wickedsleepy - Sleep Therapy Analysis

[Sleeprider]

I think you should return to a higher starting pressure of 9.0 with EPR 3. The collar is working to avoid positional apnea clusters, but your pressure is still relatively low and EPR insufficient to resolve flow limits. Flow limits are persistent enough that I think you need to start looking at bilevel (Aircurve 10 Vauto) as a potentially better solution. Let's get a closer look at respiration by posting some 3 to 4 minute views of your flow rate graphs.

[PeaceLoveAndPizza]

I wonder if the pressure changes are causing sleep disturbances, which could account for some of how you feel.

One experiment to ponder is whether a fixed pressure would help with comfort. Maybe a fixed pressure of 10 with EPR of 2 as a starting point. You can either try CPAP mode set up as such, or stay in Autoset mode with min and pressure set to 10 with EPR of 2.

[wickedsleepy]

Ok, here's what I tried:
Two nights ago:  min pressure raised to 9, EPR still at 2.  still using the OTC dental device.  no improvement.
Last night:  min pressure still at 9, EPR raised to 3.  still using OTC dental device.  I still feel the same... very dizzy, brain fog, trouble focusing (eyes and mentally)

I also noticed that lately I have been having muscle aches, and last night I woke up doing some hyperventilating (I think that was the RERA just before 5am).  These are some of the reasons why I'm wondering if there's CO2 rebreathing or something like that.

I attached last night's charts.  I attached one additional chart with a zoom-in around those hypopneas.  I had two clustered hypopneas (I believe this was chin tucking from being on my back with my Contour pillow being a bit high, although I did have some good scotch in the late afternoon), one RERA, and one CA just before getting up.  Overall these scores are great, so why the cognitive issues?  

I'm wondering
1. CO2 rebreathing
2. low O2 saturation for some reason? does wide-open-mouth sleeping cause this?
3. I have enough shallow hypopneas that the machine isn't detecting just enough to cause brain fog?
4. Can EPR actually be causing the issue?  Should I drop it back to 1 or even off to see if that helps?
5. I'm destined to be mentally impaired for the rest of my CPAP life?


           

[wickedsleepy]

Update: For the past two nights, I backed off EPR and used a flatter pillow, just to try something different. First night, no EPR. A rougher ride with a few higher pressures and more wake-ups. Next day I still felt a bit dizzy but maybe with less confusion/cognitive issues. Last night, EPR set to 1. Somewhat smoother night, still dizzy today but also less confusion/cognitive issues. Just tired. It feels like its a tradeoff... the EPR does seem to make things a bit smoother, but it feels like higher EPR is having some negative consequences.

I did find an article that explained for some people high EPR (which reduces EPAP) can result in lower O2 saturation, since there's less expiratory pressure support keeping the airways open on exhale. Idk.