same old story, new 'victim'

[dirtwork]

        I find myself floundering and am hoping some of you might have some thoughts or suggestions.  I am a 70 year old male, good health, no weight problem and physically active.  I first went on a CPAP in 2010, adapted quickly to it and had improved sleep/rest.  It seemed that the improvement in sleep was beginning to subside and in 2012 I saw a Dr. about physical obstructions.  At that time, I had my palate shaved, uvula and tonsils removed and sleep improved markedly without the CPAP.  Apnea problems began to recur in June of 2022 and I went back to the CPAP.  I did not choose to get a sleep study done (original study was 2010 when I was prescribed CPAP) and discovered this website about 4 months ago and have been monitoring with OSCAR since then.  I have gotten myself up to speed somewhat on terminology and use of daily information on OSCAR but it seems that AHI numbers have been creeping up again.  My AHI numbers were 10+ until I reduced CPAP pressure incrementally down to 4 and numbers dropped to 1-2 fairly consistently, this was done in early January.  Lately I have been having more events that move the AHI up over 4-6.  This occurs when the periodic breathing and or variable breathing events get high.  I use nasal pillows and have mouth breathing issues even with the use of a chin strap.  I have tried tape but am not satisified with the mechanics of that.  I did try a Dreamwear Full Face Mask and very much liked it for comfort but my numbers shot to the 12-16 range consistently with it.  I will attach an 8 hour view from last night (NOTE: dates and times on OSCAR are as per what the SD card is giving it.  This shot is for Mar. 11 and sleep times are typically 8 to 9 PM thru till 5 AM.)

[dirtwork]

    Thought I would add this screenshot from last night as a comparison for my initial thread, and hope it moves it up to possible attention of moderators.  My 7 day average AHI is 4.92, last night much better but not the norm.  Thanks for your attention and help.

[OpalRose]

The chart from the 7th shows strong positional apnea.  Notice how the apneas are clumped together?  This happens when you are sleeping in a way that cuts off your air.

Sometimes just sleeping on your back vs side will cause this.  
Also, consider what type of pillow you use.
One flatter, less fluffy pillow is better than 2 pillows, which can cause your head to tilt forward and restrict your air supply (like kinking a hose).  Try to be more aware of your sleeping position.  

http://www.apneaboard.com/wiki/index.php...onal_apnea

The chart on the 8th doesn't look bad at all.

With all that said, I'd like to see you use a little higher pressure.  A pressure of 4cm can cause some to feel "air starved."   You stated that higher pressures raised your AHI, but what was the make-up of that higher AHI?  It would help to know that.  

If you're willing, raise your pressure to 7cm and try a C-Flex setting at 1.  

Try this for a night or two and repost your chart.

[dirtwork]

        OpalRose,
Thank you so much for your reply...I hope all of you know the service you provide for those of us "wandering in the wilderness".  I am attaching screenshot from Jan. 12 with pressure at 7.5, flex level at 2 mode C-Flex+.  This is not exactly your suggestion but I gradually decreased pressure and saw AHI numbers go down progressively as I dropped to pressure 4.  I'm not sure why I have the C-Flex set at 3, it seems I thought I was fighting less on expiration (??).  With the screenshot from 3 days ago and reading threads here I wondered about positional apnea.  I use a contoured (therapy?) pillow which I switched to in effort to keep my head back.  I side sleep at times (both sides) but seem to find myself on my back an equal amount of time.  I will try to be more diligent, and will try your suggestion on pressure/flex setting.  Also will get a cervical collar and am beginning to investigate switching to an autosense CPAP.  I want to avoid doing another sleep study, I already know that I need a CPAP and have a sense that the best route is help from here and apparently the local medical supply place is sleep problem knowledgeable.  
Your time is appreciated, thanks, R

[OpalRose]

Sorry, I just realized all your screenshots are from 2021. Is the year on those screenshots correct? A lot can change in two years! Do you have anything current?

In the charts where you said your AHI was higher due to raising pressure from 4 to 7 wasn't so much from the pressure, but from the Positional Apnea.

[dirtwork]

The 2021 date is incorrect.  The month is correct, day is 3 days off, and year is 2 years off....they are all current 2023.  I have not discovered a method to correct the dates and hourly times on charts.  So all information is from Jan. 2023 to current.  AHI  numbers were high at pressure 7, then dropped as I lowered pressure down to 4.  I agree and understand the likelihood of positional apnea.  I assume this would also have effect on the variable breathing and the periodic breathing which are periodically high and AHI numbers jump on those nights.  Leak rates were also higher with the higher pressures, they seem to have stabilized at 4.  Each thought brings a new question??