HIgh RDI, low AHI, Seeking Guidance (I feel really bad)

[franmv]

Hi everyone,

I'm a 21-year-old male, 175 cm tall, and my weight stays around 72-74 kg. I recently did an at-home sleep study (attached) that showed a low AHI but a high RDI, meaning a lot of RERAs. I'm really new to CPAP and have some questions.

My Experience:

• Without EPR: My AHI drops to 1-2, but I feel terrible – exhausted during the day.

• With EPR: My AHI goes up, mostly due to central apneas, but I feel a little better overall. Not sure if the EPR is just helping mask the RERAs.

I've attached some OSCAR data from last night using 3 EPR so you can see the details, and another one using 0 EPR.

Background:

• I've had excessive daytime sleepiness for as long as I can remember.

• Been taking ADHD stimulants since late 2022.

• Diagnosed with sleep apnea in February 2024.

• Been using Resmed 10 APAP for three months (end of February till now).

• I have chronic nasal congestion and a slightly deviated septum.

• Currently using a nasal mask, but a full face mask is on the way.

• Tried cervical collar and it helps a little bit to lower the AHI (the obstructive events though, not the central ones).

• Planning to get a DJS and septoplasty in 2025.

Questions:

• Could the EPR be making the central apneas worse?

• Is it possible that I'm feeling better with EPR on because it's actually treating the RERAs better, even though the AHI looks higher?

• Any tips for dealing with the RERAs in the meantime? Would different pressure settings help?

• Does this look anything like UARS? What can I do or try in the meantime?

I rarely remember dreams, and haven't had a refreshing night's sleep in ages. Any advice or insights would be greatly appreciated!

Thanks in advance!
https://imgur.com/gallery/epr-off-epr-on-5D2BXHV
NEW LINK UPDATED: https://imgur.com/a/5D2BXHV
https://imgur.com/a/HfNq2Ub

[franmv]

https://imgur.com/a/5D2BXHV
Not sure why but the original image on the post gives me a 404 error so I am posting the link again.

[vandownbytheriver]

https://imgur.com/a/5D2BXHV
Not sure why but the original image on the post gives me a 404 error so I am posting the link again.

I'd try a night of straight 8cm CPAP EPR 2 and see how it goes... it looks like the FL's piss off the pressure, which brings on the CA's. Also SleepHQ is better for sharing graphs I find... I use both, Oscar for home perusal and SHQ for sharing. You probably should get an O2Ring or equivalent... O2 has a lot to do with how you feel. Do you have UARS? Hope not... sticky wicket.