AHI all over the place, new to AB

[Oihead]

I decided to stick with the 8 min last night and give it a few days.  Glad I did.  Last night I slept straight for over 8 hours, didn't even realize that I had even rolled on my back and slept awhile there.  I have been avoiding any back sleeping as that is when I experience the most events.  I expected a high AHI because of the back sleeping but was surprised when I checked that it was 2.5.  I feel really refreshed and clear headed today.

I continued to use the cervical collar since I have had the best nights with one on.  I went back to the 2.5 wide collar.  I think the night before when I had the really crappy number I had the 3 inch collar on too loose and when I lay down it
pushed up my neck and I tucked my chin under the collar.  Stupid me but heck I can't be responsible for what I do when asleep!  Thanks Sleeprider for confirming my assumption that it may be positional so I can try to be more aware of what I am doing.

[Oihead]

I gave it a week with a collar and pressure of 8-15 and flex of 2 to give it a chance after increasing the min.  I was optimistic for a couple of days since I had a .73 4 days in but unfortunately the AHI still has some pretty good swings.  The 7.95 reading was on a day that I spent the first half awake, tossing and turning.  I wear a Fitbit to bed to get an idea of how my sleep went, it shows sleep stages which I know may not be accurate but it does seem to correctly indicate a lot of my awakenings.

So I'm struggling with what to try next.  Lower pressure? lower/no flex? remove/tighten collar?
On the bad nights I wake up with a very puffy face.

12.27 see previous post for data
2.54
2.38
.73
7.95
4.02
9.6

https://imgur.com/a/jPGzi
https://imgur.com/a/1NOX3
https://imgur.com/a/UtTjZ
https://imgur.com/a/HU1IY
https://imgur.com/a/CVv5D
https://imgur.com/a/Mb8VN

[Sleeprider]

Variations like this are rarely to do with settings, and the clustered events still look like some positional issues.  I'd take a look at your pillow(s) and see if they move your head and neck out of alignment, or other issues. Your session on 11/19 had a lot of central events, which is not typical for you.  I think it would be too early to start managing for that.

Your respiration is abnormal in that inspiration time is longer than expiration, and the flow chart is showing some oddly uneven respiration (note how it looks like a rough hair brush?).   Maybe we could zoom in to where we see the actual wave form and see what's going on there.  Overall, your therapy is okay, and some it is quite good, but there is room for improvement.

[Oihead]

Sleeprider, thanks again for your input.

I went back to a couple of months data and all seem to have the discrepancy between the inhale and exhale times.  Not sure where you want me to zoom in but here are some shots when I am not experiencing events.  I do see my inhales are not smooth and rounded, I am using a gel pillow.  I checked July when I was using the nasal mask and see the same discrepancies.   Sometimes I feel like I have not completed taking a breath and then the flex kicks in?

https://imgur.com/a/Mb8VN
https://imgur.com/a/E19sT

[Sleeprider]

Oihead, thanks for posting the more informative charts.  It is extremely common to see this I:E issue/error in Philips machines.  First, your respiration timing is normal, it is the machine that is in error. In your case, almost all inhales are flow-limited with downward sloping peaks. This leads into a normal exhale that ends with a longer than usual null (zero) flow before the next inspiration.  The Dreamstation is erroneously counting all the time at null-flow and inspiration as inhale time, and not counting that as exhale.  At the same time,the machine is missing the flow limits and leaving pressure low.

If you don't mind, let's take a similar closer look at the obstructive and central events.  What are your Flex settings?

[Oihead]

Well, AHI back down to 3.8 for the night.  I paid extra attention to my sleep positions, only on my sides and no fetal positions where I tend to curl up including my head.  I started out very frustrated but feel I am getting the help I need thanks to everyone on Apnea Board.  Many thanks to Sleeprider, and congrats on being a Monitor!

My chart last night had a section I have not seen before.  I have included before and after to see if it provides a clue.

https://imgur.com/a/Kupif

Here are some closeups of some obstructives and centrals.  I also included events breakdown, I see some are under the 10 seconds that would qualify it as an event.  Another Dreamwear quirk?

https://imgur.com/a/KbhZY

---

Well, AHI back down to 3.8 for the night.  I paid extra attention to my sleep positions, only on my sides and no fetal positions where I tend to curl up including my head.  I started out very frustrated but feel I am getting the help I need thanks to everyone on Apnea Board.  Many thanks to Sleeprider, and congrats on being a Monitor!

My chart last night had a section I have not seen before.  I have included before and after to see if it provides a clue.

https://imgur.com/a/Kupif

Here are some closeups of some obstructives and centrals.  I also included events breakdown, I see some are under the 10 seconds that would qualify it as an event.  Another Dreamwear quirk?

https://imgur.com/a/KbhZY

Forgot to add that I am using flex of 2.  That is what was set for me and I have not ever changed it.

[Sleeprider]

I think trying Flex at 1 might be worthwhile. Shouldn't hurt anything, and might help out the timing.

[Oihead]

I had 2 great weeks (several AHI under 1) after increasing my min pressure to 8 and lowering flex to 1.
I was away for 3 weeks to care for mom and had to sleep on sofa and still managed readings around 3.5
but then AHI started to creep back up.  A week ago I increased the min pressure to 8.5 and today I had
AHI of 1.43 with no obstructives.  Many of my events are still positional, with many SWJ when I roll over
or having a restless/sleepless night.  Learning to relax more as I never had issues falling asleep and staying
assleep prior to CPAP.

https://imgur.com/a/e5WM1

I just figured out that I am set for A-flex, will probably switch it to C-flex at 1 to see what happens.  I did try
NO flex but had to switch back after a half night but may try it again at a later point.

I am no longer having aerophagia issues.  I think that I may have overcompensated for my chin tucking(even
with soft cervical collar) by slightly tilting my head backwards.  When they do CPR, the head is tilted back to open
the airways...and stomach too!  Now I just let my head relax and fall naturally.  It may just be a coincidence and
I may just have adjusted to CPAP use.