Back to auto?

[Ockrocket]

When first trialing CPAP almost three years ago I used a Dreamstation set on Auto.. then when I decided to buy a Dreamstation of my own to use for my therapy my respiratory specialist had it set to fixed pressure, primarily because he thinks fixed will prevent apnoeas better than auto. 

Although my numbers were reasonable, they never seemed as low or consistent as when on auto.

So along the way I bumped my fixed pressure from 7 to 8, and all has been good for the last 12 months or so, even though my AHI normally sat between 1.5 and 2.

But over the last few weeks my numbers have been climbing, and if I average 4 or above then I lose my professional driving endorsements.

My wife has mentioned that I seem to be opening my mouth more often in my sleep ( I use a F&P Eson nose mask ) so last night I downloaded the SnoreLab app and recorded my night.. 

As it turns out I do now have quite a few episodes during the night where I open my mouth and air rushes out, in combined total I had 46 minutes of air loss through my open mouth last night.
So I'm starting to think I'm relaxing more in my sleep than I used to, and that is allowing the higher pressure to push my mouth open, and ultimately giving me false AHI numbers.  

Tonight I'm going to reset my machine to auto, and I'm going to try a low of 6 and the high at maximum. 
I will see how this goes for a week, given my respiratory specialist and I have not always seen eye to eye over how personally involved in my treatment.. I'm not going to tell him I'm making changes. 

I just had my annual compliance check up and have 12 months before I have to go and get him to sign off for me again.. by then I will have the data to back up my change of settings, or I will hopefully have found an answer by some other means to keep my numbers down where they need to be.
If not.. then I will give up my professional driving endorsements, because I will at least be able to keep my driving licence at private level.
I sure as hell don't want to give up my ability to travel with my campervan and ride my motorcycle, I won't let that happen if I can possibly help it.. 

Wish me luck in the nights and weeks ahead. 

[jaswilliams]

Good luck keep us informed how it goes

[chill]

If you have not tried a soft cervical collar, that is what fixed the open mouth problem for me.

[Ockrocket]

Good luck keep us informed how it goes

Thanks, I will update after I've had a couple of nights on the new settings.
I'm planning on at least 4 weeks with only minor adjustments (maybe minimum 6 to 7 or 8 if necessary) and will update further down the track as well.

If you have not tried a soft cervical collar, that is what fixed the open mouth problem for me.

I sweat a lot at times, I don't like neck pillows and the likes.. but I will have a look at what collars are available to see if I can find one that may work for me..
Thanks for the suggestion chill. 

[Ockrocket]

Update..

No significant change, still up and down with my AHI.. and my average is creeping up as time goes on. 

[70sSanO]

You really need to download OSCAR software and post some charts. AHI is nice to know, but without data you are just flying blind.

I ran a number of years at 2.5 AHI, with centrals running about 1.5. Then the wheels started to come off and my centrals jumped. No machine settings, collar, or mask (I wear a FFM with no leaks) was going to solve it.

It may just be mouth breathing, but it might be something else.

John

[nohypopneanow]

It was June 2018 when I got a sleep test.    My AHI was 77.
  
I was setup for getting a CPAP and received it by the end of July 2018.  My sleep life has been improving since then.  I was at a fixed pressure. My AHI or Apena Hypopnea Index was often quite high, like, 8 to 15.

I am now using an APAP with even better results and consistently having AHI's of less than 5.  My APAP treatment is working.  It is not a cure, but a treatment for a chronic (ongoing) condition.

My APAP can be run in AUTO or in CPAP.  My machine is being run in AUTO with  my settings being 10 for low and 17 for high.  So, my machine based on what it senses, adjusts the pressure to what I need throughout the night between those settings.  That is the beauty of AUTO.  The machine does the work.

In fact, my old CPAP machine looks exactly like my APAP.  The difference?  The brains and some labeling.

I am feeling the best I have felt in years.

There is no getting better or being cured, just treated.   

[Ockrocket]

You really need to download OSCAR software and post some charts. 
John

I have Oscar ( and previously Sleepyhead ) I have some screenshots, but I need to check which information is the most useful of the various screens available and screenshot those.

My APAP can be run in AUTO or in CPAP.  My machine is being run in AUTO with  my settings being 10 for low and 17 for high.  So, my machine based on what it senses, adjusts the pressure to what I need throughout the night between those settings.  That is the beauty of AUTO.  The machine does the work.

There is no getting better or being cured, just treated.   

My Dreamstation is APAP/CPAP.. I was tested on auto, then my respiratory specialist switched me to fixed because his theory is that it prevents more apnoeas than auto does by just reacting to them.

I think auto gave me lower numbers though, so without my specialist's knowledge I'm trialing auto again to see if it makes a difference.

Today I have bumped my minimum setting up to 8 from 6 today ( 7 was my original fixed pressure, but then I bumped it to 8 because I was feeling air starved when trying to go to sleep.. again without my specialist knowing, or even noticing, the increase.)
I have the upper setting at 20, which is maximum for the Dreamstation. 

I have also picked up a headband/sweatband to try as an improvised chin strap to see if I am perhaps sleeping with my mouth open more often than I used to. 
If the headband makes a difference I will find a proper chin strap.

[Geer1]

Post OSCAR screenshot for 2 or 3 nights that you feel to be representative of average nights. At least one showing on CPAP mode and one showing the recent APAP night.

Charts should show event flags at top then pressure, leak rate and flow limitations.

With that information we might be able to help. Without data asking our advice is like asking a blind man if your hair looks good.

[Dormeo]

Geer1, the Philips machine won't have a separate graph for flow limitations.

Ockrocket, as Geer1 says, please show the graphs for events, pressure (not mask pressure), and leaks. A couple of things to turn off before you take the screenshot:

VS2 (doesn't have meaning and clutters up the picture)
pie chart (go to file, preferences, appearance, unclick pie chart)
calendar (click the little triangle to the left of today's date.