Looking for tips to dial in my settings

[tomkatt]

Your AHI is all central apneas, effectively no obstructive apneas.  Fortunately they are just during transitional sleep, "twilight" sleep.  It is worth working on those central events though, you effectively lost a half hour of sleep, and your oxygen level may not be very good during that time.  I suggest logging oxygen levels with a recording watch or ring, you may find your oxygen level is dropping during that phase.  Mine can drop dramatically during the first half hour of sleep, low 80's, if left uncontrolled.  I learned this with a ring monitor that could be set to vibrate at a set oxygen level, it was like a 5 alarm fire.  I now regularly use a ring that can import into OSCAR.  

I see you are using soft response.  In my case this increases the number of central apneas. Try standard response and see if it helps.  EPR and ramp also increase them for me, but I see you aren't using them.  I also find that using the full face mask setting with pillows decreases my central apneas, you could try it.  These settings all indirectly change the blood CO2 levels.  You actually want to increase CO2 because it is what drives the urge to breathe.

Finally, what position are you in when you go to sleep?  In my case the central apneas are very position dependent.  If I'm on my right side I get many more central apneas, especially during sleep transition.  Oddly I have a much lower AHI on my back than either side, because with a machine I have no obstructive apneas but quite a few central and hypopnea events.

Thanks for the advice.

Central apneas: They seem to have become an issue with the recent mask change (previously used a Dreamwear cushion, had a terrible time switching to N30i cushion, but better now with the P30i pillows). I always had a few early in sleep (seems to be treatment related in general), but nowhere near what's happening now. I'm hoping they reduce in the next week or two as I get used to the new mask since I've never used pillows before, but will give the standard response a shot and see if it helps.

Regarding SPO2 levels, I have an oximeter that can test when I'm awake, but it doesn't have any sort of logging/memory retention. Best I could do is check before I go to sleep and if I wake up, but I'll keep an eye on it if I can. I'll see if I can get something better in the future.

Sleep position: Generally either on my right side or on my back. Usually I'm most comfortable sleeping on my back, but sometimes if my back is sore after a workout, I'll stay on my side. I tend to switch a bit when initially laying down, which is probably that period where I'm not actually asleep yet.

Regarding the window where I effectively lost 30 minutes of sleep: Yeah, recently it's been hard to wind down and actually fall asleep, even when I'm tired. Stress I guess. I'm hoping that improves over time and I fall asleep more easily in that "twilight" window as well. Some of that is probably related to adjusting to the new mask too, since I've used the Dreamwear for the last six years or more, and the change to using the pillow mask has been good, but very different.

Question regarding the full face mask setting: How does that affect things? I know the P30i is expected to be on the pillow setting; is there some benefit, or change in how the airflow works with full face?

[tomkatt]

So, better numbers last night after switching to full face, a bit less CAs, but standard response wasn't for me. I tried it the night before and my numbers and centrals got worse. Better after going back to soft response.

Now though, with full face and soft response, I'm having two issues:

1. I'm hitting pressure limits, maxing out at 11 cm. So I probably need to increase that to 12.

2. I'm drying out hard. My tank just can't give me enough humidity, and turning up the hose heat so it can go higher dries me out further.

If you got any tips I'm all ears, otherwise, just gonna keep testing and seeing what I can improve over the next few days.