No change in REM or sleepiness despite lower AHI

[sleepy4466]

Thanks to folks on this forum, I have been successfully acclimating to my CPAP machine and managed to lower my AHI from about 10 to 5 at night, but it still has not left me any better off. My REM is still very low (about 6% of last night's sleep) and I feel no less sleepy in the mornings. Thanks to the comments on this thread, I increased my pressure minimum to 11 and this did help on one previous night of sleep, when I got an amount of REM I normally get on an OK night of sleep (link below). Previously, I consistently got worse sleep wearing my CPAP. So, it is an improvement, but now I'm just back to square one. I'm not sure what to do next, as my minimum pressure is pretty high.

I was advised by one professional to wear a nose mask and that my current mask may leak too much, but my nose is too stuffy to not wear a full face mask. I've tried flonase, but it's still too congested to breathe comfortably. I tried adding humidity and that didn't work either.

http://cpaptalk.com/viewtopic.php?f=1&t ... 2#p1342452

Here is the screenshot from last night. Any idea what to do? I have an in-lab sleep study which I can provide. The upshot is that I have mild sleep obstruction, mostly from non-REM hyopnea and some RERA's. I thought halving my AHI would make me feel better, but it doesn't. My oura ring can decently tell when i have a good night's sleep, because I get over an hour of REM, which is very rare for me.

Any ideas on what to try next are very much appreciated!

screenshot-20200220-094710.png (684.69 KiB) Viewed 317 times

[zonker]

Thanks to folks on this forum, I have been successfully acclimating to my CPAP machine and managed to lower my AHI from about 10 to 5 at night, but it still has not left me any better off.


Any ideas on what to try next are very much appreciated!

screenshot-20200220-094710.png

while the link is appreciated, it's best to stay in one thread so folks can easily see what your history is. thanks.

i don't know why you think your minimum pressure is "pretty high". i blow from 15.8 as a min up to 20 as a max. you can see on your chart that your pressure gets up pretty quickly past 11. in fact it's going past 12 for the bulk of your sleep.

so, if'n it were me, i'd set your pressures to 12 and 20, or even 13 if you want.

good luck!

[Pugsy]

First of all you need to learn how to figure out if those flagged events are real asleep events or related to arousal/awake time.
http://freecpapadvice.com/sleepyhead-free-software
False positive flagged can happen in any category...not just CAs/centrals.
More minimum pressure is normally the usual advice when the obstructive components of the AHI is higher than we want but make sure that more pressure will fix them first. More pressure won't do a darn thing for arousal/awake events unless the arousal is preceded by a real OA/hyponea which causes the arousal. So make sure what you are wanting to reduce with more pressure is able to be reduced by more pressure.

Not all arousals are caused by airway related issues.

AHI alone doesn't guarantee that we will feel the good numbers. AHI of 0.0 can be meaningless if we simply slept poorly for some reason other than airway related issues. There is so much more to feeling the low numbers than getting them. Getting them is the easy part.....feeling them...now that a whole other story.

I prefer to figure out if what I want to fix is fixable with more pressure. If you don't want to take the time to learn then you can of course just increase that minimum again...your choice.

Just remember that we can have our sleep disrupted by a lot of things that are totally unrelated to sleep apnea and the machine simply can't fix any problems unrelated to the airway.
Medication side effects...prime culprit....do you take any meds at all, if so, what?
Pain, other health issues, bed comfort, etc...they can all mess with our sleep and how we feel and more pressure won't fix them.