Was doing well, AHI slightly higher, lots of leaking between 4-5am.

[jkang9080]

I don't wake up feeling as refreshed anymore. I was doing really well after some suggested tweaks by the board - specifically adjusting EPR and playing with min/max. I have gained around 5lbs recently. Attached 3 days worth of data - not sure what's causing the huge leaks. I don't get too congested.

[PeaceLoveAndPizza]

CA’s are the culprit, as you already know from your previous thread. Given you have already have dialed back EPR to 1, you could try a fixed pressure of 9 with EPR 1 to see if it is the late pressure swings causing them. At lower pressures things look good, so locking it in may work.

Give it a try for a few nights and let us know. If things go totally bonkers, then revert, but worth a go.

At the same time, make sure you are keeping the airway open with a lower pillow and possibly a soft cervical collar to keep your neck from kinking. It could be that as you go into REM you are chin-tucking which closes some of the airway, which increase flow limitations, and requires the machine to increase pressure to keep it open. Something to ponder.

[jkang9080]

Set manual pressure to 9. I have a chinstrap, that should help with collapse I think. Maybe the strap is stretching out too much and I need to replace it. I do have a cervical collar, may try to use that tonight. Woke up with aerophagia today, but I think there's been some kind of improvement? Attached last night's Oscar data here.

[jkang9080]

I tried busting out the cervical collar again, and wow. What a difference it's making. It looks like you were spot on about chin-tucking during REM. AHI down to 1.22 - but the most noticeably thing is that my AHI spikes are maxing out at 3. Before, my average AHI was around 2-3, but going up to around 9 at peak. Thanks!

[PeaceLoveAndPizza]

Ta. It is my pleasure to help.