Looking for help on what to do.

[qwertyxyz]

Hey everyone, I'll start with that I'm not new to cpap, (been using it for around 1.5 years) but haven't felt very many benefits from it and haven't gotten much feedback from my sleep specialist. Recently I've started using a SD card and looking at my data in OSCAR. Previously I had mostly just been paying attention to my usage time (as that's all the insurance company and the FAA care about) but noticed now that my average AHI is quite high (7.5-8.5) and was looking for some insight on some ways I can change the settings of my machine to hopefully make therapy more effective. I've attached the 3 most recent nights of data in OSCAR, any help is appreciated.

   
   
   

[staceyburke]

You are having positional apnea.  You can see positional apnea where either H or Oa events are clustered together.  Getting rid of as many as you can will lower your AHI.  Positional apnea can NOT be controlled by pressure changes.  You have to find out what position you are getting into and cutting off your own airway.  Have you changed your sleep position?  Sleeping on your back?  Using more (or new) pillows?  These things can cause positional apnea by chin dropping to your sternum and cutting your airway.  Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar.  I have a link to collars in my signature at the bottom of the page.  It shows people who are not wearing a collar and the SAME person wearing a collar.  There is a huge difference between the two.

Some of the centrals may be misdiagnosed and could be obstructive also.  I would like to try a different setting to see if it helps.

Min 7
max 14
EPR full time set to 3.

[jdougc]

staceyburke is right, you are having positional apnea. A soft cervical collar can help as stated.
Your pressure swings might be arousing you, it is not helpful to your therapy. It might be taking too long for the pressure to clear your airway and then the pressure drops back down.
Can you try cpap mode of 10.4 near your median, with EPR of 3 to help with the flow limits?
Or tighter limits on APAP. 10.4 to 12 cm of pressure.
APAP is used by many to find the sweet spot of pressure.

[qwertyxyz]

You are having positional apnea.  You can see positional apnea where either H or Oa events are clustered together.  Getting rid of as many as you can will lower your AHI.  Positional apnea can NOT be controlled by pressure changes.  You have to find out what position you are getting into and cutting off your own airway.  Have you changed your sleep position?  Sleeping on your back?  Using more (or new) pillows?  These things can cause positional apnea by chin dropping to your sternum and cutting your airway.  Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar.  I have a link to collars in my signature at the bottom of the page.  It shows people who are not wearing a collar and the SAME person wearing a collar.  There is a huge difference between the two.

Some of the centrals may be misdiagnosed and could be obstructive also.  I would like to try a different setting to see if it helps.

Min 7
max 14
EPR full time set to 3.

Thanks for the response. I sleep on my back normally, as I'm overweight and sleeping on my side has always caused back discomfort. My problem early in my therapy was me ripping the mask off in my sleep and found that was from me turning in my sleep and misaligning the mask so I've fixed that by creating "wedges" with extra blankets and placing them under my sides to keep me in one position on my back. I'll try a flatter and thinner pillow to see if that helps and look into a collar if it does not. As far as the settings, I had heard here that a wider pressure range is typically worse than a tighter, more precise range since the changes in pressure could potentially cause you to stir awake. Is that not the case? When I was first given my machine it was set to those exact settings, 7-14, but i dialed the minimum up a bit to 9.4 as my median was ~10. Again, thanks for the help.

[qwertyxyz]

staceyburke is right, you are having positional apnea.  A soft cervical collar can help as stated.
Your  pressure swings might be arousing you, it is not helpful to your therapy. It might be taking too long for the pressure to clear your airway and then the pressure drops back down.
Can you try cpap mode of 10.4 near your median, with EPR of 3 to help with the flow limits?
Or tighter limits on APAP. 10.4 to 12 cm of pressure.
APAP is used by many to find the sweet spot  of pressure.

Thanks for the response, I think I'll start with the tighter APAP limits and turning EPR back to 3 and see how it goes. Like staceyburke recommended, I'm going to try using a flatter and thinner pillow to see if it hopefully helps and if it doesn't look into a SCC.