Do I even actually have sleep apnea? At a loss for what to do from here.

I was "diagnosed" with an ahi of about 9 about exactly a year ago via a Lofta home sleep test. I know Lofta is considered reputable within the community, but I don't know how much I trust it. Of course, we all know the state of American healthcare and getting a real sleep study is rocket science apparently, but that's beside the point.

Anyways, my symptoms last year were waking up in a panic gasping for air - usually right as I'm falling asleep - feeling the need to sleep in almost every morning (talking 10-12) hours of sleep, lack of focus, and having this dissociated/unreal exhausted feeling throughout the day like I pulled an all nighter, despite getting plenty of "sleep".

Fast forward now, I have a CPAP which I always use. My ahi is always below five - usually between three and four - though I can rarely seem to bring it below that no matter how much I tweak my settings. Apparently, rule of thumb is that below 5 is okay, so I don't fuss with it too much. I have Oscar and I read my data regularly, but the data is so confusing. It is always a cluster of random events, both clear airway events and obstructive apnea events mostly, but also usually with the other stuff (RERA, hypopnea) sprinkled in. Yes, they still fall under an ahi of five, but I don't understand what is going on, as people say increasing pressure reduces OAs but increases CAs, and I typically have a pretty equally balanced amount of both. I should mention, a lot (most really) of my "clear airway events" have choppy breathing patterns before they occur, which I've read could mean they aren't actual CAs, but rather a result of me tossing and turning and/or just holding my breath in my sleep.

I should clarify that I'm a major hypochondriac. Sometimes I fall asleep without the CPAP and I awaken choking and/or with a pounding heart and sometimes a headache, but I can't tell if it's just anxiety/stress making me read into symptoms too much, other times I've slept without the CPAP and felt fine. The symptoms of my sleep apnea seemed to have come out of nowhere last year. I still feel the need to sleep over ten hours most days even with the CPAP.

For context, I'm 22 year old male. I have a little bit of body fat - mostly stomach/thighs area - but I'm not "fat" and I have a normal sized neck. I do have a deviated septum, but I'm able to breathe through my nose fine while I'm awake afaik. I only drink/smoke (usually vaping nicotine or weed, though I quit the nicotine recently) occasionally, either one or two nights a week. I have a job where I'm pretty active, and I'm starting to get consistent at the gym again after a couple years of slacking, but I am generally active. My diet is alright and if anything I just overeat a lot.

I'm at a complete loss of what to do. I'm stuck in this constant state of limbo of not knowing whether or not I need the CPAP, and if so why, how to fix it, and being too scared to sleep without it, while also fearing it's just making my sleep worse with micro-awakenings and making me toss and turn. My Oscar data continues to be confusing. All of my family looks at me weird and think I'm schizo for thinking I need the CPAP, none of them take me seriously. I told my doctor in January and she doesn't even take me seriously. They said they would schedule a real sleep study for me but basically left me hanging and responded with passive-aggression when I would hound them about it.

I don't know what else to do, but I did order a blood oxygen ring to try sleeping without it and see what that says, but it's currently on backorder and I don't know when I'll get it.

Also, I suppose I can post some of my Oscar Data on here if it's helpful at all, but like I said, I have experimented with probably a hundred different variations of settings by now to almost exactly the same results every time : AHI between three and five, with clusters of random types of events, sometimes with the odd lucky day where it's only one or two. I have been reading up on all this stuff along the way but I feel like I'm getting nowhere and I can't figure anything out based on this data.

I removed the profanity from your post. It wasn't helping anything and certainly wasn't needed.

And if you want anyone to try to offer ideas or explain what is going on....we need to start with those OSCAR reports.
Otherwise I have to go see if my crystal ball is fixed.

viewtopic/t172378/StickyIf-you-want-CPA ... l#p1260774

Could you bring the crystal ball out? It would be really helpful in my situation, thank you

Miamis4 wrote: ↑

Fri Aug 15, 2025 2:04 pm

Apparently, rule of thumb is that below 5 is okay, so I don't fuss with it too much.

around here, we consider an ahi of 5 to be too high. you'd do better if ahi was around 2. but we need to see that data because each of us is different with no one size fits all solution.

Miamis4 wrote: ↑

Fri Aug 15, 2025 3:04 pm

Could you bring the crystal ball out? It would be really helpful in my situation, thank you

It's broken and I don't like guessing if I don't have to and I don't have to here. You have data available so use it. Some people aren't so lucky.

You can either do the work to help us try to help you or not.
Your choice,

Here are a few different screenshots of data from the past year, just to show the results from different settings. I have tweaked my settings quite a bit over time, but I am always met with similar inconsistent results like the ones below.

I believe that way too many people become overly distracted with the question of whether they "have" something or not. The much deeper and more meaningful question from the standpoint of a patient is "Will I get benefit from the therapy?"

The only way to get the answer for that as a patient is to optimize use of PAP so that it is used at the optimal pressure(s) all night every night--no dozing off without it. That way the brain learns that sleep is its friend, not its enemy. That retraining of the brain ideally lessens anxiety over time as full restorative powers of good sleep with proper sleep hygiene becomes possible.

Understanding that relationship between sleep and anxiety can be the key to dismissing the niggling doubts of "Do I really have OSA or simple anxiety that is throwing off my numbers?" Doesn't matter. All that matters is whether putting the effort into proper long-term use of optimal pressures for all sleep eventually improves quality of life.

Meantime, let the medical people be concerned with how they fill in the blanks for meeting medical diagnostic criteria and treatment protocols; you just focus on getting your PAP use and sleep hygiene as good as they can be. Supplying the OSCAR experts here with all that they need to help you do that and listening to them can go a long way toward your goal of finding improvement so you can evaluate for yourself what experience has taught many of us about what truly-optimized PAP use can accomplish, from a patient's point of view.

I wish you the best.

I am searching Amazon for a replacement for Pugsy's broken crystal ball, but I'm not finding any products that consistently meet customer expectations for revealing the profoundly unknown, according to the posted customer reviews.

lazarus wrote: ↑

Sat Aug 16, 2025 10:18 am

I believe that way too many people become overly distracted with the question of whether they "have" something or not. The much deeper and more meaningful question from the standpoint of a patient is "Will I get benefit from the therapy?"

The only way to get the answer for that as a patient is to optimize use of PAP so that it is used at the optimal pressure(s) all night every night--no dozing off without it. That way the brain learns that sleep is its friend, not it's enemy. That retraining of the brain ideally lessens anxiety over time as full restorative powers of good sleep with proper sleep hygiene becomes possible.

Understanding that relationship between sleep and anxiety can be the key to dismissing the niggling doubts of "Do I really have OSA or simple anxiety that is throwing off my numbers?" Doesn't matter. All that matters is whether putting the effort into proper long-term use of optimal pressures for all sleep eventually improves quality of life.

Meantime, let the medical people be concerned with how they fill in the blanks for meeting medical diagnostic criteria and treatment protocols; you just focus on getting your PAP use and sleep hygiene as good as they can be. Supplying the OSCAR experts here with all that they need to help you do that and listening to them can go a long way toward your goal of finding improvement and evaluating for yourself what experience has shown many of us have learned that truly-optimized PAP use is from a patient point of view.

I wish you the best.

dammit, just when I have you pigeonholed as a smart ass....


very well said, sir, very well said.

Miamis4 wrote: ↑

Fri Aug 15, 2025 11:27 pm

Here are a few different screenshots of data from the past year, just to show the results from different settings. I have tweaked my settings quite a bit over time, but I am always met with similar inconsistent results like the ones below.

thanks for the upload of graphs. if you could make changes and post it in this format-
it would help folks here as it would provide the needed data.

thanks!

and as I'm Mr. bad example, hide the calendar.

zonker wrote: ↑

Sat Aug 16, 2025 11:49 am

. . . just when I have you pigeonholed as a smart ass....

You are not wrong.

lazarus wrote: ↑

Sat Aug 16, 2025 12:22 pm

zonker wrote: ↑

Sat Aug 16, 2025 11:49 am

. . . just when I have you pigeonholed as a smart ass....

You are not wrong.

oh no you don't! you're not going to get me in trouble with pugsy for hijacking a new user thread.

(would have sent this as PM but you seem to have that turned off?)