[CPAP] OSCAR Metrics. I Need Help - Brain Fog

[TylerM27]

Hello, new member and CPAP patient here. I have been experiencing extreme brain fog ever since a septoplasty that I had 3 years ago. It usually sets in mid day or in the evening and lasts until I go to sleep. For context, I had my in-lab sleep study in February and my AHI was only 6 per hour, but my oxygen saturation was low(bottomed out at 79% and was below 88% for 47 minutes). Also, I am a 28 year old male who is healthy otherwise. I'm about 5'8" and weigh around 145lbs. Here is an excerpt from the sleep study:

Total recording time was 477 minutes with total sleep time of 315 minutes
for a sleep efficiency of 66%. Sleep onset latency was 68 minutes and wake
after sleep onset was 94 minutes. Stage REM latency was 93 minutes.

There was evidence of mild obstructive sleep apnea.

The apnea/hypopnea index (AHI) was 6 per hour, with 3 per hour meeting CMS
criteria for sleep apnea. REM AHI was 10/hr. Lowest oxygen saturation
recorded was 79%. Oxygen saturation was below 88% for 47 minutes.

Heart rate ranged from 52 to 88 bpm, with an average of 66 bpm and no
arrhthymias were seen.


So that brings me to now, I've had my CPAP machine since June 26th but haven't had any relief. I know that it just may not be long enough for the CPAP to fix my problem or that my settings may still need adjusting, but i'm really struggling quite badly. I've been using my Garmin Venu SQ2 to track my SpO2 and I know that it isn't super accurate but it's all I have at the moment. I'm afraid that my problem is still there even though my metrics look pretty good on OSCAR and my doctor says that my apnea is well controlled. I was wondering if any of you can see anything in here that they may be missing. I'm attaching my OSCAR logs for Monday night and my Garmin sleep report that shows my SpO2 throughout the night. 

Some random thoughts:
- Is it worth it to buy an actual oximeter? The ones that can sync with OSCAR/seem reliable are quite expensive but I will buy one if it'll be much more accurate than my watch. 
- Did anyone struggle with brain fog like this and get better? It is hard to keep pushing and I have been struggling to work lately.
- I know that it could just be that my watch is wrong and that I just need more time with the CPAP machine, just seeing if anyone else has some insight
- I quit nicotine cold turkey about 8 days ago, which definitely has impacted my sleep and could be contributing to how I feel at the moment but I haven't had any relief since starting CPAP

Thank you in advance for your responses and please let me know if you have any questions about my condition or treatment

[staceyburke]

I would make 2 changes - min pressure and EPR.

Min 8
EPR set to Full time
EPR 3

:Your flow limits are moving your pressures up and to control them we need to change the two settings.  Try it for a night  and post OSCAR tomorrow.  I'm sure there are other changes we can make that will help but start with this and we will go from there..

[Phaleronic]

Welcome to the forum TylerM27

Your hypopnea events are the most concerning, and with your low pressure of 6cm minimum it's not helping, so please raise that pressure to 9cm and leave EPR off and see how you feel for a few nights. Your 99 percent pressure is at nearly 16cm so you need higher pressure, and EPR throttles that, and since you're not using it let's take the easier route of gradually raising your minimum pressure until these events are taken care of please.