Minimal Improvement After Years on CPAP, Need Help

Hello! I’ve been using CPAP since 2021 to treat mild/moderate OSA. I was first diagnosed 14 years ago.

Despite consistently low AHI (<5), I still really struggle with fatigue, brain fog, and other symptoms of poor sleep. I’ve had little success treating these symptoms, so I’m trying to revisit my sleep as a potential root cause

I've seen multiple sleep doctors, but they often dismiss my concerns because my apnea is “controlled.” Still, I feel terrible and want to rule out anything that may have been missed. If anyone can help me interpret my OSCAR screenshot below or suggest what to push for next (e.g. titration, in-lab PSG, etc.), I’d be extremely grateful.

I have included a screenshot from last night.

I’m happy to share any more context or information, but I wanted to keep this post brief. Thank you very much in advance.

Do you take any medications of any kind for any reason? If so, what?

Do you have any other physical or mental health issues going on?

The only systemic medications I take are lamotrigine (300mg) and minoxidil (2.5mg). The rest are topical medications. All systemic medications were started within the last year.

I have depression, GAD, and social anxiety. I also have chronic muscle tension/pain.

Pretend you're someone else reading your note(s). What would YOU think and advise given what you see?

Hi, Julie. Thanks for your suggestion. If I knew what to do, I would have done it already, which is why I've asked for help here.

I have seen several sleep doctors over the years who tell me that my apnea is treated because the AHI is under 5. It kind of ends there, even if I try to follow up. It's hard to know what to push for or who to talk to if I can't get further than this with sleep doctors. My understanding is that sleep disordered breathing is more complex than just AHI (let me know if this is wrong), but I'm not sure who to speak to about those concerns.