Saw my new sleep doc. today & posting this update for anyone interested:
1.) PB and/or CSR not important unless both CA & OA are greater than 10 each an hour (still bothers me anytime total is over 5/hour)
2.) No need to worry or involve the heart doc. unless the events are at least as in no. 1 above (looks like PB not bad enough to worry??)
3.) Agrees that mine looks like complex apnea but as long as it can be held as low as it is now all is OK with APAP. (agreed)
4.) Believes decision is still out if ASV reduction of CAs with periodic breathing when CHF is present is a good option. (agreed)
5.) Believes it is fine for me to keep making my own pressure changes when self knowledge & control is good with some guidance. (agreed)
6.) Believes it is better to not make a lot of changes as it can create our bodies to not settle down into the best pattern. (might be correct)
7.) Believes that mask leakage is very important - can be more of the cause of events than we are aware of. (agreed)
8.) Believes we should not look at the hypopneas but just total AI as he believes the scoring (human or machine) leaves a lot to be desired.
Past few weeks I've been concentrating on sleep position/mask leaks first and min/max pressures second. Now have leaks pretty well in control and using the following actions in achieving my results:
1.) Keep the CA events 25% or less than the OA events.
2.) Minimize the TTA (total time in apnea).
3.) Try to keep PB/CSR at zero (none in the last 2 weeks & 1 in the last 30 days).
I've managed to now have occasional days with no CA and maintaining an average AHI of 3.25. The doc. likes the present settings so I will leave them as is for now.
Here's a few charts to see the progression:
http://imgur.com/a/Lxmmd
Again, I cannot say enough how much I appreciate all the help and support from everyone on this forum.