3 months with CPAP and still choking (charts included)

[earthless]

Recently almost choke to death while in sleep.

Sleep study shown 0 AHI, 7.4 RDI, 8.7 arousal index and 2.7 REPA index.
I was prescribed APAP with pressure ramping up to 7 cm.
Sleep study also states there's a mild upper airway resistance syndrome.
OSCAR shows similar results with AHI below 1 and it's mostly clear airway or hypopnea and rarely any OSA events.


Attached 3 month summary and daily chart when choking incident happened.

[Gideon]

Welcome to the forum.

Could you post a copy of your redacted sleep study, please.
So there is no misunderstanding describe what you mean by 'Almost choke to death in sleep'.
Also, provide a zoomed-in segment of your choking episode. Let's see if we can tell what happened. Include full night screenshot of the night it happened.

Based on the UARS and the Flow Limits you want to increase EPR to 2, and maybe later to 3.
It is very important to know how you feel, and how you perceive your breathing and the changes to settings

[earthless]

I haven't had any issues during sleep study.
Issue apparently became more often after I started using CPAP device.
I'm getting up at night during sleep because of choking.


Attaching zoomed in version and sleep study with 2 replies due to 3 attachment per post limitation.

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Sleep study continued.

[Gideon]

1 more zoom, try 2 minute zoom, we need to see each individual breath waveform to see what is going on.
In detail describe your choking, trouble inhaling? exhaling? what started it? what stopped it? How does the CPAP feel to you?We have to understand what you are sensing to help you. Your numbers are excellent, it is how you feel that makes a difference in what we suggest.

[earthless]

Attached one more screenshot at 2 minute mark in extra zoom.
Can't attach more because of attachment quota.

I'd say I have trouble inhaling when I choke.
Same feeling when some food is stuck in your throat or when you're drowning.

It starts all of the sudden after about an hour of sleep.
Maybe it has something to do with prescribed pressure that's too high for me.

But I had the same problem before which is why I got CPAP device in the first place.

Some medical background:
I have deviated nasal septum and congenital diaphragmatic hernia but ENT doctor said it's nothing to be worry about.
Sleep doctor thinks the same and insists I just have a snoring problem.

[Gideon]

That is a 20 minute window. See the waveform in the OSCAR logo? That is what you want to see as the wave form in the flow rate chart.

[ardenum]

look into laryngospasms.

[sheepless]

acid reflux, common with apneacs, could be a cause as well.

[earthless]

I'm adding 4 second zoom in previews.
I couldn't attach any more because of attachment quota so adding external image server
imgur.com/a/3H7QVhn

I doubt acid reflux is a cause since I don't experience any issues of pain or burning in my chest.
On another hand it's not uncommon for me to eat before I go to sleep late at night.

Laryngospasm should have been noticed by ENT doctor but nothing was found.

[Gideon]

That is a 4 minute and 18 second view.  I can see some minor flow limitations but nothing that should be bothersome at all.  Certainly no choking.
FYI a scale change to +/-60 and setting the dotted line at zero would help to differentiate inhale and exhale.