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+--- Thread: [CPAP] Snoring, Flow limits and fatigue on CPAP (/Thread-CPAP-Snoring-Flow-limits-and-fatigue-on-CPAP)
Snoring, Flow limits and fatigue on CPAP - PureCha0s - 12-11-2024
Hello everyone, long time lurker, first time poster
I have been using my cpap machine for around 10 months now. This all started when my housemates noticed I was snoring slightly while sleeping with the cpap machine.
Last week, I went to my sleep tech's office, and they increased my set pressure from 10 cmH2O to 14 cmH2O. This seemed to help and my snoring went down significantly. However, I started becoming more aware of waking up at night (maybe 4-5 times at night, mostly just roll over to the other side and fall back asleep, rarely it keeps me awake for 30minutes+) and feeling fatigued when I wake up, and so I decided to pop my data into OSCAR to see what's up.
Again, I still do feel fatigued in the mornings, but daytime sleepiness has subsided significantly on the new pressure. But my goal is to make my cpap therapy the most optimal it can be, before moving on to other avenues to address my fatigue.
I'll include an image of average nights from before my pressure was increased to after. My flow limits and snoring decreased significantly, and I do generally feel a lot better, but now I want to see if I can improve this even more.
My questions:
1) Is there anything that stands out that could be causing me fatigue/ nighttime arousals?
2) Do the flow limits / snoring values look good now or should I aim to decrease them further? There are still flow limit spikes to ~ 0.3 and snore spikes to ~ 1.5 on most nights, even though the 95% values look good, is this normal? Can I increase my set pressure past 14 cmH2O on a nasal pillow mask? (resmed swift fx). Would changing EPR either up or down (current setting: 2) help? Could it be that my airway is collapsing in the expiratory phase at night and causing the flow limits/snoring?
3) I noticed there are sometimes very short spikes in leak rate right after some unmarked/short apnea events as shown in the flow rate tab; are these just mouth leaks? Am I opening my mouth to try and catch my breath at those moments?
Sorry about the long read. I look forward to hearing your thoughts!
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RE: Snoring, Flow limits and fatigue on CPAP - staceyburke - 12-11-2024
Your main problem seems to be Flow Limits. FL are apnea just like O and H events but are not lasting long enough to be classified as O or H (at least 10 seconds) and are NOT counted in AHI. But they do stop you from getting into deep sleep and can wake you up.
Your better looking night was at 14 high. It helped your flow limits and if you move the EPR to 3 it will help more.
You Should also turn off the ramp. During ramp you are not getting any therapy. Only use it if you can not get to sleep without it.