Grouping of events last 3 nights

[blueridge33]

Hello all,

New here but have been on CPAP therapy for going on 2 years now. Average AHI has been around 1 for the last year on a fixed pressure of 6 this entire time. The last 3 nights however I have noticed a significant grouping of events at a similar point in the beginning of the night that last around 45 minutes which is causing my AHI to go up. I'm not really sure what it is exactly and hoping I could get some insight from those that are much more in tune with this data. For reference i'm 31 and my initial AHI was mid 70's when I was originally diagnosed. I took well to therapy and have not had issues adjusting to the mask or anything. I use a nasal cradle from the dreamwear line that extends off the top of my head. I was thinking I may need to tighten it if it had slipped off or something but its around the same time frame every night for roughly the same length of time which seems a little too patterned. I wouldn't say my sleep was any worse than usual the last 3 nights and do not recall fully waking at any specific point until earlier in the morning. I did try upping my pressure from 6 to 7 (which i've never changed) this last evening just to see if it would make a difference and it was still the same clustering. I will take sleep aids sporadically on weekends - magnesium glycinate or ashwagandha. I did not take anything to sleep last night thinking that my have contributed prior. Any insight would be much appreciated. Please let me know if I need to add any additional info or graphs. I've included last nights full data and an up close of the cluster. I can add the previous 2 nights as well if you would like to see those. Thank you!

[Pugsy]

What is your usual sleeping position at about the time frame of the cluster of events?
On your back maybe??

You need more pressure during this time frame.
Any special reason you are using fixed cpap pressure instead of maybe using auto adjusting pressure mode and allow the machine to deal with the OAs and Flow limitations (which are really ugly) and the machine would want to kill them.

[blueridge33]

I'm not entirely sure about my position at this time. I typically fall asleep on my left side but I've woken up on my back multiple times as well so certainly could be the culprit. No specific reason other than when they did my titration study initially they told me to use the fixed pressure of 6. I've contemplated switching to the auto adjusting mode but wasn't sure if I should discuss it with my physician first sine my AHI was typically pretty low for the longest time. I have gained a few pounds over the last month or so which my also be a factor that I hadn't considered. Any recommendations on what range to set it to for the auto adjusting mode? Thank you for your feedback!

[Pugsy]

If it were me I would give these settings a trial and just see what happens.

Mode....AutoSet (auto adjusting)
Minimum....7
Maximum ....12 (yes I know it is limited but I doubt seriously if you need that much except for maybe during the ugly time)
Turn on EPR full time and set it to 3. (this may help with the FLs during the ugly time)

The 6 cm fixed does a decent job at all other times of the night so I wouldn't expect to see much pressure changes at other times of the night.

2 main factors for dramatic pressure needs differences
1...REM stage sleep
2...Supine sleeping
Both of which can worsen OSA and a cause for potentially a lot more pressure needs.

Normally first REM doesn't happen until around 90 minutes or so after sleep onset. I don't think you have been asleep 90 minutes before the ugly cluster happens plus you should have REM stage at other times during the night and we don't see clusters later during the night in the pattern we would expect to see if REM were involved.

That's why I suspect supine sleeping.

[blueridge33]

Thank you Pugsy i'll give it a shot! Very much appreciate your knowledge and time.