My AHI is at 4.8 but I still feel tried everyday.

My AHI started at 108.1 and the CPAP has lowered it to 4.8 for two years now. It doesn't matter because I still fall asleep at work everyday and can't do anything around the house, etc. No one believes me since the AHI is at an acceptable range. I was prescribed Trazadone at 100ml which worked good for 11 days but my tolerance level quickly made it useless even at 450ml. Has anyone else experienced this? I'm running out of options and I can't continue to live like this. It's been going on for the past 10 years.

I use the Phillips Dreamstation at a pressure setting between 16-20

Thank you

Have you used OSCAR to look at the data on your machine to see what is happening during the night. It may show some room for improvement in the setup, or that you may need a BiPAP instead of a CPAP. They go up to 25 cm of pressure.

Alright I'll look into the BiPAP. I didn't know the difference between the two.

Thank you

Sacrofago—I empathize. You have a big problem. First, you clearly have very severe sleep apnea. (Severe is anything north of an AHI of 30.) And your treatment, sadly, isn’t working to the point of alleviating your symptoms, so that you can function.

You clearly need more help: first from your sleep lab/docs in treating your OSA more effectively and, perhaps, from other sources, because there’s a possibility of more than one thing going on. Research other sleep disorders such as Idiopathic hypersomnia restless leg syndrome, REM Behavior Disorder and narcolepsy. (Sometimes sleep disorders travel in pairs, or even threes.) ask your sleep lab. Perhaps you need an in lab study.

It IS possible to combine more than one therapy for sleep apnea. Some people use both a dental device AND a PAP machine. (Two of my friends are doing that.) Plus, there are surgical implant possibilities and surgical possibilities, generally. And don’t forget to consider such things as positional therapy, weight loss, treatment of allergies and other life-style interventions.

A friend of mine with an AHI of 120(!) recently underwent a palate expansion procedure to lower his pressure requirements to enable him stay within the air pressure range provided by his RESMED Bi-PAP. (As he aged, he was requiring more pressure than his Bi- PAP could provide.) It worked for him, and he’s been happy with the results.

Also, a residual AHI of 4.8 isn't necessarily optimal. That means that your sleep is still being disrupted almost forty times a night during an 8 hour night! I felt a huge improvement when my residual AHI went from 3.0, to 0.3 with my transition from my gen 8 to gen 10 REMED APAP machines.

The most important thing is: Don’t give up! Healthy sleep is worth the diagnostic and treatment battle! (I’d like to say “journey’, but frankly, mine was more of a “battle.”

Good Luck! And keep us posted on your progress.

Download and use Sleepyhead Software or a similar program (Oscar). You will be able to get a good analysis of your sleep pattern. I use a wedge under my pillow to elevate my head, it helps. I take a 10mg tablet of melatonin which also seems to help. Good Luck.

All great information I really applicate it. I do use the pillow wedge and I take 20mg of melatonin every night. I have also used breath right strips, mouth tape, chin straps, nasal dilators, mouth guards, a weighted blanket, etc. I wish I can to this forum earlier.

Thank you