So I experimented with the Aircurve last night, with the 8.0cm of pressure I'm used to, but I did EPAP of 4 (PS 4), which I had previously struggled with. It felt a little weird at first but I managed to fall asleep and seemed to get through the night without any centrals. But unfortunately I was back to having the same crappy sleep that I was having over a month ago when I was using the BIPAP steadily. I pretty much woke up like clockwork every hour, usually during dreams, which is exactly what was happening a month ago. My Oscar data looks fine, other than there were a lot of mask leaks for some reason, which didn't seem to be noticeable so I don't know if that was causing me to wake up - my awakenings were very much the same as they used to be when there were no mask leaks so I don't think that was a factor in me waking up every hour.
https://imgur.com/a/gCIUp2v
So I really don't know what's going on here. Maybe someone with a bit more knowledge about all this stuff might be able to consider all the clues and figure out why the Aircurve at 8 cm with PS of 4 is causing me to wake up every hour during dreaming/REM, and why the Autoset with the same pressure, but EPR of 3, allows me to get longer stretches of sleep, sometimes 2 or 3 hours. What exactly could be going on here?
It makes me me wonder about Expiratory Palatal Prolapse, which I know we kind of ruled out back in February, but I have heard that Bilevel can make that worse so that's the only thing I can think of....and I am pretty sure I am dealing with some kind of soft palate/velopharyngeal issue which can be associated with Expiratory Palatal Prolapse. My flow curves don't seem to suggest that so maybe it rules it out....but at the same time I don't want to definitively rule anything out when there's
something going on that is hard to explain.
I have also done a bit more thinking and reading about issues that I am quite positive are part of problem, relating to the mental/psychological/lifestyle factors. I had mentioned way earlier in this thread that I went from working for a good company with a lot of friends and coworkers that had a great sense of community, to suddenly working as a freelancer by myself from home, and my sleep problems began and coincided with this shift in my life....and I have definitely noticed my life has been a lot more isolated and lonely during times that my sleep has gotten worse, so it caused me to look into this, and there are actually quite a few articles and studies about this exact issue.
https://pubmed.ncbi.nlm.nih.gov/22043123/ the study concluded:
"Loneliness was a significant predictor of sleep fragmentation. Humans' social nature may partly be manifest through our dependence on feeling secure in our social environment to sleep well."
I've also read about how loneliness causes actual stress on the body and contributes to depression and anxiety that can affect the nervous system and can contribute to that sort of low arousal threshold that makes someone quick to wake up at the slightest disturbance.
It seems kind of crazy but it actually makes a lot of sense, and definitely seems relevant in my case. These last 6-9 months have been a vicious cycle for me in which I've become more and more isolated as my sleep problem have persisted, and I've been much less willing to do certain activities or go out at night, or go on dates, because I'm either tired, or I'm worried about making my sleep worse, or I'm worried about how my sleep problems will affect a potential relationship. I also don't like the idea of having to use a CPAP around a girl...which I know is kind of vain but I cant help but think about that. I've even been worried about trying to change my job situation because as a freelancer I have more flexibility to deal with my sleep problems, or sleep more in the morning. But it's kind of a Catch 22 because I may actually sleep better if I come out of my shell and force myself to go to an office every day and work with people, or have a girlfriend to keep me company and do stuff with regularly. It feels really sad to say, since it hasnt been a problem for me in previous years, but I've definitely become quite lonely lately, and with a lot of my friends getting married and having kids, I don't have many people to do stuff with anymore, other than my family and a few friends occasionally, but I often find myself being alone most days with no one to do anything with. And from what I've read about loneliness, this is a definite contributor to stress and I'm sure can be capable of making my sleep worse. It doesn't seem to be a well documented phenomenon but it makes a lot of sense.
I still think there are some physical factors at play as well, since I have observed sleep problems at times when I was in a good mood, and not feeling depressed or lonely...and I have been noticing snoring and awakenings where I feel out of breath (especially with the BIPAP), so I'm still not ruling that out. But I'm certain that overcoming some of my mental health and loneliness issues in my life will at least strengthen my body's tolerance to disturbances in my sleep. It definitely makes sense that if my nervous system is stressed from these issues in my life, that I would be way more on-edge and be more inclined to wake up from any kind of stress during sleep - possibly even from elevated heart rate/funky breathing during REM?