42 days of APAP, need assessment

[icancant]

I started APAP therapy on March 02 2020, my original pressure prescribed from the doc was 6 cm H20 low/15 cm H20 high. My next appointment with my doc won't be until May 29th so I used his initial prescribed settings for 30 days and then I bumped the low pressure up to 11.2 through a series of small increments. My "mean" pressure was around 11 so I thought increasing the pressure to around that area was a good point for my low pressure to start at.

I think I'm feeling a little bit better at this higher pressure, but I still feel "fuzzy" in the head at times, and mid to late afternoon I'm struggling to stay awake.

My initial sleep study was an "in home" type, and resulted in a RDI of 29, indicated bradycardia, and my saturated oxygen was 65% at the lowest recorded value.

I would be grateful if a kind soul would be able to look over my screen shots and suggest any changes to my settings.

[Pugsy]

How are you sleeping and feeling?

The bulk of your AHI is central apnea/clear airway and there's not much we can do about them with your machine.
There's also the chance they may be more arousal/awake related.
See the last video here
http://freecpapadvice.com/sleepyhead-free-software
If you weren't really asleep when those centrals got flagged they don't really count and are more of a byproduct of poor sleep than apnea issues. You have to be asleep for them to matter.

[icancant]

Thanks Pugsy for the informative reply!
I’m a side sleeper, I do toss and turn a lot while I sleep. My shoulders, low back and neck are all painful and I’m always changing position to relieve the pain.
When looking at my flow rate chart, a large portion of the time it seems like I take a deep breath and what follows is a obstructive or a central apnea.
Is this normal?

[Pugsy]

It's normal to see flagged events of any kind after a big gulp of air but that big gulp of air means you weren't asleep. We don't take big gulps of air when we are asleep.
It is common to hold our breath when changing position in bed. We sort of take a breath and turn over and then resume normal breathing.
The machine only measures air flow...it doesn't have any way to know that you are half awake and just turning over.

I have to change position a lot myself and I get about 75% of my AHI being related to SWJ sleep/wake/junk or those false positives related to changing position.

I have seen false positives in all the event categories. It's not limited to central apneas. Sometimes the arousal breathing is very pronounced and easy to spot and sometimes it's just a couple of slightly irregular breaths preceding the flag.

So a big gulp preceding the flag...probably SWJ....a big gulp after a flag where it looks to be a real asleep event is likely what we call a recovery breath and common.
So a gulp before a flag...probably not asleep....big gulp after the flag and the flow rate before the flag is nice and rhythmic...probably a real event followed by a recovery breath.

[icancant]

Thanks again Pugsy, stay safe!