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[paps]

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[Pugsy]

Snores and quality of sleep...mainly if you wake yourself up often from the snores.
I think I would consider just staying at these settings for a couple more days and see how I feel during the day and see what the gastric issues do....and/or consider another small drop in EPAP and see what happens. You have room in terms of the AHI.
This time I would do maybe 0.5 decrease in EPAP and IPAP and see what happens with the gastric issues and the snores.

If you aren't waking up a gazillion times from the snores that might be better than the belly issues. Hopefully find some settings that let your belly issues subside and not cause AHI to go horribly high and let you sleep decently.
Like if you can sleep more comfortably on your side with the lower pressures then you won't need the higher pressures that are needed when you are on your back because it's the higher pressures making the gastric issues worse.

Sometimes it is difficult to find just the right combination to deal with the problems that cpap pressure cause because we still need a pressure to deal with the OSA stuff.
The snores are the lessor of the evils as long as you don't think they are impacting your sleep and causing a ton of wake ups.
It's the wake ups that mess with our sleep architecture...too many of them and we feel like crap from lack of normal sleep cycles.

[Krelvin]

Any thoughts what to do tonight?

Give it a couple days at the current setting. You don't get a good sample without staying put for a 3-4 days.

[paps]

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[Pugsy]

How would I know if the snores were preventing REM sleep?

Unfortunately there is no concrete way to tell about sleep stages with these machines except sometimes we can isolate probable REM sleep stages if we see clusters of something on the reports. In your case probably more dense clusters of snores...and that's only if maybe your OSA is worse in REM sleep.
If you aren't waking up often then most likely your are achieving the normal cycles of sleep.

[paps]

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[Pugsy]

Your AHI is still well within acceptable range at the new lower pressures.
I would give this new setting a few more nights to see if these results are the norm and not a fluke. See how you feel in terms of belly issues and overall...and then maybe try another 0.5 drop in both EPAP and IPAP and see what happens.

If it weren't for the belly issues...I wouldn't change anything but since you are still having belly issues...I would keep trying to reduce the belly issues until I got to the point the AHI and how I felt wasn't acceptable....at least that is what I would do because I would want to do without belly issues if at all possible without totally putting the cpap therapy in the toilet.