[Treatment] Therapy is helping, but only a little - good AHI numbers, bad sleep

[Dormeo]

Could you share a recent chart with the settings you've switched back to?

[tiredsleeper]

You can see it in my previous post (9-11 pressure, EPR3)

[Dormeo]

The three most recent charts are all fixed 9. Do you have one from, say, last night with the settings you were using earlier?

[tiredsleeper]

Hi, posting a chart with earlier settings (9-11). Unfortunately lately I've been feeling a lot worse, very tired. Looks like leak rates went up, is this causing it? Why could that be?

[Dormeo]

It is certainly possible that the leaks are disrupting your sleep. Are you using the F20 mask or a nasal mask? (Your profile says both.) Do you need to replace your mask? Or maybe adjust the straps, using an online video as a guide?

Also, you are having so many large leaks that your machine can't deliver the pressures your settings call for, and it can't always detect what's going on with your respiration. So this is a problem that needs fixing even if the leaks aren't disrupting your sleep.

I also want to raise the question whether some other aspect of your health might be contributing to your daytime tiredness. Here are some blood tests that might be good to ask your doctor for: testosterone, thyroid, iron, vitamin D, B vitamins, autoimmune diseases (especially in the connective-tissue-disease family). Any chance you have long Covid?

[tiredsleeper]

I am currently using n20, I've had very low leaks with it for quite some time, still felt tired, now suddenly getting big leaks, might be the blocked nose - I am using Dymista 2x a day, it's a chronic problem. Straps seem okay. EDIT: I do not use F20, I use N20, I forgot to update my profile.

I've checked other aspects you speak of - I have low vitamin D, but I've been supplementing it for months now. Rest should be okay. No covid, I'm pretty healthy right now. Working out 3x per week, 2x cardio.

Should I start taping my mouth?

[Dormeo]

If you breathe through your mouth during the day, it's worth seeing whether you can reduce your leaks by taping your mouth or using a soft cervical collar. A collar might do the trick if the problem is just that your jaw drops down during the night. Otherwise you'd want to try tape.

I would recommend having your vitamin D level rechecked. If your body has trouble absorbing vitamin D, or if your deficiency has some other underlying medical cause, the supplements you're taking may not be getting you up to normal.

[tiredsleeper]

Sure, I will recheck the vitamin D and explore options of tape/collars - but I do not breathe via mouth during the day.

Some people recommended me to check out the ASV machines as I apparently have apnea with both OA and CA happening at the same time. Should I explore this option?

[tiredsleeper]

Hi guys, vitamin D level is good.

Still haven't tried mouth tape - not sure if needed.

These are my stats from yesterday, I've been feeling like a total zombie without the will to live, does anybody have any tips that I could try? 
(not sure why Oscar is splitting my sleep into two days, I've set the timezone properly)

[Dormeo]

It's possible the leaks are disrupting your sleep, whether you're aware of it or not, so I do think it's worth trying to deal with them. Give tape a try, and if your main problem is jaw-drop, you might also want to try a soft cervical collar to keep your jaw in place.

You asked in your previous post whether you would benefit from an ASV. The answer to that is "no." The ASV is meant for people with high CA indexes; it "forces" breaths for them when they don't breathe spontaneously.