Wavy breathing + breathing through nose

[bencol]

Hi all,
As marked in the screenshot, I notice periods of sinusoidal breathing. Is this normal? I've been using a CPAP machine for 4 years now. My initial sleep study showed an AHI of 40, and while I'm definitely sleeping better with the machine, I still don’t wake up feeling fully rested.
I use an AirSense 10, primarily in APAP mode set between 7-12 cmH2O. I’ve also experimented with CPAP mode in the range of 7-13 cmH2O and a nasal pillow mask, but this sinusoidal breathing pattern always appears regardless of the settings.


I also have a question about breathing through my nose. I'll try my best to explain:
I can breathe through my nose even with my mouth open at high CPAP pressures by closing off my airway at the back of my mouth—kind of like how you can open your mouth underwater without water going into your lungs or stomach.
Most advice about mouth leaks involves keeping your mouth closed, but I already use a chin strap and tape to completely seal my mouth. However, when I fall asleep, the muscle that closes off my mouth airway relaxes. This causes my cheeks to puff up, which wakes me up.
Do you have any advice for this? Would tongue exercises help? I feel like a nasal mask might work better for me because when I gently push on my lower jaw, it close off my throat completely.
Thanks




       

[gainerfull]

Tough to tell without zooming in on segments but the waxing & waning of the breathing pattern suggests hypopnea. Plus you have some residual flow limitations around the start of each hypopnea plus some lingering leakage that can also cause it as well due to the disruption.

Here are some things you can try to avoid the chipmunk cheeks:
[DME Link Removed] Search YouTube for "How to Fix Chipmunk Cheeks with CPAP"

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[G. Szabo]

Would you turn off the calendar and ensure all the statistics are visible on your Oscar?

[Deborah K.]

I suggest you turn your minimum pressure to 8.

You need to turn ramp off.  You don't need it anymore.

Turn EPR on full-time set at 3.

Those changes should help with your therapy and comfort.

Again, welcome, and good luck with your therapy!  

[bencol]

G. Szabo Here's another screenshot with all data:
   

[bencol]

Deborah K.
Thanks for advice. Unfortunately I have tested quite a few settings and this wavy breathing I'm concerned about always occurs.
   

[G. Szabo]

Your flow limit is still high. I suggest increasing the minimum pressure even higher. What about 9.6 cm? It can mitigate the distorted inhalation peaks and reduce the waves.

[bencol]

I'll give it a try and report back in few days.