two months in and still feeling crappy

[navidson]

            Hello,

I was diagnosed with "mild" sleep apnea (AHI 5.3). I put the word "mild" in quotes because it doesn't feel mild. It's been a life-ruiner for me. The symptoms were pretty sudden onset, too. I used to sleep just fine, but starting in Dec 2022 I began waking up gasping for air during sleep. I had an at-home sleep study done in April (report attached). It tooks me months to actually get a machine. I was given a Philips Respironics DreamStation on September 15. I have been using it faithfully every night. While there have been significant improvements in my sleep, there are still many mornings where I wake up feeling indescribably sh**ty: headaches, brain fog, and a general feeling of misery. These subjective symptoms are only weakly correlated with the AHI numbers, although the numbers seem to be in the ballpark.

I have been poring over my data using OSCAR this whole time. I am posting last night's data along with the aforementioned sleep-study report. Although the AHI is low (1.12), this represents a distinctly terrible night of sleep, possibly the worst since I started treatment. I can't tell from the data what's wrong, although I suspect a generally limited inspiratory flow rate, too subtle for the machine to register and adjust to but severe enough to make me feel like crap.

According to the sleep study, the sleep-disordered breathing in my case presents like UARS in some ways: relatively low occasions of hypopneas and apneas but quite a lot of RERAs. I am a little reluctant to bring up the term "UARS" with my doctor since that seems to be a controversial diagnosis, but in my opinion it could be a productive avenue to explore for treatment improvements.

Anyway, I humbly submit my data to the experts here. I will do anything for relief!

[PeaceLoveAndPizza]

The main thing that jumps out to me is that you have some leaks that will definitely impact the quality of sleep. There are also some good sized flow limitations driving up the pressure, which will impact it as well.

A few things to consider:

1. Using a soft cervical collar or mouth tape to help get the leaks and chin tucking under control
2. Trying out a full-face mask like the F20, F30, Evora, etc, to help with the leaks if a collar/tape does not help
3. Turn off ramp as it is doing nothing for your therapy and may be adding to your discomfort as it increases pressure

I suggest not zooming in on charts unless someone asks to see it. We look at the entire night to get an idea of things that may be impacting sleep quality.

My final suggestion is more a personal choice, but I would check when the time is appropriate about getting a Resmed CPAP, and Airsense 10 Autoset or Airsense 11 Autoset to replace the PR.