Insight on OSCAR Data - Can't Figure Out Solution

[kevin123432]

Hi all,

Was wondering if you guys could help me with my OSCAR reports.

Some background info to maybe help you guys.
I have a longstanding issue with dizziness so when I started on APAP it was affecting that dizziness (I assume something relating to sinus/inner ear pressure changing).
Because of this, we decided to stick to a constant pressure which helped after my body got used to the pressure.
What I've found is that 8cm of pressure is where I feel the most rested but unfortunately, I'm still pretty tired throughout the day.

I see some weird things happening with my breathing patterns. I can't tell if it's an issue with mouth leaking, or the wrong type of mask, etc.
I also see both the leak and flow limitation graphs are doing some weird things, I'm just not sure how to help it.
Something else worth mentioning, I am on an SSRI, Viibryd, which may affect my sleepiness a bit, however it's difficult to test this since I'd have to ween off of the medication over a few weeks and forgo the positive affects it has.

Here's a link to some OSCAR screenshots:
https://imgur.com/a/mviq3jS

Cheers!

CPAP: Resmed Airsense 10
Mask: Dreamwear Under Nose
Pressure: 8cm
Usage: 8 hours a night, for 1.5 years

[Pugsy]

Are you experiencing any nasal congestion at night? Sometimes nasal congestion causes increased flow limitations.

[Pugsy]

You might also look up "SSRI meds and sleep".
Extensive studies have been done and not only can SSRI meds cause unwanted daytime symptoms they can also mess with sleep quality in general. They are known to mess with the sleep stages and decrease the amount of REM that a person gets.

More reason to try to get off them when we can.

[kevin123432]

Interesting note about SSRI's. I can talk to my doctors about it, see what their thoughts are.

Are you experiencing any nasal congestion at night?

Not really at all. I take a nasal spray most nights and don't have much congestion in general nowadays.

[ChicagoGranny]

SSRI

There are many people who had undiagnosed/untreated sleep apnea and were inappropriately prescribed psych drugs. The root cause of their malady was sleep apnea. Some of them started using CPAP therapy and no longer needed the psych drugs.

[Miss Emerita]

You have heavy flow limitations. These are limitations that fall short of being obstructions, but they require you to exert extra effort to inhale. For some people, they are disruptive to sound sleep.

FLs from swollen nasal tissues can't really be addressed via a PAP machine, but it sounds like your FLs may be down in your pharynx. A good experiment to try would be to raise your minimum and introduce EPR (expiratory pressure relief). EPR drops your pressure when you exhale; by the same token, it increases your pressure when you inhale, which gives you a little boost that can help with FLs.

You will need to raise your minimum to keep your pressure at exhalation steady at 8. Otherwise you might see more obstructive apneas, which you don't want of course. So you could try a fixed pressure of 11 with EPR of 3; or a fixed pressure of 10 with EPR of 2; or a fixed pressure of 9 with EPR of 1.

If you try this experiment, I'll be interested to learn how it goes.

[kevin123432]

Some of them started using CPAP therapy and no longer needed the psych drugs.

This is something I've wondered. I was prescribed the anxiety meds before I was diagnosed with sleep apnea.
I wonder if the anxiety was a result of the sleep apnea. It's hard to know without weening off of my current meds which is its own mess.

you could try a fixed pressure of 11 with EPR of 3

Makes sense. So it keeps my exhale at 8 but my inhale is at a higher pressure.
I'm going to try this the next couple of days and report back.

[ChicagoGranny]

This is something I've wondered. I was prescribed the anxiety meds before I was diagnosed with sleep apnea.
I wonder if the anxiety was a result of the sleep apnea. It's hard to know without weening off of my current meds which is its own mess.

I wouldn't try weaning off until the CPAP therapy is working well.