Nine months of CPAP use, low AHI, still exhausted

I have been using my Philips Respironics DreamStation Auto CPAP with my Philips Respironics DreamWear Nasal CPAP Mask since 30 Nov 2018. I have used it every day with an exception of about 10 days in the time period. The exceptions were when I was on a red eye flight or my nose was irritated so I used my mandibular advancement device. I am just as exhasted as I was before I started using it. My AHI scores are usually very low (<5, often <3) but I still feel exhausted when I wake up. For the first month I used it between 10 and 12 hours per night to see if that would help. I fall asleep immediately with it and wake up when my alarm goes off, but still feel exhaused. I have been looking at my data in SleepyHead. I have been back to my general practitioner and my sleep doctor since I started using it. I have had a full physical and blood workup. They both say I shouldn't be tired since the CPAP seems to be working. I just moved halfway across the country to the mountains of CO and a new job, but am still exhausted. I am open to any suggestions. I have been walking for about an hour probably five days a week, but still feel exhausted and too tired to really work out.

Here is a summary history. I am 6'9" tall and currently weight 315 lbs. I have always snored but I think it got bad around 2009 when I hurt my knee, began excercising less, and gained weight. Prior to that I was around 250 lbs.

2013-06-30 Sleep study (AHI 13.0)

2013-07-15 CPAP sleep test (AHI 0.6 with CPAP)

2013-07-20 Prescribed a ResMed S9 Elite CPAP, tried it for a week, could not fall asleep with it on

2013-09-13 Tried Provent Sleep Apnea Therapy

2015-02-05 SomnoMed SomnoDent Classic Sleep Apnea Device, Oral Appliance, Mandibular Advancement Device

2018-11-30 Received Philips Respironics DreamStation Auto CPAP with my Philips Respironics DreamWear Nasal CPAP Mask, fell asleep immediately and slept through the night
-Still wake up exhausted

2019-01-10 to 2019-04-29 Multiple appointments with general practitioner and sleep doctor, both say I should be feeling fine based on physical exam, blood tests, and CPAP results

2019-06-28 Moved to CO at 8000 ft elevation

2019-07-17 Philips Respironics DreamWear Full Face CPAP Mask

I have lots of pictures of my SleepyHead logs.

Any suggestions are welcome

I’m so sorry you are tired all the time. There are experts here who may be able to help you dial in your settings to maximize the benefits you get from using your machine. And wouldn’t it be wonderful if that helped you feel more rested?

It’s great you’re using Sleepyhead. Could you post two charts from the past week or so that seem typical to you? Please post a screenshot of the daily chart after turning off the calendar and the pie chart. Stack your graphs like so:

Events
Flow rate
Pressure
Leaks
Snores.

Scrunch the charts a little to get them all in one shot. You can do that by grabbing the gray horizontal lines that separate the graphs.

ryanenorth wrote: ↑

Sun Sep 08, 2019 9:48 pm

I have lots of pictures of my SleepyHead logs.

Let's see some *screenshots* of recent nights, as explained here:
wiki/index.php/Sleepyhead:Organize

here are my large leaks for the 2162 days I have on my SD card. 8 large leaks and every time is that I removed the mask without stopping my cpap. Over the years I have had thousands of leaks severe enough to wake me up and they have never been registered as large leaks. That's why I say this statistic is useless.

centrum wrote: ↑

Mon Sep 09, 2019 8:15 am

cpap.GIF

here are my large leaks for the 2162 days I have on my SD card. 8 large leaks and every time is that I removed the mask without stopping my cpap. Over the years I have had thousands of leaks severe enough to wake me up and they have never been registered as large leaks. That's why I say this statistic is useless.

There are a lot of the graphs in the overview section of statistics that I would deem "useless". This particular LL graph is one of them.

But when looking at the nightly detailed reports....they aren't necessarily "useless". In fact they can be quite informative in some situations.

Pugsy wrote: ↑

Mon Sep 09, 2019 8:21 am

centrum wrote: ↑

Mon Sep 09, 2019 8:15 am

cpap.GIF

here are my large leaks for the 2162 days I have on my SD card. 8 large leaks and every time is that I removed the mask without stopping my cpap. Over the years I have had thousands of leaks severe enough to wake me up and they have never been registered as large leaks. That's why I say this statistic is useless.

There are a lot of the graphs in the overview section of statistics that I would deem "useless". This particular LL graph is one of them.

But when looking at the nightly detailed reports....they aren't necessarily "useless". In fact they can be quite informative in some situations.

Thank you. One thing I seem to notice, the resmed 10 and the system one do not provide the same quality of statistics ... is it possible resmed 10 to do better ?(Which would be normal since the model is more rescent)

centrum wrote: ↑

Mon Sep 09, 2019 8:35 am

Thank you. One thing I seem to notice, the resmed 10 and the system one do not provide the same quality of statistics ... is it possible resmed 10 to do better ?(Which would be normal since the model is more rescent)

"Better" is subjective and really depends on what a person is wanting to see that they find useful.

Respironics and ResMed report the data in a different manner and one is not necessarily better than the other...just different.
Some people prefer one way over another and that is a subjective thing.
I actually prefer the Respironics way of flagging FLs over the FL graph from ResMed but other people prefer it to be the other way around.
But then I started my therapy on a Respironics machine over 10 years ago so that is what I was used to seeing for years and years.

ResMed and Respironics have always reported the data a little differently right from the beginning many, many years ago when they first starting actually recording data so people could review it.
You would really have to go way back in time to see which machine brand actually started recording efficacy data to figure out the answer (and that's still a maybe answer) to see who was actually first.
They have both been reporting pretty much the same data for years.

So "better" is probably in the eye of the beholder. There are things about both brands that I like a little better than the other but that doesn't necessarily make one better than the other for everyone else. So more "different" than necessarily "better".

I don't mess with the overview stuff at all unless I am checking usage hours long term. It's potentially useful for trends and patterns which is really all this data was designed to do in the first place and not a nightly visit under the microscope. DMEs and doctors only really care about trends and patterns and remember....DMEs and doctors are who these manufacturers deem as their real customers that they want to keep happy. It was never us the end user that anyone really cared about in terms of keeping happy. We are lowly peons who are too stupid to understand any of this stuff.

I have attached screenshots for three nights in a row. The AHI values were 1.96, 5.53, and 12.10. I think I took an Ambien on the night with the lowest score. I normally only take Ambien when I am traveling internationally and the time change will be more than 3 hours.

Please review this thread for formatting hints on how we like to see the reports so we can best offer ideas to maybe help you.
You have included graphs we don't need and omitted the stuff on the left side that we do need.

viewtopic/t158560/How-to-post-images-for-review.html

Were you awake during the time periods where the clustering of events was the heaviest on that AHI of 12 report?
Between 4 to 5 and 6 to 7???

You probably should take a crash course on figuring out awake/arousal related flagged events and asleep flagged events.
http://freecpapadvice.com/sleepyhead-free-software

The lower AHI nights with the Ambien usage...you probably slept sounder and less arousals or awakenings to cause false positive flagging which resulted in lower AHI nights. I suspect the higher AHI nights are when you have more arousals or awakenings....now why you have crappy sleep resulting in those arousals...million dollar question.

Pugsy wrote: ↑

Mon Sep 09, 2019 8:50 am

centrum wrote: ↑

Mon Sep 09, 2019 8:35 am

Thank you. One thing I seem to notice, the resmed 10 and the system one do not provide the same quality of statistics ... is it possible resmed 10 to do better ?(Which would be normal since the model is more rescent)

"Better" is subjective and really depends on what a person is wanting to see that they find useful.

Respironics and ResMed report the data in a different manner and one is not necessarily better than the other...just different.
Some people prefer one way over another and that is a subjective thing.
I actually prefer the Respironics way of flagging FLs over the FL graph from ResMed but other people prefer it to be the other way around.
But then I started my therapy on a Respironics machine over 10 years ago so that is what I was used to seeing for years and years.

ResMed and Respironics have always reported the data a little differently right from the beginning many, many years ago when they first starting actually recording data so people could review it.
You would really have to go way back in time to see which machine brand actually started recording efficacy data to figure out the answer (and that's still a maybe answer) to see who was actually first.
They have both been reporting pretty much the same data for years.

So "better" is probably in the eye of the beholder. There are things about both brands that I like a little better than the other but that doesn't necessarily make one better than the other for everyone else. So more "different" than necessarily "better".

I don't mess with the overview stuff at all unless I am checking usage hours long term. It's potentially useful for trends and patterns which is really all this data was designed to do in the first place and not a nightly visit under the microscope. DMEs and doctors only really care about trends and patterns and remember....DMEs and doctors are who these manufacturers deem as their real customers that they want to keep happy. It was never us the end user that anyone really cared about in terms of keeping happy. We are lowly peons who are too stupid to understand any of this stuff.

Thank you

centrum wrote: ↑

Mon Sep 09, 2019 8:35 am

Thank you. One thing I seem to notice, the resmed 10 and the system one do not provide the same quality of statistics ... is it possible resmed 10 to do better ?(Which would be normal since the model is more rescent)

Resmed has always provided better data.

Why do you like to keep derailiing other peoples threads? start your own.

palerider wrote: ↑

Mon Sep 09, 2019 12:02 pm

centrum wrote: ↑

Mon Sep 09, 2019 8:35 am

Thank you. One thing I seem to notice, the resmed 10 and the system one do not provide the same quality of statistics ... is it possible resmed 10 to do better ?(Which would be normal since the model is more rescent)

Resmed has always provided better data.

Why do you like to keep derailiing other peoples threads? start your own.

What the hell are you talking about ?

centrum wrote: ↑

Wed Sep 11, 2019 11:33 am

palerider wrote: ↑

Mon Sep 09, 2019 12:02 pm

centrum wrote: ↑

Mon Sep 09, 2019 8:35 am

Thank you. One thing I seem to notice, the resmed 10 and the system one do not provide the same quality of statistics ... is it possible resmed 10 to do better ?(Which would be normal since the model is more rescent)

Resmed has always provided better data.

Why do you like to keep derailiing other peoples threads? start your own.

What the hell are you talking about ?

Which part don't you understand?

palerider wrote: ↑

Wed Sep 11, 2019 11:49 am

centrum wrote: ↑

Wed Sep 11, 2019 11:33 am

palerider wrote: ↑

Mon Sep 09, 2019 12:02 pm

centrum wrote: ↑

Mon Sep 09, 2019 8:35 am

Thank you. One thing I seem to notice, the resmed 10 and the system one do not provide the same quality of statistics ... is it possible resmed 10 to do better ?(Which would be normal since the model is more rescent)

Resmed has always provided better data.

Why do you like to keep derailiing other peoples threads? start your own.

What the hell are you talking about ?

Which part don't you understand?

Why do you like to keep derailiing other peoples threads? 

centrum wrote: ↑

Wed Sep 11, 2019 5:20 pm

palerider wrote: ↑

Wed Sep 11, 2019 11:49 am

centrum wrote: ↑

Wed Sep 11, 2019 11:33 am

palerider wrote: ↑

Mon Sep 09, 2019 12:02 pm

centrum wrote: ↑

Mon Sep 09, 2019 8:35 am

Thank you. One thing I seem to notice, the resmed 10 and the system one do not provide the same quality of statistics ... is it possible resmed 10 to do better ?(Which would be normal since the model is more rescent)

Resmed has always provided better data.

Why do you like to keep derailiing other peoples threads? start your own.

What the hell are you talking about ?

Which part don't you understand?

Why do you like to keep derailiing other peoples threads? 

This is not your thread, but you start posting your stuff in it.

Simple. And it's not the first time.