[Treatment] Low AHI but erratic flowrates, often still fatigued

[sancardinal15]

Thank you, @Gideon and @Sleepy_Quixote,

Here are the results from last night with some details. First detail is transitioning from REM to deep sleep, second is transitioning from deep sleep to REM. I'll keep running these settings or tweak them slightly over the week to see how it goes. I slept ~7hrs straight before being woken up by the mask leaking on my face (didn't get much sleep after that). 7 hours makes it the second longest I've slept continuously, with first place being given to the night before -- I wonder if my sleep architecture is slowly recovering somewhat independently of treating for more stable breathing? Is that a thing?

Flow limit was 95% 0.05 and 99.5% 0.16. I've done better than this before, including in some of the screens I posted using just vcom and fixed pressure cpap (look at the overview screen too) -- the only other different thing tonight is that the flowrate seems thicker, with more tidal volume. I feel alright today, but not much better than yesterday, still some yawning in the early afternoon so looks like I still need to fix something.

I'll look into getting a sleep ring to track movements and O2. I wonder if PLM is the culprit -- treating that seems like a whole separate ordeal 

[Sleepy Quixote]

@sancardinal15

Leak Rate looks great, yes Flow Limit is still a bit rough, the main thing is to get a few days in with consistent recommended settings so those who really know this stuff here have something to work with for recommending further tweaks. Hopefully Sleeprider will take a gander once you get some history with this setting.

Some of the flow rate in those two zooms actually looks pretty good. Smoooth. 05:46 on through 06:00 and on looks very nice. Need some more of that.

Sometimes it takes awhile to adjust to new settings and really see the proof in the pudding. The best results come from good Flow Limits, not necessarily AHI, though the two do tend to go hand in had, good low flow limits usually show lower AHI.

If you get a sleep ring that also does motion you can put it on a toe and get a real good idea of your PLM status and if you turn up positive, its a lot easier to deal with, they have some decent non addictive meds that do well in reducing it. Gotta confirm you have it first. Your wave forms look a lot like mine early on. The only problem is Doctors wont take data from a commercial sleep monitoring device. Remind me, I seem to remember you said you looked into RLS but didn't think the description fit? Right? RLS is PLMs daytime sibling and Doctors will diagnose that from a persons description of symptoms. Several of the meds to treat one are the same as the other.

Keep us posted and keep on keepin on!

[Sleepy Quixote]

@sancardinal15

Just had another thought, your Flow Rate zoomed out looks a lot like mine when my allergies get going. Do you perchance have allergies or impaired sinuses? If so the occasional spritz with Flonase is a huge help. I wouldn't recommend any of the other options, Flonase is the only nasal spray one can use without worry of getting your turbinates' addicted to it. Even then its only for occasional use.