(11-17-2019, 12:02 PM)bonjour Wrote: Welcome to the forum.  We can definitely can and will help you.  

The first and obvious thing that needs to be fixed is that you are tucking your chin and because of that positional shift are causing a positional apnea.  See how your obstructive events are clustered, and heavily so? That is the indication.  That is common and fortunately, easily fixed.  Get a soft cervical collar, see my signature for a link.  This will quickly and efficiently lower your AHI.

Also, you have a lot of periodic breathing, It is important to see the details behind it.  Zoom in, click on the chart in an area with periodic breathing until about 3-4 minutes is showing so multiple breaths are showing.  Please do this for several different instances and screenprint them (F12) and post.  
 
Finally, so we know all,  You stated AFIB, thanks, any other heart, circulatory or breathing issues?  COPD, asthma, CHF, heart attacks, and Meds, especially for the above or for pain, recreational or otherwise.   This is for the elimination of other issues and is prompted because of the combination of AFIB and PB.

Thanks

(11-17-2019, 12:07 PM)mesenteria Wrote: I have the same experience with AFib, and that's what led to the sleep lab and the AHI of 31, also 'severe.'  I haven't struggled, though, but I clearly see that you are struggling.  We'll figure this out.

First, I see a lot of clustering.  I don't know your preferred vs now-default sleeping position, but it's quite likely that you are tilting your chin towards your chest as you relax, sag, and fall asleep.  If this happens, you'll get apneas.  If you habitually have CA events, or even just hold your breath, as you fall asleep, and if you're constantly thrashing around restlessly, or being aroused for other reasons, you'll have lots of CAs every time you go through the cycle of falling asleep anew.  It really is a vicious cycle.  Narsty, as some would say.

It would be highly advised for you to purchase, or find, a soft foam cervical collar and begin to use it.  Unfortunately, it is going to be yet another intrusion on your previously 'normal' way of sleeping, particularly if you find it 'hot' around your neck, a rather common complaint.  But it will be an oh-so-important addition, I think, that may remove a lot of the obstacles to a continued and lengthened cycle of proper sleep.

Others will offer their insights and experience.  Please be patient.

(11-17-2019, 12:37 PM)CapeMayDan Wrote: Sleeprider has great information on cervical collors.
Here is a link that might help you.>>>> http://www.apneaboard.com/wiki/index.php?title=Soft_Cervical_Collar

I use a cervical collar and a product called The Eliminator. It is a tremendous help to me.
The Eliminator has a tendency to tear but is easily fixed by sewing it back or you can just return it for a new one within the warranty period.
JMO, The Eliminator is really more comfortable.



Dan

(11-18-2019, 12:13 AM)sleepyp Wrote: The cervical collar is a very good option for clustered events, it helped me a lot.

Did you start therapy at 12cmH2O or did you build up to it? 12 is pretty high for a new user.
These graphs are very messy, like what I got when the pressure was higher than I could comfortably take at the time.
I'm getting great results at fixed CPAP 11.5 now, but it went really messy a couple of months back when the machine went over 10.
It might be worth trying a dropping the CPAP pressure down a bit, stay there for a week and then add 1cm each week until you get to 12cmH2O comfortably.