I did an at-home test and an at-home titration with an auto machine from the sleep clinic. Both gave my AHI as very low to non-existent. The doctor (pulmonologist) said maybe I have UARS and that I should do a CPAP trial to see if it would help my fatigue. With the help and advice from some wonderful people here at cpaptalk, I was able to choose a machine and get supplies to start my trial. I've been totally compliant with the machine for over a month now, but unfortunately the fatigue remains unchanged. I sleep for 10-11 hours a night almost every night and still feel so tired all of the time. I've been looking over my data in SleepyHead and my AHI has always been under 2.0. I still do have a bunch of events every night though (Clear Airways, Hypopneas and Obstructives. I get Cheynes Stokes respiration flags sometimes as well). From what I understand, a low AHI does not rule out UARS. I also recently saw an ENT recently and he confirmed that I have a deviated septum. I do not know if that plays a role in any of this.
I'm seeing my pulmonologist again next week and am not sure where to go from here. I still strongly feel that my fatigue is sleep-related since I've always needed so much sleep and can never get enough of it. I also tend to wake up briefly at intervals a lot during the night. Do I push for an in-lab PSG to look for some other kind of sleeping disorders (I previously only did an at-home one with no EEG component)? Do I try get tested for UARS? From what I've read, the only way to definitively test for that is with a pressure probe down esophagus. I believe the sleep clinic I went to before doesn't test for UARS at all. Any ideas or advice would be really appreciated. I just want to be able to live a normal life, which I haven't been able to do for years because of this persisting fatigue.
I've posted some screenshots of my flow rate waveform FWIW. As you can see, there's only a handful of flags every night, but they are there nonetheless.
