Still waking up tired

[Sleepyparrot]

Hi

I’ve been using a cpap - resmed Airsense 10 for over a year and whilst my AHI is typically below 5 I am still waking up tired and my Apple Watch registers a lot of micro awakenings and a lack of deep sleep (I know wearables aren’t the most accurate but I find it useful).

I am interested in any ideas to tweak my settings

Thanks for your help

[staceyburke]

Look at your pressure chart, it looks like a mountain range.  I have found that you get much more restful sleep the less change in pressure.  The Pressure in a ResMed is driven by the flow limits.  You have a lot of small flow limits and they stop people from getting deeper sleep and can wake some people up.

To combat flow limits we use EPR.  I would suggest 2 couple changes.

First raise the min to 8

Next make sure your EPR is set to full time and set it to 3.

I think you will get better sleep with those changes.

[Sleepyparrot]

Thanks I will try this

[Expat31]

Agree with the pressure settings, but would be easier to post just the following graphs, (in order of importance) :-

1.Events
2.Flow rate
3.Pressure
4.Leak rate
5.Flow limitations

Also your our settings section is currently obscrured.

Best result would be to get everything on one page. To do this, go to Preferences/Apparence and reduce graph height to say 100, and application font to 8 to see if this helps. It all depends on your screen resolution.

You could also just try the settings as below.

Just a bit of trial and error necessary.

[Expat31]

Oops, attachement should be this!

[Sleepyparrot]

Thanks for the suggestions - I made the pressure and EPR changes - didnt seem to have too much effect - have amended the graph settings and posted last nights results.  Not sure if I need to think about a full face mask - was reluctant to do this as I can sleep with my mouth closed well.

[Expat31]

You don't have any issues with leaking, so best to stick with nasal mask.

To try to reduce you obstructive events, increase your minimum pressure to 10 could help.

Did you have significant central apneas in your sleep study?

I am inclined to think you could also reduce your EPR to 2, which may help reduce these central events.

[Sleepyparrot]

Hi just checked the sleep study there were no central apneas - I will update the minimum pressure to 10 and reduce EPR to 2 - thanks

[Expat31]

That's a good sign. Quite likely they are "false" centrals, or often described as "machine induced" that should go over time once settings optimised

One further tweak to your graphs, try reducing application font a little more for the left hand section of the graphs. If you are at 8, try 6.

The right side now is now fine, but the snore graph is not of much use.

I would suggest that better to replace with the respiration graph. With this you can often detect REM sleep (but only once your settings are optimised as indicated in my first paragraph concerning centrals). 

During  REM sleep, breathing becomes quite rapid, and somewhat disorganised, often during dreams, which is an important period of good reparative sleep. This sort of information may be of interest at a later stage in assessing sleep quality.

[Sleepyparrot]

last nights graphs with the changes in graph font size, not much change from an AHI or quality perspective - let me know if I should tweak anything else if not ill give it a few days - really appreciate all the help