6 Days on my own, then DME (Olivander's Mask Shop)

[ragtopcircus]

Those small swings did not seem to be disruptive, and I also have the option of selecting “soft response” on this machine if needed.

I’m more concerned about centrals.

I did not have any centrals during my home sleep test, and I don’t seem to have any issue with CO2 wash at EPR 3. However, I do have a pattern of getting a lot more centrals if the pressure goes over 15~16.

My father was diagnosed with CA though, and I tend to forget to breathe while awake, especially during movement/exertion, and when my mind starts to wander. I also have a history of asthma and thus adaptation to low O2/high CO2. I will go through an entire set of exercises on a single breath unless I consciously focus on each breath.

If I’m on CPAP more than a few minutes while awake, even sitting up, I start banging out centrals.

On the plus side, I can hold my breath a long time and swim a long way under water, generally farther than people much more fit than I am. The impulse to breathe just isn’t that strong.

So, I’m trying to leave a little bit of headroom / margin.

[Sleeprider]

I would leave things alone. All of your OA events on 10/5 were preceded by a larger inhale suggesting that you may have shifted position or just taken a breath and held it a few seconds. The one at 01:15:30 is clearly a breath hold. These short events are not a problem, however it looks like any sleep disruption occurred before the OA. With settings at 13 to 16 and EPR 3, your pressure only moves about 1-cm between the minimum and 95%, that is nearly constant fixed pressure. Do what makes you most comfortable, but I don't see a problem.

[ragtopcircus]

The Airsense settings feel spot-on. I’m still having trouble getting used to the wheezing air intake though (what others have described as the “wheezy whale”). While it isn’t really very loud, the noise machine has to be set quite loud to mask it, which isn’t helping either. Sometimes I’m sleeping great, and sometimes I’m not.

[ragtopcircus]

Wow, I think this is what sleep is supposed to look like! I'd have liked to get another hour or so before waking, but I'll take it! Is this showing four REM cycles, waking at the end of the last one?

   

[Sleeprider]

Sounds like you have found what works! Congrats.

[ragtopcircus]

And then there's the last couple of nights .... Sinus congestion is a big, chronic, long-term problem for me. I use Singulair (leukotriene inhibitor), XyZal, Fluticasone, Nasalcrom, etc. Ultimately, I probably need septoplasty and turbinate reduction, because a major contributing cause is really the messed-up geometry in my nose. That is not an option right now though.

Last night, after delaying going to bed while I tried to get my sinuses open, I tried switching between the F30 and F20 a few times, but could not sleep while mouth-breathing. Nothing much shows up in Flow Limitations because I was awake and putting a lot of effort into breathing through my nose or trying to fall asleep while breathing through my mouth. Then, feeling desperate to breathe and sleep at the same time, I tried switching back to the P30i pillows and turning up the pressure manually. I settled on 17 fixed (higher than I normally go) with EPR 3 (and wishing for more), and finally got a little sleep.  An hour or so later, when I woke after or during a REM cycle (I think), my sinuses had opened enough that I was able to switch back to my normal settings. The gradual increase in flow rate during that period is interesting.

It's also interesting that I seem to have tolerated the higher pressure fairly well. There is one bogus CA event during the Wake Sleep Junk, and one around 3:26:50 that might be real (or more WSJ). Now I'm wondering if I should exchange the For Her for a Vauto while I still can. Not that I need to go that high all the time, but it definitely helped. I seem to tolerate EPR/PS well, and could have used a bit more.

   
   
   
   

[ragtopcircus]

The "Central" at 3:26:50 with IPAP 17, EPAP 14 (EPR 3), if that's even what it is, only shows one missed breath following a deep breath, and then two very shallow breaths at roughly the right times before going back to normal.

[ragtopcircus]

I tried a big jump up last night. It's a philosophical shift from what works best when my turbinates are at their shrunken best to figuring out what I need on a more typical and achievable night. I bumped the IPAP up to 15~18, with EPR 3. I briefly tried bumping the humidity up from 5 to 6, but that seemed worse so I went back to 5 before going to sleep.

There's a minute-long CA event at 23:10, just as I fell asleep the first time, but then I seemed to adapt. The second one at 0:42 looks like one of my typical 11 second breath holds during arousal. The 22 minute gap at 1:46 is sort of artificial. When I woke, I purposely roused myself enough to assess how I felt and whether to continue the experiment (deciding yes). I went back to sleep easily at 2:10, and seem well-adapted to the higher pressure for the rest of the night.

The initial CA is significantly longer than typical for me, but it did not reoccur. For now, I'm chalking that up to adjusting to a big change, but monitoring.
   
   
   
   

[ragtopcircus]

Btw, I arrived at 15 by experimenting while awake. It's basically the point at which I wanted IPAP to be a little higher and EPAP a little lower.

I don't seem to have any trouble with mouth leaks at that pressure. I am using an Eliminator collar (stuffed with buckwheat hulls instead of the molded foam) to prevent chin tuck. I was awakened by soft hissing a few times though (most notably at 00:30), which was easily stopped by giving the mask a nudge. This seems to happen during REM, so I guess I'm moving around a little. It may be time to replace the cushion.

[sheepless]

a small point I mention because I haven't studied up on sleep architecture (meaning I'm not sure about this). I read that people prone to periodic limb movement don't have them in REM because our muscles are paralyzed, ostensibly so we don't hurt ourselves dreaming. if true, your mask issue may be more from slouching face muscles than from movement. again, a small point but one I'm curious about.