Sudden Change in Results

[Unathletico]

            Hello. If anyone can help I'd appreciate any input on a sudden change in my recent therapy results. I have been using my machine for 5-6 months. I have no problems with compliance and results were good up until recently (average AHI about 1.3). My sleep test was 5.8 AHI, 15.8 RDI after adding in RERA. I was diagnosed with OSA as most of my events during sleep study were obstructive hypopneas and RERA. The only apnea during my sleep study was central.  During use of my machine nearly all events have been classed as central apneas. My doctor said not to worry about them at that level. Recently, however, they have increased substantially and last night was AHI 13.8, virtually all shown as central apneas. My doctor reduced EPR from 3 to 1 two nights ago as a result of the increasing trend but last night was my worst result yet. I wore a pulse oximeter and my oxygen was dropping rapidly from 98 by 8 points to usually around 90 and then recovering after a minute or two after waking. My thoughts are whether this is positional because I could not feel air from the machine unless I lifted my head stretching my neck fully and holding it above the pillow (a cpap pillow on a wedge one) and holding it c 45 degrees. I was having large hypnic jerks even at times when my stats looked fine - I guess my body just didnt want to let me sleep. My pressure range has been 5-8 but often the machine seemed to be operating at the low end of that.

I have managed to download Oscar and have attached a screenshot (i couldnt quite get the snore part to show). I hope this helps and would be grateful for any input.

[Narcil]

there is little evidence that PA causes CSA even if there are few cases, like this one. do you sleep on your back?

maybe try cpap mode see if it helps? i would try 7cm epr off, epr usually make CAs worse.

i would show this to your doctor, focusing on how you feel the next day. that seems like too many CAs to ignore but i'm no doc

[Sleeptechmaster]

If you weren't feeling pressure due to your head position you may need more pressure to overcome the obstruction happening. When you got your AHI diagnosis were you supine?

[Deborah K.]

Yes, you now have incredibly high CAs. If you would post a redacted copy of your sleep study we might be better able to advise you.

[Phaleronic]

Welcome to the forum Unathletico

Pressure is too low and the CAs are likely a result of this pressure issue, please set min pressure to 8cm and max pressure to 15cm and move the PAP mode from for her to standard. Also is EPR on, we can't tell because your charts are cut off. I agree with Narcil that you should try cpap (fixed pressure) soon too, once we see how your charts look at the settings above and what it does to your CA events we can move on.

[Sleeptechmaster]

Also if you started a new medication that can increase them.