.2 AHI

So, last night's AHI was .2. I slept in a mostly upright position most of the night. I can tolerate that better than on my side. Could I have possibly found the right mask, the right pressure and the right position to successfully treat my sleep apnea? If so, a major celebration is in order. I have been trying for so damn long.

Do you seriously intend to sleep upright the rest of your life?

Due to severe arthritis in the lower back, I sleep on an adjustable bed with my head raised to about a 45 degree angle, and my feet raised. This position takes the pressure off of my back, allowing me to sleep.

If you sleep well and feel rested sleep however works for you. The AHI will undoubtedly vary over time.

Glad that you found a position that works!

Congrats on finding a workable solution for your problem.
I have always said that whatever works for a person and they are happy with it and comfortable...then go for it.

lwieland11's history.
She has OSA and the pressures needed to resolve the OSA issues have triggered central apnea as well...plus she has a strong positional component to the OSA side of things...supine sleeping really cause the OSA to need much higher pressures and the pressures then trigger really bad aerophabia issues. Talk about being stuck between a rock and a hard place.

When she can stay off her back things are well managed and the aerophagia monster stays away. Side sleeping presents its own problems so that leaves sleeping upright or semi upright in an effort to keep the pressures low enough to keep the aerophagia monster away.

Correct, Pugsy. It's been more than challenge figuring all this out. It's a semi-upright position that is working now. I've also managed to train myself to keep my mouth shut while sleeping. That, too, is making a huge difference with the aerophagia. Still have some(if I do open my mouth periodically)but not nearly as severe as it can be. I'm so encouraged!!

I'm usually between 0 and 1.2 AHI, treated. I've even questioned in the past if I really had bad apnea at all, or if the test just showed that because I had a cold when I took it. I'm sure the cold made my numbers worse, but also the therapy is just effective for me. After accidently missing a night (stayed up reading too long, without putting my mask on) I could definitely tell the difference. ALso I have Resmed, which doesn't count anything under ten seconds. I did an efficacy test by getting an oxygen monitor, and my O2 still dipped to 87 once or twice. so I upped the pressure a bit!

As Pugsy predicted, the AHI is fluctuating again over 5 the past 2 nights, 9 last night. Have no idea why. Crap.

I don't know how much of a REM worse component your OSA might be and that might explain some of the higher AHI times.
Not much you can do about REM like you can with sleeping position.
If your OSA is worse in REM (and it's common for people to have it be worse in REM or supine or both) then your machine with current settings simply can't hold the airway open optimally. The only solution is more fixed pressure and that would cause the aerophagia monster to come for a visit.
So you have to decide which makes you feel worse....the aerophagia monster or the elevated AHI.
If you can't really tell much difference in how you feel with the higher AHI (other than being annoyed it is elevated) then I would think the aerophagia monster is the worse of the two evils.

If the higher AHI is sporadic and you feel decent despite the numbers...you may have to simply accept it as a compromise because to try to fix it all the time could very well make you feel worse all the time from the aerophagia monster coming for a visit and never leaving.

Good advice. Thank you. The AHI tends to be way high if I sleep 8+ hours with the machine. Doc thinks that is REM related. If 4+, AHI much closer to 5.

It's logical. More hours of sleep would mean more REM cycles. So not unexpected given your situation.
Even a little higher AHI night is still a lot better than what you were having though. So while not ideal...it's an acceptable compromise in your situation.

This would be where having the ASV might help...it would auto adjust for the REM pressure needs...but the drawback to that (besides the cost of ASV) is that if it auto adjusts upwards much the aerophagia monster could return and if you tied its hands so it wouldn't go as high you end up with pretty much what you are using now.
Damned if you do and damned if you don't.

In your situation with your particular issues with aerophagia being a significant issue I think that just accepting an occasional not so pretty night numbers wise is going to have to be an acceptable compromise for right now.
Maybe later if we get lucky and stumble across a good used ASV for you to try and see how you do with it...might be worth looking in to at that time. I know it would have to be dirt cheap for you but I will keep a look out for one. You never know what might pop up.