Bipap Titration advice needed.

[Rubicon]

It looks like a lot of your events are centered around REM (IDK where the positional thing came from) as well they should for a few reasons.

BTW Ambien is a REM suppressant so that's probably where the rest of your REM went.

Anyway, if increased events during sleep appear (and NOT awakenings because I think you've got to work on the insomnia) you might want to see if they occur with a ~90 minute cycle. At 10+ cmH2O in REM on the titration you were still having events, so when you are having REAL events (and not SWJ) it could be that a boost in therapy is required.

[amafra]

The last line, ronco (snore) does not have any data. May not be caught, I'm pretty sure I have. I remember when I was in my twenties, I went to the US for a couple of months and I rented a room in a house to keep costs low. The owner's house had two small kids, like 3 and 5 yo or so. They point to my room and say, monster lives there. They could hear my snoring from outside and they thought I would be a monster sleeping here. They just could not realize it was me sleeping at night snoring at full power.
My ex wife used to sleep earlier than me and she was dead rock. After she got a new job that requires her to sleep later, she had a pretty bad time falling asleep if I got to sleep first. My current girlfriend, if we sleep together, will be pushing on me all night long, to make me stop snoring. I usually sleep in another bedroom, if I'm in a hotel, then we are both going to have a pretty bad night.

[amafra]

It looks like a lot of your events are centered around REM (IDK where the positional thing came from) as well they should for a few reasons.

BTW Ambien is a REM suppressant so that's probably where the rest of your REM went.

Anyway, if increased events during sleep appear (and NOT awakenings because I think you've got to work on the insomnia) you might want to see if they occur with a ~90 minute cycle.  At 10+ cmH2O in REM on the titration you were still having events, so when you are having REAL events (and not SWJ) it could be that a boost in therapy is required.

Thank you for your suggestion. I will work on quit Ambien. The sleep specialist said 13 would be conservative number that could require higher pressure, she could not test because I woke up.
I can't understand why the latest fixed tests, Autoset, S and Vauto (fixed ps, epap) I had central apneas, it scared me. That is why I'm using ASV auto. I feel better on ASVauto as well.

[amafra]

Buddies, I appreciate all the help here. I see all the effort of members to help others achieve better sleep and consecutively better life.

I had device issues at the beginning, most modes not working and device reboots. Thanks to a good person that helped me to fix it and I appreciated it. 

I will update the post when I get to fix my positional apnea and let you guys know what method worked best for me. Other people have the same problem.

The importante take here is how knowledgeable members are and how much it helped, I'm going for 3rd polysomnography, bipap titration this time and neither doctors or technicians could spot that my clusters of apneas could relate to positional issues. They all said I don't know why you are getting this.  Without the help of you guys I would keep battling the wrong battle fighting cpap modes instead of understanding that cpap was fighting my positional chokes and possibly eliminate or use Vauto sudo S as main drive mode. Sleep hygiene started as recommended.

Thank you all for the time and support, as I learn more I will help people in this forum.
I'm glad to become part of a well intended group of people, especially Sleeprider (hope fixed plumbing) , Crimson Nape, Sarcastic Dave and Rubicon.


Best regards. 

Last night just for update (Min EPAP 5, Max EPAP 15, Min PS 3, Max PS 10)

[Sleeprider]

Once you get the chin-tucking resolved, you will need to start working on time in therapy. I keep seeing 1-2 hour chart and wonder when you actually sleep.

The leaks were fixed on Saturday. The plumbing is easy, the tough part is tearing up a finished bath to remove the vanity and flooring, then sawing through the floor. Found the leak in an old tee-fitting that had lost solder and used PEX with Shark Bite connectors to fix, then put everything back together, and celebrated with a hot shower. Today's task is to blow-out the plumbing and move a 40 gallon hot water heater to a new location and re-route that plumbing and electric, and install a main shut-off valve on the plumbing system entry. Wish me luck.

[amafra]

Once you get the chin-tucking resolved, you will need to start working on time in therapy.  I keep seeing 1-2 hour chart and wonder when you actually sleep.  

The leaks were fixed on Saturday.  The plumbing is easy, the tough part is tearing up a finished bath to remove the vanity and flooring, then sawing through the floor. Found the leak in an old tee-fitting that had lost solder and used PEX with Shark Bite connectors to fix, then put everything back together, and celebrated with a hot shower.  Today's task is to blow-out the plumbing and move a 40 gallon hot water heater to a new location and re-route that plumbing and electric, and install a main shut-off valve on the plumbing system entry.  Wish me luck.

Hey buddy. I can't usually pass 2 hours. When pressure goes higher I tighten up the mask making it very uncomfortable and taking it off at some point. Woke up at 6, 2 hours cpap, 4 hours without.
Can't get rid of "espresso" yet. I need to find a way to get rid of positional apnea so I could have more stable pressures and possibly move to a pillow mask. The Mirage Quattro is huge but seals better, F20 leaks.

Seems like a lot of work, it will last a long time after all that fixing. 
Wish you the best.

[SarcasticDave94]

The mask you list is a ResMed F20. Correct? That's a similar too tight required to not leak pattern I dealt with for a bit. The solution was getting a different mask. I myself moved on to a Fisher and Paykel Vitera. Very little strap tension and it controls leaks about 1000% better than the F20 ever will.

[amafra]

I will see if I can get it shipped to me. 
I do have a mirage but it is too bulky, airtouch ( median size is too small), I got airfit large replacement cushion, thinking that the median is not the right size. Turns out that median airtouch is smaller than median airfit and large airfit is too big.
With my beard growing up again, I think  it is making proper sealing even worse.
Have you tried a nasal pillow mask like airfit P10 or Fisher and Paykel Brevida?
Does a pillow mask allow OSCAR to report snoring?

Thank you for the follow up 

[SarcasticDave94]

No I've not tried either of those yet. I don't even have a machine right now due to very complex needs and stubborn doctors. I have tried the ResMed N30i fit pack and then later got the P30i cushions to swap in. I mouth breathe too much to tape. At times I must breathe through my mouth so no leeway on it.

[amafra]

It may not work for me as well. 
I see it requires mouth adhesive or something to maintain the mouth shut.

Tks