after years of CPAP success...big problems

[Gideon]

How do you feel.? This is important!

Your Pressure is being driven by Flow Limits! For this reason, the flow limit chart is important so grab the bottom of several charts, Pressure and leak mostly, and the Flow Limit chart. to include on the screen print.

Your AHI is in the golden territory. Settings at this point should not be adjusted on numbers, but on comfort, symptoms, how you feel, so how do you feel.

[SarcasticDave94]

If it were me, I'd work on mouth and mask leaks. That's what stands out on these charts. The pattern is that leaks are controlled early in the sleep session, but as time passes into the middle of the session onward, leaks present themselves. Maybe a sleep position change, movement, introduced a pillow knocking the mask off kilter, something like that.

[Sleeprider]

If you can find some space to include the flow limits chart that might be helpful. I see some big reductions in respiratory flow around 03:00 and after 04:45 on 1/26, and somewhat less after 04:00 on 1/27. I think these are flow limits and they may be positional (chin-tucking).

[JenniferJuniper]

How do you feel.?  This is important!

Your Pressure is being driven by Flow Limits! For this reason, the flow limit chart is important so grab the bottom of several charts, Pressure and leak mostly, and the Flow Limit chart. to include on the screen print.

Your AHI is in the golden territory.  Settings at this point should not be adjusted on numbers, but on comfort, symptoms, how you feel, so how do you feel.

I feel terrible every day for about the past month. I'm so tired I can't keep my eyes open, and this is new. For the second night in a row, I had to remove the mask in the wee hours because I felt like I was breathing deeply and still not getting enough air. I have never had to remove my mask in 8+ years of CPAP therapy. 

[attachment=39388][attachment=39389]

[Gideon]

We still want to see the Flow Rate. see the organization link in my signature.
The pattern of the flow limits screams positional, please read the cervical collar link in my signature.

[Dormeo]

You can squeeze graphs into your screenshot by grabbing the horizontal gray bars that separate them and pushing them up. Please provide these graphs:

Events
Flow rate
Pressure
Leaks
Flow limitations.

I wish we could tell whether the FLs were in your nose or in your pharynx.

[JenniferJuniper]

You can squeeze graphs into your screenshot by grabbing the horizontal gray bars that separate them and pushing them up.  Please provide these graphs:

Events
Flow rate
Pressure
Leaks
Flow limitations.

I wish we could tell whether the FLs were in your nose or in your pharynx.

Is this right?
[attachment=39395]

[Dormeo]

Perfect, thanks. Do you have any sense of whether your nose gets progressively stuffy over the course of the night? Or whether you shift into a different sleep position from time to time?

The reason for asking about sleep position is that you may be tucking your chin down toward your chest, which can narrow your airway enough to cause problems. If you have a high pillow, try one that is fairly flat and firm. And experiment with using a soft cervical collar. Gideon has provided you with a very helpful link on that subject.

[JenniferJuniper]

Yes, I have a cervical collar and can try it again. I can also flatten my pillow. Thank you so much for the advice. I will see how things go tonight.

[Sleeprider]

Good job on the chart. It will be interesting to see if a collar makes a difference.