Central sleep apnea? need help on pressures

[flappypalate]

Hi all,

I was wondering if you all could provide some help. I am really struggling the last 2 months getting only 1 hour of sleep a night due to constant arousals. I have been using CPAP for over 5 years and only recently ran into problems after discontinuing medication and losing 50 lbs. My old machine did not have graphing capabilities and I recently just got one that does and I'm trying to figure out how to optimize my pressure settings now. 

Prior to this I was using a constant pressure of 9 and steadily increasing to 10.4 over the years. Now I seem to be having even more arousals and obstruction issues while exhaling even though my airway seems more clear. I wonder if any of you can tell me what these flow rate patterns indicate. I'm scared that I have developed central sleep apnea and am trying to get a overnight PSG done asap. 

Any tips on what my pressure settings should be will be greatly appreciated!



           

[staceyburke]

It looks to me you are having some positional apnea. PA is when you sleep in a position where you cut off your own airway. Have you changed sleeping on your back or sleeping with a fuller (higher) pillow? It is also called chin tucking where your chin drops down to your sternum cutting off your own airway.

[flappypalate]

I am actually struggling so much this sleep was only achieved while sleeping while sitting up. 
I used to sleep on my back because for some weird reason sleeping on my side would make the obstructions worse.
I might be chin tucking as I am falling asleep sitting upright, I will try a different incline on my bed tonight. 

Something else I've noticed with my new problem is when I relax my throat muscles to mimic what it does during sleep I notice I have something flapping around and I am not sure if it's the larynx tightening up or the palate prolapsing. 
I read that "Airway closure can be observed during central apnea either via active laryngeal closure reflexes induced by hypocapnia"
I've been trying to get a sleep study / sleep endoscopy done but I cannot find a doctor to do it here and am considering flying across the country for it.