[Treatment] First follow up with Dr.- can someone help me understand my data beforehand?

[Kvothe]

Hi everyone,

I just joined up, so please let me know if this isn't allowed, or if there's a better place I can post it.

I was diagnosed with Sleep Apnea after a sleep study in January. I didn't speak with my Dr. after that, but I have a copy of my results. 
The topline is:

• AHI 38
  
• RDI 189
  
• O2 nadir 86%
  
• sleep efficiency of 60%
  
• no REM captured
  

As a baseline, I'm still not certain how to interpret this. As a bit of a vent, I wish my doctor took the time to go over these results with me. Based on what I've read, an AHI of 38 is pretty bad, but I have no clue about the rest of it. The RDI really jumps out at me since (if I understand the way its generated) that means that I'm having a TON of RERAs. They look like somewhat detailed results to me, so if someone is curious about anything, please let me know.


The CPAP has thus far worked wonders for me. I feel so much better than I did beforehand. When I can sleep with the CPAP, my AHI plummets. I felt like I was running on the barest of fumes beforehand, and while I don't feel healed yet, I feel as though I'm recovering. That being said, therapy hasn't been perfect thus far. Some things I've done to make things easier is turn off my ramp, increase the EPR, humidity, and tube temp, and I'm using Lanolin cream to help protect my nostrils.

The biggest issues I feel I'm having right now are keeping it on after waking up from sleep. I don't know why I'm waking up in the middle of the night, but afterwards it's very difficult for me to fall back asleep with my mask on. Sometimes, it feels like I can't get quite enough breath, like I need to take really really deep breaths. Could this be a flow issue? There's a bit of discomfort from the headgear/mask where the straps touch my cheeks and where the mask touches my upper lip. I also wonder if the higher EPR setting is resulting in low pressure when I start to inhale, which could maybe make me feel like I'm not getting enough air? My other thought would be that I mostly seem to hang around ~8.5 pressure, and my pressure seems to routinely be lower than that when I wake up. Maybe it's worthwhile increasing the minimum pressure up to 8?

Then again, I'm also pretty new to CPAP therapy, and these may be totally normal growing pains. I think I'm doing a generally decent job of getting 6+ hours with my CPAP, and only a couple days below 4. So- if anyone is interested and would like to talk or help, I'd love to learn. I'm posting a few screenshots from last night- the whole night, when I woke up and took off the mask, and what looks like a really long OA (17 seconds?!). I can post more nights, zoom in wherever. Thank you so much for reading!

[Sleeprider]

You seem to have already taken all of the necessary steps to optimize therapy, reduce AHI and flow limitation. Everything you have done, is exactly what you would have been advised to do on the forum. Well done! Based on your comments, you are strongly on the mend. With regard to your feeling of wanting more air when you awaken at night, I think you should experiment with higher minimum pressure. Your current minimum pressure of 7.0 is the minimum for using EPR at 3, however your median pressure on the night shown is nearly 9.0 cm. I think you should ease your way toward that mark as a minimum, and it might clear up the minor remaining discomfort.

Welcome to the forum, and congratulations on the excellent job of self-optimization.

[Kvothe]

Thank you! I agree re: increasing min pressure. You're thinking somewhere around 9 as a target? Of course, I can always try to adjust up and down in .5 increments. By the way- is that frenchie yours? One thing I'm looking to do with some of this newfound energy is getting a dog!