Persistent fatigue, CA

elikrohner wrote: ↑

Tue Jul 08, 2025 8:10 pm

I changed the range to be tighter because I thought the lower max range would help for pressure related arousals.

How would that work?

less pressure related arousals. if I don't need the higher pressure and the machine thinks I need it bec. of leaks etc... than why let it go higher.

You are assuming that higher pressures are causing the arousals. You might be assuming incorrectly.
You are assuming the the arousals are breathing related...as in some sort of flow limitation or whatever....You might be assuming incorrectly. You are aware that the machine's auto adjusting mode algorithm increases pressure not only for OAs or hyponeas but also snores and flow limitations???? These aren't always so easily seen.

You are assuming that the machine wanting to increase the flow rate of air in response to leaks that means more pressure.
You are incorrect.

elikrohner wrote: ↑

Wed Jul 09, 2025 8:47 am

if I don't need the higher pressure and the machine thinks I need it bec. of leaks etc... than why let it go higher.

So how do you know for sure that you don't need more pressure????
These machines do NOT increase the pressure in response to leaks. Now the air flow itself might be increased a bit but that's only until the pressure gets up to the pressure it was set to be. It won't/can't go higher just because of a leak itself. Now the increased air flow (air moving) may seem like it is increased but the pressure itself doesn't change within the parameters set but what it "feels" like doesn't mean it is.

There are two main types of arousals.....spontaneous arousals (means we don't know the cause) or breathing related arousal (that's where cpap comes in) but the machine can't tell us what caused the arousal....we only know it happened by the irregular breathing we see (when we can see breathing) but we have zero way to know with any certainty what caused it.

Make sure that the problem you are trying to fix with cpap settings has the ability to be fixed by those settings.
If pressure changes aren't the cause of the arousals then changing the settings to strictly limit the changes is unlikely to produce desired results because it's trying to fix a problem it hasn't caused.

I don't know (and don't have any way to know) what might be causing your arousals and I don't know if that means train wreck sleep is causing the fatigue. It might and it might not. Reviewing the breathing itself (when that data is available) lets us get a good idea as to whether a person is asleep or not but it can't tell us why.

Not all our sleep problems are related to airway issues and the machine can only maybe fix airway issue problems (when optimally set).
It won't/can't fix crappy sleep from anything not related to the airway no matter how much we might want it to.

Interesting, I thought you base the settings off of 95% and average.
Ether way here is a new link maybe you can see the data better:https://sleephq.com/public/teams/share_ ... 949ca68f09

Your flow limitation graph is fairly active and it appears that when the FLs are more active then that's when the pressure line pretty much maxes out. Not surprising as FLs are one of the data points that will drive pressure up. That's because according to the auto adjusting algorithm those FLs need to be better prevented because FLs can disturb sleep.

I assume we can't blame the FLs on nasal congestion????? If you are having nasal congestion then we have a different discussion.

Could those FLs be a factor in arousals.....it's possible.

I scrolled through your July 9th report.
I couldn't find one single CA/Central that was an asleep flagged event.....every single one of them were post arousal.
Now the hyponea...meh...hard to tell and you didn't have but a handful of them anyway. I don't think that they are a big problem at all.
If it weren't for the post arousal CA/central flags your AHI would be barely something to talk about.

You had some periods of sleep the 9th but you also had a LOT of arousal breathing segments. Some were prolonged and some were very brief. How much of that might be FL related? That's an unknown that we really have no way to know with any certainty one way or the other but it is a maybe.