[Symptoms] Terrible brain fog and tiredness despite low AHI - Can you see anything in OSCAR?

[youthfulapnea]

Hey all, 

I've been using my CPAP for ~7 months at this point in time, I have very good compliance often wearing the mark consistently for 7-9 hours of sleep per night. 

Unfortunately despite my high compliance I'm waking up every day feeling extremely tired and having a general sense of confusion/brain fog. I feel like I can't critcally think as I could a few years ago and have a general feeling of "being out of it". 

It would be great if some of the CPAP veterans on this forum could have a look at my OSCAR results and let me know if you see anything that could use tweaking. From an AHI perspective things seem to be going well with an average of <1 per night, however I know that's quite a crude measure of overall therapy success. 

I'm using the Philips Respironics DreamWear Nasal CPAP Mask with Head and an Airsense 10 Autoset. 

[OpalRose]

Your results are near perfect as far as low AHI, and low leak rate. But there are a couple things to be aware of.

The leak rate graph does show some spikey areas which suggest mask movement.
That may happen if you move around a lot.

And even though the 95% flow limitation is low, look at the FL graph and line it up with the pressure graph. You can see where the FL causes the pressure to rise.
This is disruptive to sleep.

An adjustment that might help. Set your minimum pressure to 7cm. This will allow you to receive the full benefit of EPR. EPR and the higher pressure should tamp down any Flow limitation and hopefully keep your pressure from spiking.

Repost after a night or two.

[youthfulapnea]

Thank you, I've made those adjustments and will see how I go over the next two days.

[youthfulapnea]

Checking back one day in - no difference at all. Will check back in tomorrow.

[OpalRose]

Go ahead and post a current Screenshot.

[jiyun]

I'm just like you.. How are you these days?

[UnicornRider]

We were having similar problems, last fall we had a respiratory illness hit our household, everyone tested negative for Covid and Flu. After a couple of months i happened to catch a low SpO2 reading on my mom. After a further check all four of us had low SpO2. Luckily only my mom ended up on supplemental O2, the rest of us responded to the audible and vibratory alarms reminding us to inhale (sounds like a blond joke coming) so we could restore our SpO2. It has been 7 months now and we have improved a lot but still have the alarms going off several times each day.

May not hurt to check your SpO2. It's cheap and easy.

[gainerfull]

As UnicornRider mentions it's a great idea to check sp02 via something like a wellue o2 ring to give you more data to aid you in uncovering what's causing your daytime sleepiness & brainfog. Another possibility is REM fragmentation which the Apple Watch does a pretty good job at picking up on. I'm using the Apple Watch SE w/ the latest Watch OS and it's helping me tune my own therapy for better results.