Clear Airway Events Mixed with OSA, what can I do?

HI everyone,

Lately my issues have been with CA events and flow limits and leak rates. My leak rates improved drastically when I switched to Bleep Dreamports, so I'm not sure why they're spiking again. I tried to mimic the same pressure and EPR settings as the week I had a good AHI, but now I'm battling leak rates with it so it's not as good as I hoped. I also go back and forth between mouth taping and a chin strap, but found that their effectiveness isn't that great.

I like to toss and turn a little in my sleep from my back to my side and I've read that if therapy is correct, I shouldn't be doing that. I believe this is wherein most of my issues reside. Lately I think I got the CA events tamed down because of the use of EPR 2 setting, but I can't seem to figure out my leak rate. I'm replicating everything from that week my AHI was good. I'm just asking this forum to get a different set of eyes on the situation and see if I can figure something out.

I know AHI isn't the deciding factor (it's how I feel in the morning), but I've learned that it's usually pretty darn accurate. The first two images are from last month when the settings were amazing, and I've tried to recreate them recently and it's just not working out. I've also noticed that a lot of my events are classified as Obstructive, but when I zoom in, there is no inspiratory spike signaling it was OA. Which makes me think there are even more CA events. Also, do you see how even the peaks and drops are in my flow rate. Almost every single time I see this, I wake up feeling great. What is causing my flow rate charts to be spiky and uneven?

Thanks in advance!

You don't have a problem. Quit trying to find some.

I'd be a lot more worried about leaks if I were you.

Julie wrote: ↑

Sat Jan 21, 2023 5:30 pm

I'd be a lot more worried about leaks if I were you.

Why?

palerider wrote: ↑

Sat Jan 21, 2023 9:13 pm

Julie wrote: ↑

Sat Jan 21, 2023 5:30 pm

I'd be a lot more worried about leaks if I were you.

Why?

There is a strong correlation in the OP's posted data between the largest leaks and the times when the OP has turned the machine off.

There is also a strong correlation in the OP's posted data between quit spiky parts of the flow rate graph and more activity in the leak graph. Since spiky parts of the flow rate graph can correspond to restless periods with a lot of SWJ breathing, it's reasonable to conclude that the leaks the OP is experiencing may in fact be waking him/her up enough to fracture the overall sleep.

So even though the leaks are under Resmed's official Large Leak definition of 24 L/min, those leaks may be pesky enough to be triggering multiple wakes and arousals during the night. Fix the leaks, and the number of wakes/arousals might go down.

I don't see it.