Help please

[Jlcds2]

Diagnosed moderate level mostly hypos and reras but fragmented sleep and uars. Failing pap can’t seem to get any good help cause ahi looks low. Did a tiration test it was horrible but they said all good 8 epr 3 so now I have been playing around on pressure. Exhausted. Please help https://sleephq.com/public/teams/share_ ... bdaf31e052

[ozij]

The single night you posted is at a fixed pressure of 11.2
It shows bouts of flow limitations which might be the reason for your crappy sleep.

In order to really understand what's going on, we'd have to see more examples of your nightly results, and how long you stayed at each pressure.

Based on this single night I'd say the following:
There are periods when you breathing is smooth, others when its interrupted.
The interruptions could be a result of the pressure being too low.
ResMed machines are very responsive to flow limitations, so I'd first test what happens if you set the machine on auto, and give it its head so to speak. That way, you can learn if higher pressure eliminates those flow limitations.

Whichever change you make stick to it for 5 nights or so -- unless its intolerable.

[Jlcds2]

Thank you . I was tirtrated at 8 epr 3 but I’m not sleeping on that and they were horrible doctors, I have more uars than apena and I wasn’t staying in rem. I was waking constantly. I’m sleeping more at higher I can tell but I’m worried about the centrals that are popping up now . I’m swallowing a lot of air. Lots of nasal issues . I believe I need a bilevel I have trouble exhaling.
https://sleephq.com/public/teams/share_ ... f387621433
I went to bed super late bad habit lately with this but today feels closer than normal than others. I still have to sleep elevated and on my couch. I know my treatment isn’t right I even had trouble getting a correct diagnosis.

[Miss Emerita]

I agree with the advice that ozij has given you. I also note that your FLs improved when you raised your EPR from 1 to 3, so that pressure differential is helpful to you.

Your FLs are quite heavy, even with EPR of 3. Do you have a stuffy nose? If not, I think you'd be a good candidate for a bilevel machine, especially the Airsense 10 or 11 VAuto. If you can afford it, you might consider buying one out of pocket, either new or lightly used.

Also, I see you've recently been using your machine for only part of the night, and I didn't see any nights when you could have gotten 8 hours of sleep on the machine. Try working on that. Also try working on consistent times when you go to bed and get up.

[ozij]

I also note that your FLs improved when you raised your EPR from 1 to 3, so that pressure differential is helpful to you.

When I use this link https://sleephq.com/public/teams/share_ ... /dashboard and move through the nights I see nightly pressure changes. Not good.

I don't think one can compare fixed pressure at 8.2 EPR=1 (Sept 30) to automatic (APAP) at a minimum of 12 EPR=3 (Oct. 3). Furthermore, each night between these two had a different pressure setting. As a matter of fact, on Sept 30th, at about 02:00 AM you raised pressure from 8 to 8.2. and on the following night on you started out at 11 lowered from 11 to 10 at about 03:30. The following evening you changed the pressure again, starting at 11.2 fixed.

That's not how you'll get to learn anything about what you need in the long run. Your brain and body have to get used to sleeping with air blowing in. They need time to adjust.

I’m swallowing a lot of air. Lots of nasal issues .

Back off to a pressure where that's not happening. Stick to it for some nights. When you start making chages, increment the pressure at 0.2 at a time, not more.
Nasal issues could be caused by too much or too little humidity.

ozij, using VPN because I'm still banned by IMPERVA

[Miss Emerita]

Ozij, I'm glad you noticed this, which I didn't. It may be that higher EPR helps, but the evidence we have doesn't help us reach any conclusions about this.