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Help with Oscar - Still Very Tired - MikeR20 - 10-05-2023
Hello all,
1.5 months in and I am still tired despite sleeping 10+ hours. I tried different masks and different EPRs, and made sure I always slept on my side.
Recently upped the pressure since I had trouble breathing when was still awake. I believe this helped.
I have tried for some weeks with a pillow mask but went back to the nasal mask.
Does someone have any tips on how to sleep better based on the graph below? The majority of events that I had were Clear Airway Events. The sleep study indicated some central apneas (none when sleepin on the side), but the doctor only said Obstructive Sleep apnea.
I am going to have a Follow-Up appointment soon and discuss this issue. Have some problems breathing throw my nose, I'm going to see if surgery is available and if it could help. I sleep with my mouth taped.
Any tips would be great.
My previous Post with some other info: https://www.apneaboard.com/forums/Thread-Clear-Airway-Flow-Limitation
Thanks a lot
RE: Help with Oscar - Still Very Tired - gainerfull - 10-05-2023
Hi Mike - how many sleep studies have you done and was a cpap titration included? If so - what was your optimal pressure? Did you have central sleep apnea w/ out cpap?
On the plus side it looks like you're doing great in the leak department however your minimum pressure is too low if you're going to use EPR @ 3. Effectively you're pressure is at 8.5cmH20 and as evidenced by the light blue events (obstructive) it is not enough to keep your airway open.
At the end of the day you need more minimum pressure so the simplest approach would be to raise your minimum pressure to account for EPR but considering you're experiencing so many central apneas I may recommend you use less EPR because you could be experiencing co2 wash out.
Do you have any other nights at the same pressure range but lower EPR? Have you ever tried constant pressure mode at 12cmH20?
RE: Help with Oscar - Still Very Tired - MikeR20 - 10-05-2023
Hi,
I only have done a sleep study without a CPAP, which indicated some Central Apneas, only laying on my back.
The hypopneas didn't come classified.
I have been tightening hard the mask, to prevent leaks, the reason I switched back to the nasal mask, since that the pillow mask kind of hurts when tight. These last nights are the first ones at this pressure. It was at 9.5 with a pillow mask, but I feel like the pillow mask feels a lot "stronger" when compared to the nasal mask with the same pressure.
I have tried lower pressure and EPR with the pillow, but I guess I can try some nights with EPR 2 or 1. Have some problems breathing through my nose, so it's hard to turn it completely off with these pressures.
RE: Help with Oscar - Still Very Tired - gainerfull - 10-05-2023
Ok sounds good, when the light blue obstructive events no longer register you'll know you're doing well with the minimum pressure.
Sleeping on a wedge pillow helped me reduce the number of central apneas I have per night, you might consider one yourself.
RE: Help with Oscar - Still Very Tired - MikeR20 - 10-05-2023
Thanks, I'm going to try to up the pressure.
Can not really grasp the sudden changes in central apneas when the settings are the same.
Regarding the hedge pillow, I actually have been looking into that, since I would like to try to sleep on my back again. I have noticed a spike in AHI when I fall asleep in my back, including Clear Airway Events.
Do you use to sleep on the side or on the back?
RE: Help with Oscar - Still Very Tired - upsman - 10-06-2023
(10-05-2023, 06:45 PM)MikeR20 Wrote: Thanks, I'm going to try to up the pressure.
Since most of your events are central in nature, I wouldn't advise RAISING your minimum pressure. This may actually cause an increase in your central events.
Your obstructive events are being well-treated at 11 cm and you're using EPR of 3 cm. Sometimes EPR can have a negative effect on central events by causing CO2 washout and removing the trigger to breathe.
You might try a minimum of 9 cm and reduce EPR to 1 cm for a few nights and see if anything improves.