50 yr old male. I am trying for the nth time in 10 years to use a CPAP. I've given up on all my other attempts after a handful of nights because of poor mask fit, leaking, discomfort, increased tiredness, etc.
The reason I'm trying again now is because of more noticeable cognitive problems, especially memory related. This has gotten steadily worse, especially in the last five years, and it's causing me difficulty at work. Of course, I'm also always tired, and have been for a long time, so it would be nice to address that as well.
I've had three sleep studies over the years. My most recent sleep study was in 2015, no CPAP, just sleeping, and the results were very similar to the two previous studies: "Mild-moderate sleep apnea". Summary from the most recent study:
"DISTURBANCES OF SLEEP:
The minimum oxygen saturation during the study was 92 percent.
Snoring was present. The Apnea Hypopnea Index (AHI) was 1.6 events per hour of sleep (2.1 while
supine and 5.4 in REM sleep). The Respiratory Disturbance Index (RDI) was 14.0 events per hour of
sleep, and included respiratory effort related arousals (RERA) in addition to AHI. Periodic limb
movements of sleep (PLMS) did not occur. Cardiac rhythm was sinus."
The full sleep study:
Question #1:
- The study clearly says
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Apnea Hypopnea Index (AHI): 1.6: 0 - 5 / hour
Apnea Hypopnea Index while Supine 2.1: 0 - 5 / hour
Apnea Hypopnea Index in REM 5.4: 0 - 5 / hour
I had a more recent (~1 yr ago) at home "study" from my HMO. I don't remember what the device was -- not a CPAP. Maybe a pulse oximeter and a watch? The results they sent me from that were:
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AHI: 2
RDI: 5
Oxygen Level: Normal
- The AHI from both the above studies is very low. Based on those numbers, it seems like my sleep apnea should be really be just "mild". I've theorized that, even though the AHI is low, the apneas are happening during REM, so that they are having a significant effect re my fatigue, etc. Is it common for people who have such "low numbers" to actually see significant benefit from CPAP therapy? Can I really expect to get a much lower AHI with CPAP? I'm pretty committed at this point to try to get compliant, even if it's just to rule out sleep apnea as a significant cause of my fatigue and cognitive issues, but it's a lot of work, so if someone said, "seriously, don't bother", I might...not bother
Current Issues
I've tried a lot of masks over the years, and the Hybrid (https://www.cpap.com/productpage-replac ... -CPAP-Mask) has been the most successful, so I'm focusing on that for now. I just got a new cushion and nose pillows. Here's my data from last night (everything until 21:30 is just fussing with mask):
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Question #3:
- I'm just thinking that you are probably all going to tell me that I really need a full nights worth of data to get any kind of an accurate AHI.... Yes?
Question #4:
- Given the graphs above, was my therapy "successful"? The AHI is low, but there are obviously some events. I've read that's to be expected: that anything lower than a 5 AHI is considered 'good enough'. But, I'm also seeing some pretty significant leaks during the band of OAs around 22:20. The leaks aren't LL's, but could they be compromising the effectiveness of the CPAP? I.e., with fewer leaks, what I likely be getting fewer events during that time?
Question #5:
- Mask fit. In APAP, my max pressure seems to be around 12. When I try this awake (mask on, lie on back, run CPAP at 12), my mouth blows open, like I'm a puffer fish. I have tried nasal pillows in the past, and it's pretty clear I'm a mouth breather (tried chin strap, no luck, may try neck ring). I don't know if my mouth is blowing up like a puffer fish when I'm asleep, but I'm kind of assuming it is. If it is, does that somehow compromise the effectiveness of the CPAP? Should I try to resolve this mouth blowing open problem while I'm awake, so that this CPAP will work better for me?
Many thanks for any help.