Improving CPAP effectiveness

[flanksinatra]

Hello everyone! I was prescribed an APAP/CPAP machine about 2-3 months ago. My AHI during my sleep study I believe was around 8-9 (at home test). After about two months of use I do feel more rested in some regard. However, I still am feeling quite tired most of the time and still wake up multiple times per night. I will say there have been a few nights where I felt amazing the next day. Although that has really only happened a handful of times, and I can't seem to isolate what about those nights were different. I have been increasing the min pressure on my machine (ResMed AS 11) and I have not seen a major improvement. 


I also feel that I can get my AHI down more. Most nights it is around 2-4. I know that >5 is considered ideal. However, given that my AHI was only 8 without CPAP I feel that I should be able to get my AHI to >1. I have also been reading posts on the forum and from other sources about analyzing OSCAR data, and I have noticed what I believe to be breathing related arousals that are not being flagged. So in reality it seems that I am waking up more than what is reflected in my numbers.


I really want to feel rested again. The few nights where I did feel rested have been driving me crazy, I craved to feel that way again. I will include some screen shots of OSCAR. I will also include some zoomed in images of my breathing. If anyone has any advice or has gone through a similar situation, please let me know.


Jun 13: https://imgur.com/a/mCsD4D2 zoom: https://imgur.com/a/k3rvBsr (AHI = 3.64)


Jun 1: https://imgur.com/a/gHWrMEn zoom: https://imgur.com/a/0J8sLWP (AHI = 2.04)


May 12: https://imgur.com/a/Ig1xO6v (AHI = 4.79)


Apr 29: https://imgur.com/a/SGUgBvA (AHI = 1.43)


I apologize if this post is too long or if I included too many images. I just want to make sure I am as detailed as possible. But again if anyone was in a similar situation as me or has any advice at all please let me know. Thanks!

[staceyburke]

I would try EPR 3 for a night or 2 and see if that helps.  You still have some flow limits and this would help that.

[flanksinatra]

I actually already have some data from nights where I set my EPR to 3. I have gone through cycles of changing my EPR. I have seen some forums where people say it helped and some where people say it made therapy worse. I will include the images in this message. Thanks for the reply!