Help assessing recent charts, appt. tomorrow (!)

[Julia63]

I have been struggling for over a year with my treatment. Cpap 5/22, switched to bipap 2/23. Masks are a problem, pressures are a problem. Switched from one sleep center to another (July 23) as the previous doctor was difficult to contact and communicate with. I've only had one appointment with the new doctor in July but am hopeful as she seemed easier to communicate with and genuinely interested in my care. I have my second appointment with her tomorrow(!) so I'd love some feedback on my last 3 nights of treatments. I used two masks  most recently (as I am still having trouble with fit and have bought almost every mask available without finding one that's really right for me. I'm most comfortable with full face masks rather than nasal although that being said, none of the full face masks have worked well.
8/23-Dreamwear with headgear that was too large for me, 8/24 Dreamwear with small more snug headgear, 8/25 with Resmed F20. I have a small face and head so have been using Small cushions on all my masks.
I find that most often around 3 or 4 in the morning I get the sensation that I can't breathe/get enough oxygen, so I take my mask off. I've also often gotten the sensation that I'm so tired I'm going to just stop breathing out of fatigue and wonder whether some of my stopping breathing is not obstructive but due to some other cause because sometimes it seems to be so tiring to do the work of breathing, especially when I'm tired. I know that might not make sense. It's just that I have tried for so long now without being successfully treated I wonder if something else isn't going on, perhaps in addition to the obstructive apnea.
I am exhausted every day-even though I'm on Adderrall- and feel like all I ever think about is when can I take a nap. Thank god I'm retired or I wouldn't be able to function at all. Coupled with pre-existing depression I feel pretty hopeless at this point. I'm to the point where I feel like begging for sleeping medication so I can get some sleep because then, even if the sleep is interrupted by apnea I might roll through that quicker and just get more sleep minutes overall and then feel rested during the day. But I know that might not help.
My appointment is tomorrow and since it seems like I will only see the doctor once a month I want to go in with the most knowledge and best questions to get the most of my appointment. I don't know if I can attach the past 3 nights info but if not I'll writing a cont. post

[Sleeprider]

Still, it looks a whole lot better than previous charts.

[Julia63]

That's it? I must be missing part of this thread because I don't actually see anything you said before 'still it looks better...'

[Sleeprider]

Sorry Julia, in my last reply I must have confused what thread I was posting in. All of your charts share in common clusters of obstructive apnea. There are also periods of intense flow limits and snores that show us your current pressure or sleep position is contributing to obstruction. With EPAP set at 4.0 to 10.0 and PS 4.0, I think you would benefit from increasing EPAP min to about 6.0. A bigger problem is that your sleep position is contributing to airway restriction and obstruction. This can be the result of pillows that are too tall or firm, or chin-tucking or acute misalignment of the cervical spine (neck) that causes periodic occlusion of the airway. This is so common, our Optimizing Therapy Wiki has a section on Positional Apnea https://www.apneaboard.com/wiki/index.ph...onal_Apnea The solution can often be remedied by awareness of the issue and correction, or sometimes you may need to use a soft cervical collar to keep your neck straight and prevent chin-tucking. https://www.apneaboard.com/wiki/index.ph...cal_Collar