pressure or leaks, you seem to have room to reduce epap. no harm in experimenting; if/as/when ahi increases to the point you can feel the difference in how you feel, stop reducing epap and maybe nudge it back up until you find the setting at which you feel best.
the point is, as you know, ahi is one measure; how you feel is as- or more- important than ahi, especially when below 5. sometimes we are better off sacrificing ahi a bit for other benefits like fewer leaks, avoiding aerophagia, or in my case with asv, avoiding actively swinging pressure support.
like I said, we don't know why you feel less than rested so any further setting tweaks may or may not solve the problem. you can experiment and see. it could simply be a matter of time.
meanwhile, pay attention to things other than sdb and pap. journaling and video may be useful next steps.
I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it. 
