help with optimizing AHI--positional apnea?!?

[Tsukuyomi]

new achievement unlocked!

   

[jdougc]

How did you feel when you woke up? You need more sleep, generally you need 7 1/2 to 8 hours of sleep.

Since your Apnea was well controlled, the pressure swings were cause by Flow limits which is treated by EPR.
Raise your EPR to 3 full time.
Raise your minimum 8 cm.
Leave the ramp at 7 cm for 5 minutes, unless you feel airstarved. If so, raise the ramp pressure to 8 cm also. 
Lower your maximum pressure to 10.6 just above your median. You should have much less pressure swings and a more comfortable sleep.

See how it goes for a few nights.

[Tsukuyomi]

How did you feel when you woke up? You need more sleep, generally you need 7 1/2 to 8 hours of sleep.

Since your Apnea was well controlled, the pressure swings were cause by Flow limits which is treated by EPR.
Raise your EPR to 3 full time.
Raise your minimum 8 cm.
Leave the ramp at 7 cm for 5 minutes, unless you feel airstarved. If so, raise the ramp pressure to 8 cm also. 
Lower your maximum pressure to 10.6 just above your median. You should have much less pressure swings and a more comfortable sleep.

See how it goes for a few nights.

"Raise your minimum 8 cm"? 

Do you mean lower it from 10 to 8?

[jdougc]

No, I didn't read your settings correctly.
Don't lower the minimum pressure .

[Tsukuyomi]

No, I didn't read your settings correctly.
Don't lower the minimum pressure .

you're recommending setting minimum to 10 and max to 10.6 with EPR set at 3?

that seems curious... how would EPR 3 work if the range is only 10 to 10.6?

this night of 0 AHI was an anomaly, so I suspect that lowering to 10.6 isn't warranted.

[jdougc]

Pressure swings can cause arousals, so I was suggesting you try this for a few nights to see if your sleep improved.

[UnicornRider]

I would be curious to see a zoom image from ~0416 to ~0420. The time period of the pressure excursion, it would be interesting to see the graphs leading into the Flow Limits that triggered the corrective action.

Another zoomed view from ~0243 t0 ~0246, the time leading in to the RE Flagged Event would also be interesting.

Being as how corrective action in response to flow limits brought pressure up to 12.62 cmH2O. I do not agree with reducing Press Max. that far. You have been utilizing the pressure up to 16cmH2O until recently. Lets get a few more OSCAR Reports before we drop the Press Max, we want to ensure this is repeatable.

Pay attention to detail in all the external inputs that created this score. Then repeat it consistently and we will be able to get an improved white matter score after about three months of improved therapy.

By all means keep posting OSCAR Reports.

[Tsukuyomi]

Here's the two blow-ups you requested:

   
   

Here's one from last night when AHI was 2.4 containing most of the events relatively early on during sleep:

   

Looks like my attached graphics are coming close to the 8 MB limit (currently 6 MB). Does one start to delete the earlier ones to make room for more?

[UnicornRider]

Your recent post looks to be positional apnea, You have scored lower before, so we know you can achieve better. Attention to detail will provide better consistency,

 Two weeks ago you probably would have jumped on a AHI score of 2.39, it still is respectable.

  Are you still trying different pillows? Try not to change too many items at once, that way you can better determine the value each item adds to your sleep.

 If you run up against the 8 MB limit you may have to start eliminating some you may have too high of a resolution for your posted OSCAR Reports, It seems too early for you to run out of space. I will refer this to more knowledgeable individuals.

[Tsukuyomi]

I went back to the wedge and am sticking to that, with a leg pillow to discourage slipping down to the bottom of the wedge.

Here's how last night went. I decreased the max pressure to 14 with no obvious ill effects, and EPR is back at 3, but I had a fair amount of central events and the occasional OA without a clear positional issue.