[Treatment] Koala1 - Moving to Resmed, aerophagia, please help with optimization

[koala1]

Thank you for the explanation.
Considering that night and yesterdays night when CA happend again when I was falling asleep, CA induced by low CO2 level makes sense.
I realised I take deeper breaths when CA happens. Only after I fell asleep breath stabilise and gets shallow again, and CA doesn’t happen.

[koala1]

As some of you recommended, I have made adjustments to minimal pressure.
This time I went from 4 to 4.5 and later to 5.0.
I have to say, there is difference.

With pressure 5.0 AHI is not going above 2 so far (only 3 days) and 1.92 was after drinking  

Now I only need to make sure mask strap is tight and should be good.

[Ratchick]

Good to see things are going the right way.

[koala1]

After 2 more weeks I can say low AHI is only once or twice a week, and rest is above 2 or even 3.
Looking at graphs I still should increase pressure, so I will do it today - from 5 to 5.5.

Also I have changed Dreamwear Nasal to Nasal Pillow, and setting for the mask compensation from 0 to X1.

I had periodic breathing events on few occasions in last two weeks.
In the attachment i share last one. Not sure if this is something to be worried about. But it is new for me.

[koala1]

Here I share low AHI data.
To be honest I dont know what may be a cause of such changes, but those are m thoughts:
Low AHI is usually on end of weekend while it increase gradually toward end of week - stress could be a factor?
Drinking one day could influence sleep in following days?
Finally, too tight mask could cause it? - for last 3 days I use new Dreamwear Nasal Pillow mask and there is no need to adjust it tightly.

[SarcasticDave94]

What's the difference in feel, rest, comfort comparing low AHI nights versus your higher AHI nights? If they're similar, then you're chasing rabbit holes. You need to focus on comfort and rest also and not only the numbers.

PS Pretend for just a minute that you never saw the OSCAR data. Can you tell the above mentioned differences? Or are the differences only on OSCAR?

[koala1]

I understand what you mean.
I think the same.

Yet, I can tell difference based only on ahi number or SpO2 chart.
Sometimes with good SpO2 levels 3.6 ahi is not that bad.
Usually, however Ahi above 2.5 means lower spo2 levels.

Its not a huge difference but definitely it’s there. And I would like to achieve AHI below 2 becouse this is level I feel the best. Between 2 and 0.5 there is not much difference. At least not worth trying I think.

[SarcasticDave94]

OK yes I understand, and you have 2 excellent reasons then to keep at the attempts to gain consistency.

1. SpO2 levels that drop more on the bad nights.

2. You have given a more specific piece of data where you notice a difference in feel. You feel better if AHI is below 2.

That's much better info. I'm not scolding you, but if you post OSCAR, include the important bits of info just like that above. Being very specific helps tremendously.

OK working with this data, I'd focus on the SpO2. Are you recording it with a pulse oximeter? Best case is to have one that imports data to OSCAR. A Contec CMS 50F or Wellue ring are great choices. With the Wellue ring being the better of these. I'm thinking if you monitor oxygen and address any issue found, it may enhance resting and give better feel to sleep. Oxygen may be dropping more than realized unless monitored.

[koala1]

OK yes I understand, and you have 2 excellent reasons then to keep at the attempts to gain consistency.

1. SpO2 levels that drop more on the bad nights.

2. You have given a more specific piece of data where you notice a difference in feel. You feel better if AHI is below 2.

That's much better info. I'm not scolding you, but if you post OSCAR, include the important bits of info just like that above. Being very specific helps tremendously.

OK working with this data, I'd focus on the SpO2. Are you recording it with a pulse oximeter? Best case is to have one that imports data to OSCAR. A Contec CMS 50F or Wellue ring are great choices. With the Wellue ring being the better of these. I'm thinking if you monitor oxygen and address any issue found, it may enhance resting and give better feel to sleep. Oxygen may be dropping more than realized unless monitored.

Thank you. 
I will sum up everything in one post next time. 
Too many potential factors to miss anything. 

I use Wellue ring and import data to Oscar. 
I share them on each screen too. 
I think I have low average SpO2 all the time, since it’s always around 96%. 
That being said if it doesn’t drop below 91-92% I usually have a better night. 
Also I shouldn’t sleep again after I wake up early in the morning. Let’s say 1.5h before the time I wanted to wake up. Always SpO2 level is getting really bad during that additional sleep and I would be better off not sleeping at all. 
Does anyone has similar experience?

I’ll keep monitoring changes and report weekly or every 2 weeks. It seems I have weekly pattern and it would be difficult to say anything only after 3 nights. 

For now min pressure set to 5.5 and I keep using nasal pillow mask.

[SarcasticDave94]

FYI if you see SpO2 at 88% or less for more than 5 minutes, this is a red flag and your doc needs to be told ASAP. Here in the USA at least that 88% for more than 5 min equals needing supplemental oxygen. Again if you do see this, call doc right away.