On APAP trial; I have no idea if I should buy one? Sleepyhead data included.

[ethereal]

Hi guys,

First time poster, long time reader. I've been using a Resmed Autoset 10 for 3 weeks and my trial ends in a couple weeks. I will then need to make a decision if I will purchase a machine. As it stands right now, I honestly have no clue if I should. I'll keep this short and to the point.

Male, 25, 175cm at 78kg, not significantly overweight, otherwise generally healthy.

Sleep Study: Mild REM prominent OSA (10 AHI) with sp02 dropping to 87%. Longest Apnea/Hypopnea = 125 sec.

Symptoms: Extreme day time tiredness. Fall asleep after work almost every day, uncontrollably almost. Almost falling asleep at the wheel in the afternoon. Waking up feeling like a truck hit me. Waking up feeling like I haven't slept. Brain fog. Memory recall issues. Increased anxiety. Reduced sexual function (morning erections reduced also). Sleep specialist was keen to trial me on CPAP therapy due to the excessive day time tiredness despite "mild" OSA.

Current APAP Settings:
Mask = Philips Dreamware Full Face
Pressure = 6.4 - 9 cmH20
EPR = 2
Tube heating / Humidifier = Auto

Findings while using APAP: So, first off the started me with a nasal pillow (Resmed N30i) but I was waking up every 40 minutes due to opening my mouth, I think. I have all year round allergies and sinus issues so I tend to be a mouth breather because of it. Switched to the Philips Dreamware FFM and started to get some really good sleeps (low AHI, relatively solid). There have been days where I have felt with 100% confidence that the machine has made a difference - for example - driving home one day from work my brain was clear and switched on and I was 100% alert, and I thought to myself wow, I am usually struggling to keep my eyes open around this point. Then other days I've felt pretty average and almost like before therapy, and have had to nap (approx. 3/21 days), and other days I've just still felt quiet tired. One thing I have noticed at the beginning (which seems to have backed off now?) but my morning erections came back when I started therapy and were extremely strong, probably due to spO2 increase. Sex drive seemed much higher, and overall energy was good on my good days. Those sexual affects seem to be hit and miss now. I usually have trouble concentrating at work for more than 5 minutes, one day I noticed I was working on a problem for a few hours straight. Once it was over it clicked to me that I can't usually do that.

My biggest concern is that I have had pretty mixed results, as above, and I am concerned the good days were merely "placebo effect" because that effect can be quite powerful. Also, the people who provided me the trial (at orders of my sleep specialist) are useless (they are a retail storefront). They can't offer me any useful information, and I've had to resort to using SleepyHead to tweak my own settings. I started at 4-15 cmH20 and had AHIs of around 1-3 consistently, and a few tweaks later I am at 6.4 - 9 cmH20... as soon as I did this my AHI was 0.0 a couple nights and rarely goes over 0.5, yet they told me to increase the max pressure as the "machine looks like it wants to go higher". I asked if that will have a positive impact given my numbers are looking on point, and also I believe I wake up from the machine ramping too much pressure during the night.

Anyway I will attach some data now. Some from when my pressure was 4-15 and some from my current pressure. I have mostly Clear Airway events but not too worried about those, they seem to be getting less and less as the weeks go by. I would appreciate anyone taking the time to have a look. I have no idea if I should buy a machine or not, but from what I can see, from the data anyway, I seem to be doing okay? Is there anything else I can change?

[ethereal]

3 more screens from when I tweaked the pressure to 6.4 - 9.

[ChicagoGranny]

Keep this

APAP

or keep this

Extreme day time tiredness. Fall asleep after work almost every day, uncontrollably almost. Almost falling asleep at the wheel in the afternoon. Waking up feeling like a truck hit me. Waking up feeling like I haven't slept. Brain fog. Memory recall issues. Increased anxiety. Reduced sexual function (morning erections reduced also).

And, it will only get worse as you get older.

[ChicagoGranny]

BTW, your pressure is low. Do you really need EPR? If it were me, I would turn it off.

[ethereal]

BTW, your pressure is low. Do you really need EPR? If it were me, I would turn it off.

I have not thought about turning it off. Is there any benefit / downside to using it or not using it?

And, it will only get worse as you get older.

Normal that I'm having mixed results then, I take it? And the days I feel good, I'm not going crazy and it's all in my head ?

[ChicagoGranny]

Is there any benefit / downside to using it or not using it?

It's a so-called "comfort feature". Some people feel it is more comfortable to exhale at a slightly lower pressure. Some prefer steady pressure throughout the breathing cycle. You won't know which way you sleep/breathe better without trying both ways.

And the days I feel good, I'm not going crazy and it's all in my head ?

You may be going crazy, but wouldn't you like to feel good while you are going crazy?

[LSAT]

Even though your max pressure is set at 16, your nightly pressures never got over 10......the max pressure setting really doesn't matter. It's the minimum that is most important. Raise min to 7.... If your AHI during the sleep study was 10 and now with the CPAP therapy you are at 1-2...I guess it's working...Buy the machine