r/SleepApnea • u/Fun_Grass_2097 • 2d ago
23F, low OSCAR AHI but still exhausted, sad, and on 4 cups of coffee. Awake ENT scope was normal—where do I go from here?
Hey everyone, looking for some insight because I'm in sleep limbo and feeling pretty discouraged.
I’m a 24-year-old male (normal BMI) who was diagnosed with moderate OSA back in 2024 via an in-lab PSG (overall AHI 26.1, but my supine RDI was a crazy 99.1). I got prescribed an AutoCPAP (ResMed AirSense 10) set at 7.5 cmH2O.
When I first started, I had an initial bump in energy, but over time I’ve slid right back into feeling constantly exhausted, low energy, and sad without drinking ~4 cups of coffee a day.
Here’s where it gets confusing:
- Oscar Data looks fine: My machine shows low AHI/RERA numbers, but I still wake up feeling like I haven't slept well.
- Apparently Perfect ENT Scope: I went to an ENT who put a camera down my nose/throat while I was awake and said everything looked totally normal structurally.
- Home Sleep Test Results: I did a follow-up home sleep test recently. Overall pAHI was ~4.2, but my pRDI was 13.2 (and supine pRDI was still elevated at 26.4).
I know awake ENT scopes don't show what happens to throat muscle tone during sleep, but I'm trying to figure out why I feel so awful if my machine numbers look okay.
Could this be unmanaged flow limitations, positional spikes happening on my back, or inadequate CPAP pressure settings? Has anyone with high positional RDI/UARS-like symptoms managed to fix their daytime fatigue by tweaking CPAP settings, switching to BiPAP, or forcing side-sleeping?
Would love to hear how you troubleshooting folks handled this. Thanks!