Positional Apnea.

[Sleeprider]

The chart looks pretty good, and event rate is within reason. You are having two periods where pressure rises steeply and this could be sleep stage or positional. You seem to have decent results at your minimum pressure of 12 until we see a cluster of RERA followed by hypopnea and OA. The later events were a bit less severe. I'm going to guess the apnea events are not very long-lasting based on the lack of pressure pulses.

I think moving your minimum pressure up in 1-cm increments and observe the results. I don't think you need to go straight to 15 cm, but do what is comfortable. If you were on fixed CPAP, most therapists would put your machine at the 90% pressure of 17, so it's nice to have the relief of auto when you don't need that pressure. I agree with your conclusion the most likely cause of the periods of higher obstruction is laying on your back. Again, if you can sleep comfortable while avoiding that position, pressure can be lower. If that is how you feel most rested, the pressure can probably overcome the problem if you give it a bit more head start. The Resmed Autoset is a bit better for people like you that can have a wide range of pressure requirements during the night. Might be something to keep in mind for next time.

On the charts I would turn off VS2, and add FL (flow limitation).

[Beej]

I tried a wedge pillow last night; it seemed to help prevent me from lying on my back and lower the number of apneas. (Review under Product Reviews, Other).

[Johnboy]

I tried a wedge pillow last night; it seemed to help prevent me from lying on my back and lower the number of apneas. (Review under Product Reviews, Other).

Thanks Beej and Sleeprider

Upped my pressures to 13-20 last night.Looked like i was on for a good result and maybe even break the illusive <1 AHI. Then 6:30 came along and in an hour i had loads of events. Dont know for sure but assume i moved onto my back. Defo trying the tennis ball shirt tonight.

Attached screen shots of last night and a close up of that last hour.

Johnboy
http://imgur.com/a/08IqH

[Johnboy]

I tried a wedge pillow last night; it seemed to help prevent me from lying on my back and lower the number of apneas. (Review under Product Reviews, Other).

Thanks Beej and Sleeprider

Upped my pressures to 13-20 last night.Looked like i was on for a good result and maybe even break the illusive <1 AHI. Then 6:30 came along and in an hour i had loads of events. Dont know for sure but assume i moved onto my back. Defo trying the tennis ball shirt tonight.

Attached screen shots of last night and a close up of that last hour.

Johnboy
http://imgur.com/a/08IqH
http://imgur.com/a/8gcUe

[Sleeprider]

Actually looks really good to me. You got 7 hours of uninterrupted sleep that featured very few events or RERA. I'd just hold pat and see if the morning issue sorts itself out. In addition to back sleeping, beware of where your head drops to your chest which can directly obstruct the airway. Just be aware that that may be as much or more the cause compared to sleeping on your back.

[Johnboy]

Actually looks really good to me.  You got 7 hours of uninterrupted sleep that featured very few events or RERA.  I'd just hold pat and see if the morning issue sorts itself out.  In addition to back sleeping, beware of where your head drops to your chest which can directly obstruct the airway.   Just be aware that that may be as much or more the cause compared to sleeping on your back.

Used the tennis ball tshirt last night and AHI was 0.9 (yeah broke the 1 barrier), very few RERA's and Snoring events. Had 2 or 3 flow limitations but dont know what these mean as the flow graphs dont change when an event is flagged.

There is a kicker - i found sleeping only on my side really uncomfortable and didnt sleep well. I will continue to try but might have to decide what is more important ie lower AHI or better sleep.

Whenever i log into Sleepyhead the welcome screen says i had massive leaks but the Dreamstation says i had 100% mask fit - which one is correct and which leak like is the important one?

Johnboy

[Sleeprider]

The machine only flags large leaks that would cause a lost of therapy pressure and sensor feedback. It's best to minimize leaks, but a zero leak isn't feasible for most of us. If you routinely exceed or average 10 L/min unintentional leak, that is a pretty bad leak rate (over 40-42 L/min total leak). Full face leaks more than nasal, so that is normal. Mask liners can help, or you may need to look for a better fit. Leaks affect sleep quality.

I have always said, sleep position therapy is not necessarily natural for us, and the choice between sleep position or higher pressure is a trade-off. Congrats on the good results, but the real goal is restful sleep, and an AHI of 2-3 can accomplish that.

[Beej]

Some tips on side sleep position:
If you are somewhat wide boned from hip to hip, a pillow between the knees can help reduce twisting of the hips and back.
Similar concept if you have wide shoulders - a pillow to rest the arm on the upper side may feel more comfortable.
If you are very thin and boney or have arthritis or other sore spots on your side, a layer of foam (ex mattress topper) may help cushion and support the body without putting all the pressure on the points resting on the mattress.

[Johnboy]

Some tips on side sleep position:
If you are somewhat wide boned from hip to hip, a pillow between the knees can help reduce twisting of the hips and back.
Similar concept if you have wide shoulders - a pillow to rest the arm on the upper side may feel more comfortable.
If you are very thin and boney or have arthritis or other sore spots on your side, a layer of foam (ex mattress topper) may help cushion and support the body without putting all the pressure on the points resting on the mattress.

Thanks Beej - the problem is that i am a turner (nearly said tosser lol) in my sleep and pillows become obstacles to overcome. I am thinking of geting a new mattress as ours is well past its sell by and probably isnt helping matters.

Last night i had a 0.5 score, which is my new record and quite a fall from 52, but the journey goes on.

John

[Mosquitobait]

Glad things might be improving for you.