Well done.
Now one of the advantages of SleepHQ is it lets people on cpaptalk zoom in on the parts of the daily data that catch their eye.
On this night, what I immediately notice is that for the most part, you've got a pretty clean night. But what the heck was going on right around 5:00 AM? Here's a screenshot of what the data looks like when we zoom in:
That's a lot of events in a very short time. And since you've capped max pressure = 10cm, the machine can't increase the pressure any more in response to that nasty cluster.
So questions that need to be asked:
1) Is this possibly a REM cycle? OSA is often more severe in REM and REM cycles are longer later in the night. Do you remember if your diagnostic sleep test showed your AHI was worse in REM than non REM?
2) Did you by chance flip onto your back around 5:00 am? OSA is often more severe when sleeping on the back. Do you remember is your diagnostic sleep test showed your AHI was worse on your back than in other positions?
3) Were you possibly awake during this time?
Now knowing that you're dealing with severe aerophagia and acid reflux, I'm reluctant to simply say just go back to max = 20. But you may in fact need a bit more maximum pressure if this kind of cluster starts to appear every night when you've got the pressure capped at 10cm. In other words, you may need to bump the max pressure up to 11. (Prior to lowering the pressures, your
median pressure was 12-13cm, and that also indicates you may need a max pressure that is greater than 10 to prevent clusters of events.)
Next: Looking at the night as a whole, your median pressure is 6.46, and that may mean you ought to try bumping the minimum pressure up to 6cm---if that's comfortable for you to breathe at when you are going to sleep. That would mean the machine might have fewer flow limitations to deal with and it might help.
But finally, I'll also add this caution: Changing settings every single night in an effort to optimize them can be a no-win battle: We don't sleep exactly the same every single night, and that's why I'd actually suggest gathering at least 2 or 3 more nights data with the current settings. If you've got a nasty cluster every single day in the early AM hours, then you'll know you need to bump up the pressures by a bit. If you don't always have a nasty cluster, you'll need to work out for yourself how often the bad clusters happen and whether the nights where you've got a cluster of events negatively affect how you feel the next day.
In other words, fine tuning the pressure is a process: You make an adjustment and you gather at least 3 or 4 days of data at the new setting. You make another adjustment based on
all the data at the new setting, not just one night. Unless, of course, some new setting winds up triggering a truly disastrous night of sleep that is highly unusual for you..
