AHI of 5, still fatigued and not dreaming, apnea? or other problem?

[diabellical]

Three months ago I was diagnosed with severe apnea and given an APAP. This was discovered because of terrible daytime fatigue and sleepiness and diagnosed in a lab.

One of the things I noticed when my fatigue first started was a lack of dreaming (I used to often remember my dreams) and a lack of restful sleep.

've gotten my AHI under 7, usually around 5 most nights.

Even with my AHI around 5 most nights, I'm still very tired most days and extremely tired by 7pm every day. In addition my dreaming has not returned and have that sleep deprived "chills and need-to-sleep" feeling I had when my AHI was in the 20s and 30s -- just, instead of it starting early in the day, I get the feeling later.

Can this happen with an AHI of only 5? Below what AHI should I start looking at other causes of my fatigue?

Many thanks for your thoughts and advice!

[Miss Emerita]

As others have said, what if I sat next to your bed at night and poked you with a stick every 12 minutes? That's one way of thinking about an AHI of 5. It isn't yet where you want it to be.

People here would love to help you, but there are a couple of things they would need first. Do you have access to a laptop or desktop computer? Is there an SD card in your machine, or a slot for one? If so, you can import your data into the Oscar software (see below) and post a screenshot of a daily chart. It will be packed with useful information.

The other thing: could you fill our your profile with information about your machine and mask? That way it'll be there every time someone reads one of your posts.

[Pugsy]

People seem to think that just because they don't remember dreaming that they aren't....that's not true.

Remembering dreams is actually a bad thing...it means our sleep is being disrupted enough to cause us to wake up and form a memory of the dream.
We don't remember a dream unless we wake up during it or immediately after it.

And we can dream in any sleep stage...it isn't limited to REM stage sleep though that is where we will have more dreams.

So the lack of remembering dreams doesn't mean they didn't happen.

Now still having non restorative sleep feelings...that can happen no matter if we are dreaming or not or remembering dreams or not.
And the AHI doesn't always give us a clear marker where below so and so AHI we feel the good numbers and above so and so we don't.
I know people with AHI of 0.5 and they feel like crap...and people with AHI of 4.0 that feel on top of the world. I myself had one of my very best days in terms of how I felt following a night with AHI of 10.4. Go figure that one. Let me tell you if I could feel like that every day I would gladly accept that 10.4 AHI every day.

Is your non restorative sleep feeling related to AHI or something else? We don't know. Not all sleep problems are caused by OSA and the cpap machine can't fix a problem if it isn't related to airway issues.
Now we do try to get as low of an AHI as possible just to increase the chances of the problem being airway related and thus fixable but there is no guarantee.

How to get a lower AHI...that depends on what that AHI is composed of and what is causing it.

If you would stick to one thread it would make offering of ideas much easier. I know you have another thread but I don't remember what all we have already discussed.
It might be helpful to know more about the past history and if you would at least include a link to your other thread it would help people help you better.

[diabellical]

Notes:
1. My husband can confirm I was not snoring so I'm not sure why its showing that suddenly.
2a. Note I have experimented with Flex settings A/C. (see settings changes in one of the attached images)
2b. I also increased minimum pressure and maximum pressure. (again see settings changes)
3. I feel as bad as I've felt in months today. I'm getting ready for bed now and its 7:30.
4. I did notice a large clear airway index jump.
* I've added equipment information to my profile.


Link to previous thread. https://www.cpaptalk.com/viewtopic.php? ... ttachment]

[zonker]

Notes:

2b. I also increased minimum pressure and maximum pressure. (again see settings changes)

just a suggestion, but try to change just one thing at a time and give that change time to settle in. yeah, i know! it's hard to have patience when you want your good sleep. but these things can and do take time.

good luck!

[diabellical]

I'll do that thanks.

So here is some more data.
One night has a very low pressure and low AHI,
another night higher pressure and higher AHI.
I'm having trouble finding correlations here. Any analysis or suggestions on making the analysis would be much appreciated.

Cpap12172020.png (117.89 KiB) Viewed 494 times

CpapLowAHI12152020.png (122.24 KiB) Viewed 494 times

HigherAHI1282020.png (122.1 KiB) Viewed 494 times

[Julie]

I haven't read all from the beginning, but is there a reason your max setting's so low? Have you tried it higher?

[Pugsy]

We don't sleep the same each night so we can't go changing things every night based on last night. Need to keep a setting for at least a week and look for trends as well as give the body a chance to adjust to the new settings.

Julie....his lower max isn't the issue...he rarely hits the max anyway and if I remember right he was having some aerophagia issues.
Having a restricted maximum doesn't really cause a problem unless someone pegs out at the max for prolonged periods of time where it is obvious the machine wants to go higher but cant. That for sure isn't happening here so the maximum setting really is irrelevant in this situation. Increasing it is highly unlikely a potential fix for his problem. Even if the machine could go higher...it won't.

[diabellical]

I’ll take that to heart and be more methodical: it’s hard even for a mathematician to be disciplined with data when feeling so crappy.

Is there a particular change you would suggest making and watching for a week or so?

[Pugsy]

No...I can't offer any ideas on a change based on one night's data. That's the whole point.
Your AHI is now 1.40 with the current settings. Keep them and see if this was a fluke good night or not.
It's how I did my own experiments. I picked some settings that worked at least part of the time and kept them for a period of time to see what happened and what trends or patterns might develop. Probably one of the hardest things to do was nothing.

We simply don't sleep the same each night and if we go changing things based on last night's results we are going to be continually chasing our tails. Often it there is not a single set of pressure tweaks that works best...most often there is a range of settings that work well most of the time and that's where we try to end up. Like maybe some nights you might do a little better with a 6 minimum and some nights maybe 6.5 minimum and maybe on occasion you might do better with 7.0 minimum.
You have to give each setting ample time in your experiment though. Time for your own body to adjust and also time to cycle through the fact that we don't sleep the same each night.