AHI increase? UARS Titration help?

[TinyRussia]

Thanks for your response, I updated it.

[TinyRussia]

I had a sleep study done and the doctor told me there was extreme resistance on the nasal tracer. There was no REM sleep whatsoever, and sleep efficiency had a rating of around 20-22% (I forget the exact number). The doctor told me it was likely UARS, because EVERYTHING shows up as normal except for the lack of REM, sleep efficiency rating, and extreme resistance on the nasal tracer. He said it was very clear something is causing a large obstruction in my upper airways, because my symptoms are severe (bumping into things and tripping easily, dropping things, zoning out entirely, severe memory problems, symptoms of bipolar disorder that are linked to when I feel I slept poorly, high blood pressure, intense fatigue to the point of not being able to live a normal life, not being able to drive, very poor vision that worsens over time although I have glasses which are new).

An ENT later told me I have enlarged turbinates (due to non allergic rhinitis, something I have had for a long time) and the base of my tongue is slightly large. However, he said these were not overly large, just slightly. So he wasn't convinced this was it. I feel that my throat sticks constantly (even during the day) and taking deep breaths is often difficult. When I lay down, I feel my throat close in on itself. I feel much better sleeping elevated but this doesn't stop the throat closing. I have constant (very dry) congestion that clogs my nose somehow and cannot be cleared up.

So the doctor (who now is retired) told me to try BiPAP and base it off how I feel. I've done a lot of research in order to try to titrate since I last posted here. But it is still a lot of trial and error and I'm not really 100% sure of what I am looking at on OSCAR.

I will attach more photos of the flow rate.

[Sleeprider]

I merged your recent post into your therapy thread. Keep in mind your history and progression are important to interpreting your results.

Increasing to PS 5 has deteriorated your results, and we need to move back to the previous settings, and move a bit slower. Your previous settings were 7.0 to 10.0 with PS 3.0 resulting in a fixed bilevel pressure that shows no flow limit or snoring. You reduced EPAP min to 6.0 and increased max pressure to 11.0 and PS to 5.0, again resulting in fixed pressure, with a slightly higher CA event rate. Both charts show only a little over an hour of total therapy, so your complaint "I did not feel any relief whatsoever and the flow rate seemed to show flow limitations on inhale." is fully explained by the fact, you need to use the therapy for 7-8 hours. Based on what we see in your charts, you should focus on more prolonged therapy at night. You don't apparently have a flow limitation problem that we can distinguish from arousals related to your short duration of therapy. I think setting EPAP min 6.0 , max pressure 12.0 and PS 3.0 will allow us to evaluate your results over a small range of pressure from 9.0/6.0 to 12.0/ 9.0 and hopefully see some longer therapy that will be more meaningful in how you feel.

[TinyRussia]

The issue I have is that after an hour, consistently every night, I wake up unable to breathe and my throat feels really irritated or something. I then cannot sleep again after that with the machine, I just toss and turn over and over. And this takes a great toll on my sleep so I just leave it off and sleep. I've tried to figure out why I wake up after an hour, but I don't see anything that should cause it. One night it was a leak. But usually it just appears that randomly I wake up unable to breathe and I see nothing on OSCAR that would explain why.

So, I would ask....would you have any suggestions for this? Because I can't seem to get the 8 hours of data I need.