Oxygen levels advice

[cmpman1974]

They're accurate enough. That's why they're FDA approved.

Now you are supplementing with o2 overnight it's time to use reduced pressures without as much pressure support. 

These settings and this much pressure support is probably not what your lungs need and could/will be making things *far* worse, as they did in my case before I discovered o2 and lung dysfunction was the real culprit all along. Especially during your REM cycles.. these settings will be causing absolute chaos. You can see the chaos all night in your flow chart from it all. Significantly worse during REM.

You're having to breathe out against EPAP 9 /and/ you're being significantly ventilated with your incredibly high IPAP. A recipe for disaster.

I would be interested to see that 2L bleed with a lot less assistance from the PAP and pressure support.

It's time to titrate yourself again from square one and throw out all previous assumptions regarding PAP therapy.

You could start with Vauto mode, EPAP 4 with pressure support of 2 and let the machine go where it wants to. Trigger very high.

The important thing is reducing that EPAP and pressure support so you can exhale easier and reduce the respiratory swings from crazy over-ventilation.

I think you'll be pleasantly surprised and the next breakthrough in your sleep will happen.

I have been curious if you work in the medical field?

[Apnea23]

As it turns out, since my preterm birth that lead to ventilation/life support, my lungs have been compromised all of my life, as have my o2 levels and thus my nervous system has been overactive ever since my first breath, meaning I couldn't sit through one lesson and recall much of the information, let alone complete any medical course or degree.

If I had known now what I did 30 years ago or if healthcare hadn't let me slip through the cracks with no follow ups or respiratory testing throughout any of my youth, I would have loved to have worked in the sciences or the medical field.

Anyway, good luck. While your lung investigations continue I think you'll find very little pressure support (1 or 2) and much lower pressures will see your sleep quality improve dramatically.

PAP and over-ventilation can assist in drawing more oxygen in, but if you have resolved the o2 issue with supplemention, I think you'll find your respiratory rate and flow chart will look much calmer taking it right back down to the lower end without the ventilation effects of pressure support.

You should see less fragmented sleep, less arousals, less craziness in the flow chart. Less waxing/waning.

You may find PAP was a red herring all along, as you dial it down and down and see increasingly better sleep each time you do it

Anyway I am babbling. Good luck.