[Treatment] Looking for help tuning CPAP treatment

[alphaoptimal]

Hello,

Was diagnosed with sleep apnea about a year and a half ago.  My PCP sent me for at sleep study after complaining about excessive daytime sleepiness and bad snoring (going on for many years.)  The sleep clinic had me do an at home sleep study.  I don't remember discussing the details of the results of other than having sleep apnea, and I later asked and my AHI for the study was ~27.  She prescribed me an Auto-CPAP.

I got a Dreamstaiton Auto from the DME supplier, and initially a 4-20 cmH2O.  I went through a few mask types over the year (after starting to buy my own supplies) and started adjusting the settings after reading some of the pages online and talking a bit with my doctor.  My current setting is 13.5-20.

My results were much better than I started with, but I haven't been able to get much under ~4 AHI consistently.  I'd love to know if it can get better.  

On top of this, I've also suffering from aerophagia.  Some nights are better than others, but most days I wake up with some form of bloating and gas.  Waking up to a burp or two isn't that bad, but over the night the air works its way all into my gut and it is often pretty uncomfortable and can take a few hours to work it's way out.

I'll attach the OSCAR results from what looks to me like a couple typical days over the last week.  Let me know if there is more information that might be helpful or if you have any advice.

Thanks!

[staceyburke]

As you know less than 5 is considered ok and you have gotten down that far.  I see a little bit of positional apnea - not a lot but some..  positional apnea is when you get into a position that cuts off your own airway.  There is nothing the pap machine can do to help it.  You have to find a way to stay out of the position that causes it.  Most of the time it come when you are chin tucking, bringing your chin down to your sternum.  That cuts off your air and you have an obstructive apnea.  Sometimes it comes from sleeping on your back or with to high of a pillow or even curling up on your side..  If you can stop what you are doing you can lower your AHI a point or 2.  besides that you are doing well.

[Gideon]

On your machine to decrease obstructive events calls for an increase in min pressure, except for the bit of positional apnea called out above. Positional apnea is 'flaged' by a cluster of obstructive events.

Central events are affected by flex mostly. There are other causes but for now try reducing flex.

And ALWAYS report how changes affect you and your symptoms. In other words tell us how you feel.

[Sleeprider]

Nearly all of your obstructive events are clustered into small groups. While this is not nearly as bad as many cases we have seen, it is worth trying to resolve, because it may actually allow you to reduce pressure and relieve the aerophagia. It is these obstructive clusters that are increasing pressure, causing aerophagia and sleep disruption. Read the wiki and consider if a change in pillows or other easy change might help, or consider the soft cervical collar which has been successfully used by many members on this forum.
http://www.apneaboard.com/wiki/index.php...onal_Apnea

[alphaoptimal]

Thanks for the replies and for taking a look at the charts.

I had started reading about positional apnea; I defiantly think this could be a big part of it. I try to sleep on my side because I think it has the best results (and I would snore the least before starting CPAP) and sometimes I end up on my back. My pillows are almost certainly be too high when on my back, and I can see myself curling up too much on my side.

I’ll have to find a good pillow and look into the cervical collar.

Thanks again!