Need Help Diagnosing/(Treating?) Spouse

The background:
- Wife snores heavily
- Is often very groggy and slow first two hours after arising
- Is often fatigued and sleepy during the day
- Stays in bed from 11:00 p.m. to 9:00 a.m.
- 64 years old
- BMI about 20 to 21
- Is agreeable to see a sleep doc once Medicare eligible (2019)

She has one night on APAP pressure min 4 max 5. Nasal pillows.
Leak - near zero

You can see her events in the attached chart. Snoring is basically non-existent with these pressures. At this point, I am not worried about her CAs - she awoke often - probably, mostly SWJ.

What concerns me is the high flow limitation. Should I try a higher pressure to try to clean that up? Any other comments are appreciated.

How is her nasal congestion? If that FL is related to nasal congestion then more pressure is unlikely to help.

The machine will want to reduce FLs with more pressure because that is what the auto algorithm does but if it is related to nasal mucosa swelling it is unlikely to help much.

I think I would maybe try same experiment but open up the max to say 10 and see what the machine wants to do and see if she notices any improvement in terms of the unwanted daytime sleepiness and fatigue.

Also if she is having multiple wake ups during the night...she may or may not remember them...she may or may not be having sleep maintenance insomnia issues related or not related to breathing...that alone can cause more sleep quality issues despite getting what would appear to be adequate hours of sleep.
In other words crappy sleep quality but not necessarily from something related to sleep disordered breathing and the machine can't fix bad sleep if the bad sleep isn't from some sort of airway issue.

Snoring itself without all the other stuff can disrupt sleep quality and be enough reason to use cpap in my book.
Anything that has the potential to disrupt the sleep architecture is unwanted.

Pugsy wrote: ↑

Tue Jul 17, 2018 6:16 am

How is her nasal congestion?

She doesn't complain about nasal congestion. She was able to use nasal pillows without mouthbreathing.

Pugsy wrote: ↑

Tue Jul 17, 2018 6:16 am

Snoring itself without all the other stuff can disrupt sleep quality and be enough reason to use cpap in my book.

That's what I'm thinking. Even if she doesn't have full-blown sleep apnea, her snoring needs to be treated - it can't be healthy for her. (Maybe I can do away with my ear plugs. )

As an aside, in late May, she had a cold that lasted three weeks. Her snoring was shaking the house. She was really suffering. I had to move to another bedroom - ear plugs not effective. I believe her cold would have been of much shorter duration, if she had been using a properly titrated CPAP. At least, that has been my personal experience - colds that used to last two weeks now last three days.

For tonight, I am going to set the pressure at min 7/max 10.

Thank you, Pugsy!