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[paps]

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[Pugsy]

The 12/26/13 cluster looks like probably REM stage sleep needing more pressure. Not unusual at all.
Maybe in combination with supine sleeping. Hard to have any idea for sure that long ago and the really bad AHI nights actually aren't the norm.

I am sitting here scratching my head trying to figure out what I would do if I were in your shoes.
I think if it were me I would back up and start lower and work my way up if there's an urgent need.
Like 10 or 11 EPAP and 13 or 14 IPAP...it's a WAG though.
Let the snores happen and see if they disturb your sleep. Work on finding a pressure that your belly is happier with and see what's showing up in terms of snores at that pressure.

It's real obvious with the APAP report that the machine wanted to go higher probably mainly from the snores.
But in your situation killing the snores creates additional issues that are worse than the snores.

[paps]

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[Pugsy]

Using Bilevel pressures of 11 EPAP and 13 or 14 IPAP is not the same as using 12 fixed cpap.
Apples and oranges comparison.

[paps]

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[Pugsy]

Be prepared for snores and as long as they don't wake you up just ignore.
Let's see if we can find a pressure that gives a reduction in gastric issues and doesn't put the AHI itself in the toilet.
It's a WAG...you know what a WAG is? Wild Ass Guess.
Gotta start somewhere.

[paps]

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[paps]

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[Pugsy]

Primary goal of this experiment is to reduce the gastric issues and not cause the AHI to go wild.
Also to perhaps get you to be able to sleep on your side if at all possible for a couple of reasons...one being it is your preferred sleeping position and two being that often less pressure is needed when side sleeping and less pressure means less chance of gastric issues.

In terms of sleep quality...did you wake often last night or maybe just a handful of times and let's see how you feel today.

How do you feel about trying 10 EPAP and 13 IPAP if you are on your side?

[paps]

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[Pugsy]

RERA is Respiratory Event Related Arousal.
There's not enough of them at this time to worry about.

RERA

Respiratory Event Related Arousal... a sequence of breaths characterized by increasing respiratory effort leading to an arousal from sleep, but which does not meet criteria for an apnea or hypopnea.”

RERA Detection in the Respironics System One data..Respiratory effort-related arousal..defined as an arousal from sleep that follows a 10 second or longer sequence of breaths that are characterized by increasing respiratory effort, but which does not meet criteria for an apenea or hypopnea. Snoring, though usually associated with this condition need not be present. The RERA algorithm monitors for a sequence of breaths that exhibit both a subtle reduction in airflow and progressive flow limitation. If this breath sequence is terminated by a sudden increase in airflow along with the absence of flow limitation, and the event does not meet the conditions for an apnea or hypopnea, a RERA is indicated.

[palerider]

I woke just a handful of times. I have been cautious about using that as an indicator though because before CPAP I recall sleeping a lot, but never being rested. I'll see how today goes. There are so many other factors that it can be hard to tell...

the error that many people make is not distinguishing between "being passed out from continual exhaustion" before cpap, and "sleeping".

once you're getting some rest, you're moving into the more fragile sleep, as opposed to the rather out of it 'passed out' of before.... and even normal, proper, restful sleep, you have multiple sessions of 'just barely asleep, if not slightly awake' during the night, as you move between sleep cycles.

[paps]

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[Sleeprider]

Paps, do what you need to do for yourself. I was doing some experiments with a first BiPAP starting in mid-January. Had some pretty good initial success then did some things that didn't work so well and I needed to regroup. Went back to the APAP for a week or so, and considered selling the BiPAP. After thinking about it picked up the BiPAP again and went back to the most successful settings. For the past week I've had the consistent lowest AHI and best rest in years.

If you want to take a night on CPAP, that is one setting away. Your machine stores the prescription for each mode. So, it's easy to do a few nights of CPAP, think about it, perhaps recover, and you can return to trying some BiPAP later.

[Pugsy]

If you felt better doing cpap then by all means do cpap but I was under the impression that there was a reason you were given the bilevel device and that was what all this was about.