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[Treatment] Pulmonologist --Not use CPAP, Use mandibular. How to later cross check?
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Pulmonologist --Not use CPAP, Use mandibular. How to later cross check?
ISSUE. Previous 8  years with prescribed CPAP before later Pulmonologist's  test showed no apnea and to continue use of dental mandibular device. Four years later and  after AFIB, mild Apnea identified in another Pulmonologist's  Home test. Began with new APAP but terrible AHI and personal sleep. 3 months of results on OSCAR read by Pulmonologist, who did another home test  and yet another with mandibular device. Pulmonologist determined  that CPAP would not help with Apnea, but to continue to use mandibular device.  This works fairly well, but I would like to do occasional home CPAP or APAP test to cross check Rx  and look at changes.  How to do this?  Below paragraph is background history detail  and might be skipped   

HISTORY.  79-year-old. Mostly excellent health, but of course, sleep apnea and a few other challenges. In 2007, I was diagnosed by a pulmonologist through lab sleep test with mild Sleep Apnea (AHI 8). Subsequently used a Phillips Respironics Remstar device with good success – AHI scores 0.5 - 2.5. My regular use of OSCAR adn visits to pulmonologist validated this. Updated the RemStar machine in 2012 and continued to use it until 2014, when I switched to a mandibular dental device recommended  and installed by dentist;  that seemed to work well with less fuss. I liked and mostly enjoyed the Phillips CPAP machine for  sleep, but mask was sometimes a bother with leaks and nose scars.   In late 2015 I was concerned that I was using the right device and had another in-lab sleep test with the pulmonologist conclusion: no significant sleep apnea (less than mild) but to continue dental device for snoring. Late 2021 I was diagnosed with significant but non symptomatic AFIB and received successful cardioversion with no AFIB  return to date. Of course, Eliquis blood thinner for life.  I am a highly competitive Masters swimmer with physician well charted 50 years of regular pulse of 38-40.  Nonetheless, mid 2022 did take another sleep test both for concern of poor sleeping and also as is  generally prescribed for AFIB. Sleep Center home test read by pulmonologist found mild sleep apnea - AHI 8.5.  Got ResMed APAP 11 Note that I now  must sleep on my back due to shoulder difficulties; very comfortable on my back, but sometimes during sleep shift to the side.  Immediately had terrible use problems with mask and also with AHI results over three months, AHI rarely below 15, mostly over 20. Used OSCAR throughout to record and provided results to pulmonologist who is very engaged in Using OSCAR.   Succeeded in fixing the mask problem with full face  foam cushion  but still very poor  results both for sleep-awake and AHI Scores. Higher AHI when apparently on my side rather than back.  Pulmonologist did full sequence of AHI vs CPAP  at various pressure levels over three weeks. Equally bad results.  Then retested by same pulmonologist with an advanced home test. Again, terrible results.  Second time tested using upgraded high level home test while using the mandibular device. Some clusters of Centrals but lots of hypopneas  and apneas. Pulmonologist conclusion. Much of high AHI was awake/awakening with mild anear underneath. CPAP was not a solution but mandibular was relatively successful. This was not the result which I  was hoping for, but have continued with mandibular device.  I also use an O2 Ring for blood oxy, the results of which my  pulmonologist says are very ok and mirror the ok  oxygen levels during sleep tests results.
 
CONCERN & QUESTION. Per pulmonologist, using the dental mandibular device, which has tested better than CPAP in addressing my sleep and perhaps the Apnea. Nevertheless, I have concerns that I may somehow be able to better address the Apnea with CPAP.  I have recently received an Dreamstation II APAP-CPAP as Philip’s recall replacement, and that machine  complements The ResMed 11 APAP-CPAP that I have from five months ago.
>>>What is the best way I can use either of these machines to occasionally check my sleep Apnea with and without the mandibular device? Both machines can report to OSCAR, and I report into OSCAR  my overnight  O2 Ring oxygen and  heartrate. I have not set up the Dreamstation II yet, but straight forward.  I have an ample supply of the Air Touch F20 headset and cushions. I am a nose breather always during the day and generally during the night with Mandibular device.  But sometime during the night sleep with CPAP or APAP I seemed to shift to mouth including  inside the full-face mask. Note that I sleep on my back due to my left shoulder, but am very comfortable on my back and easily fall back asleep after BPH bathroom break(s).

How to test Apnea? CPAP set at  4 or 7, APAP set at 4 or 7 max 10? ...... I know from experience earlier that APAP set to go higher than 12 results in very high AHI scores and awakening. Also, I often failed to control mask leaks above 14-16.
Thanks
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