u/Diving-In-Data

Hi everybody,

The data from my sleep study seems (afaict) to indicate a condition somewhat between OSA and UARS: RDI of 17.3, AHI of 12.2, AI of 2.3, HI of 9.9.

My treatment so far has been:

- I was given a Löwenstein Prism 20A APAP machine, with min pressure set to 6 and max pressure to 8. I experimented a bit with the settings and it seems to get slightly better, but with lots of room for improvement.

- With min pressure 5 I never have obstructive apneas (with min pressure 4 I do have at most 1 an hour).

- From what I've learned, that means I don't need higher epap, as I don't have obstructive events? So higher ipap only to treat the hypopneas and flow limitations?

- For whatever pressure settings I have though, most of the time the pressure median is the pressure max. Does that indicate increasing max pressure? I have hesitated with this so far, as I often run into aerophagia when max pressure is 9.

- My AHI doesn't seem to consistently change with settings. It also doesn't seem to correlate well with how I feel any given day. This leads me to suspect I'm missing something here...

How would you proceed based on this? Which different settings would you recommend? I tried to fix flow limitations with softPAP, but am unsure whether it actually worked (the flow curve seems still a bit spiky to me)...

I am currently at min pressure 8, max pressure 9, and softPAP=3 (which is the max). Weirdly my machine says I have more RERAs at softPAP=2 than at 1 or 3 (the same for flow limitations)... but in any case, I can't increase pressure support more.

Also OSCAR flags a ton of events - but whenever I see others posting their screenshots, there's a lot less events. Attached the OSCAR screenshots, two flow curves of the night from the screenshot, here also a sleephq-link to the same night:

https://sleephq.com/public/d3fa42dc-a086-472c-9632-6b160baad4a9

Is it normal to have several wake periods at night? And, related, what is your typical sleep efficiency (which I guess measures pretty much the same thing)?

Mine is around 85% on average, with least 2-3 wake periods per night (but sometimes up to a dozen or so). Most of these I typically don't even remember. But my Garmin also shows some of these (though less).

I have all the typical sleep hygiene things dialed in (such as consistent bedtime, wind-down routine, dimmed red lights before bed, cool and quiet bedroom, last meal a few hours before bed, etc.). Basically everything I could find in Matt Walker's book, podcast, and elsewhere.

I'm asking since I am diagnosed with sleep apnea / UARS and currently trying to fine-tune my APAP treatment. So I'm wondering whether these wake periods are normal, or a remnant of the treatment and I should be able to get rid of these...