[Treatment] Spike in Obstructives - Potential Causes?

[bonesmurones]

Since having another sleep study about a month ago, my AHI has been consistently < 3 and I've been feeling great (as opposed to the firs 4-5 months of the year where I was struggling with my machine still set to Auto.

This last week my AHI is back up to 6-8. I had stopped keeping tabs because it was consistently under control, but I felt so crappy I started looking again cause I knew something must be wrong. I've included my AHI trend over the last month (May 21 was my sleep study, hence no usage on my personal machine) as well as a great night, average night, and my recent bad nights of sleep. I've captioned each photo for context. Happy to add any additional nights or information. 

Any help would be GREATLY appreciated. I thought I finally had it figured out and had tamed the beast. Hoping I can get back to that feeling again soon :/

http://imgur.com/a/uhJ2x

[kwhenrykerr]

Your machine is being held back by the setting. It lookes like you need to raise the max pressure to keep your airway open. I tend to like allowing the machine free range on the high side. It will only use what it needs.

Do you know how to change the settings ?

At the top of the page is a link to how to set your machine. "CPAP Setup Manuals"

[bonesmurones]

Restricting it to a fixed pressure was actually the outcome of my sleep study I had that fixed my problems earlier in the year. It seemed the spikes in pressure to fix an obstructive were waking me up and causing disruptions to my breathing rhythm. Through about 2-3 months of tinkering before my sleep study, I arrived at a similar conclusion myself, I landed on a fixed pressure of 10cmH20 and during my sleep study, the technician said that I did slightly better at 12cmH20, which seemed to be holding true for the first few weeks. 

I guess the part that confuses me is why I would respond negatively to variable pressure before, and now respond negatively to fixed?

[Crimson Nape]

By chance have you started to use a cervical collar?

[kwhenrykerr]

Good question Nape.

Some time I think it just take time to tell who is in control you or you body. My body hates to cough for hours every morning but that is what it takes to clear my airways. I use the drugs/machine only when I can not cough it out.

Several years of adjusting my cpap have helped loads. I still need to make changes once in a while. Sometimes I know why, like coming down with a cold or flu. I will bump the pressure up or I will see the machine make adjustments and I do not even know it.

I do not check my data every day anymore unless something is up. I trust the machine to do it's job given the range I allow it.

The auto cpap mode can tell you a lot that you may not be aware of. You will need to learn how to read and understand what it says.
Asking questions and reading will help if you can spare the time. I understand it is very confusing at first. Like riding a bike with training wheels at first. Then you build up to two wheels only. Next it's LOOK no hands...  

You will get their.

[bonesmurones]

By chance have you started to use a cervical collar?

Not a cervical collar, but I did start wearing a chinstrap in March and recently switched to a Halo style one with two straps on top. That being said, I made that switch the day after memorial day so it was a week to a week and a half before I had the spike. 

WRT to other changes - I also had the thought that it could be allergy / sinus related. 

I also don't check my machine every day, but felt a difference Thursday / Friday morning and went to look.  I guess opening up the top end couldn't hurt...wort case scenario I don't sleep well, which isn't any worse than the current wetting :

Appreciate the responses. I'm a very analytical person so always looking to data points as to what others have experienced and the likelihood that I'm having the same.