Sport and Diet influence on AHI

[koala1]

Until now I was pretty happy with my therapy and setting selected with your help. 
Average AHI was 0.5 and everything was great. 

Until I started doing more sports and diet. 

Overall Im in good shape but lately started to get more and more abdominal fat due to less and less movement and excercise. 

Until now I was doing moderate workouts and was riding on bicycle but it is not enough to get rid of excess fat so I decided to get back to running. Something I was not doing for few years. 

Surprisingly I have better performance then 10 years ago. CPAP magic?
But also problem with AHI is back. 

It is not a big deal. AHI went up to 1.5 on average from 0.5. But if it will be longtime problem I’ll get worse again. 

What I realised is
1. When I’m exhausted from trainings, CA goes up from 0.2 to 0.9 (more or less)
2. CA gets down when I’m rested after 1 or 2 days off from trainings 
3. Since I’m exhausted I drool a lot and since I use tape, it gets wet and doesn’t keep my mouths shut. In effect I exhale through mouth and air leak goes up to 20-25l from below 10l

Doing less training is one option to prevent CA and lower AHI overall but I don’t think I’m overdoing it right now. Instead I would like to find other way to lover CA or prevent air leakage. 

Do you think I should find FF mask (expensive option) or there are some other possibilities solutions?

[Geer1]

Post some examples of your central apnea.

I am guessing they aren't real apnea but rather you holding breath when changing position etc. My guess is this just happens a bit more after exercising due to more restless sleep, the higher leaks etc.

[koala1]

CA can emerge due to large leaks? This is something I was not aware of. Thank you.

I have taken screenshots of 2 bad and 1 good night for comparison.

Now looking at good one: no leak, no CA, no problem - this is how it works?

[koala1]

Today I used jaw supporter. Worked like a dream. No leak, basically 0l registered.
However CA was 0.5 with total AHI 1.3.

I think leak is only half of the resin why CA emerge.

[Geer1]

You will always have some CA, it is normal and anything on the 1-2 CAI range is often not real but rather you holding breath after an arousal or while changing sleep position etc. These machines aren't capable of telling when CA should actually be scored because they don't know your sleep status, if you actually had a sleep study done with EEG data they would not count any CA occurring post arousal.

The leaks can and do cause these fake CA because they cause arousal. You wake up because of the air blowing out your mouth or mask and then hold your breath, change position etc.

[Geer1]

Here is an example of a "fake" central apnea. You can see 3 normal breaths on the far left, 4th breath is potentially suspect and then 5 strange breaths that are representing an arousal. The "central apnea" occurs, almost certainly me changing position, and then breathing goes back to normal.

   

If this was a real central apnea the breathing would have been normal or gradually declining up to the apnea, no large off shaped breaths prior.

[koala1]

Thank you for showing example of fake CA.
I have checked CA from past few days as well as more previous results, also without leak.
Dont look fake to me.
As you say, either look normal or are declining toward CA.

Jaw supporter has some good influence on leaks and arousals (remember more dreams lately)
My mouth doesnt open at all, and during some nights leak is 0 or close to, but CA still emerge a little bit.
Last night I slept on lower pillow and results were surprisingly good.
I thought higher pillow helps me, but I will have to recheck it.

I know with AHI 1.5 is considered good, but I really fell difference, so will research more about what influence CA,
and AHI overall.

[Geer1]

Those look potentially real, there are also some signs of flow limited breaths as well which probably isn't central in nature though.

Main thing to try are different EPR settings as those are what usually have the most effect on both central apnea and flow limitations. The main issue is that low EPR is usually best for central apnea and high EPR is what is usually best for flow limitations. All you can do is try each setting for multiple days and see which one makes you feel best, data is unlikely to show significant changes unless it makes things obviously worse.

[koala1]

I was trying All EPR settings before.
Long story short 2 is what I can bear.
With 1 I have aerophagia and with 3 it just doesn’t seem right, also CA goes up.

For now I’ll keep using chin strap and maybe check out different pillows (again) to double-check good pillow height for me.

Thank you for your support!