I use nasal pillows. I have to turn up the humidifier different times of the year. I was a mouth breather, but wanted to force myself to learn to breathe through my nose. The pillows have helped me do that. So even when camping now I breathe through my nose.
I'm now at:
Obst Index 0.00
Clear Airway 0.16
Flow limit 0.00
Ave SpO2 93.27
Min SpO2 88.00
% in SpO2 drop 5.37%
And my new sleep DR didn't even read data from my machine but wants to sell me a new machine... I dumped her.
My newest Doc did not review the best data available before recommending new equipment. She never looked at current data on my CPAP (90 day record), nor data I have kept for 5 years to show trends. Used a 2 yr old sleep test and one night record from a recording pulse ox (which I provided from my equipt).
She used the result of one night of sleep testing to diagnose I needed a new mask. (I have only two leak events recorded on my CPAP in 90 days) It is likely I pulled it off during the test due to puffs from her new machine that were out of synch with my breathing pattern, or the slip knot on my old strap probably loosened during the night with repeated checks on the glue in my hair. I do need a new strap (adjustable preferably), but don't need a new fitting. I use nasal pillows which seal 100% if the strap is right.
How I feel about her, and whether she had a bad day or not, are irrelevant. I think these are objective observations I have made. I consider this lazy and incompetent. I won't be going back.
When I had Afib, the docs were just going to put me on heart drugs. I had to insist on testing for root cause, which came down to bad settings on the CPAP causing increasing central apnea events.
Here's a pretty good place that explains it. https://www.sleepapnea.com/diagnosis/understanding-results
My average AHI (treated) dropped from 2.6 to 1.7 when I started taking fresh ginger root daily to thin my blood and get off an irreversible anti-coagulant.
Prior sample Jan 29 - Feb 20, Postsample Feb 21 - Apr 28
AHI (treated) dropped from 2.6 to 1.7
CAA went from an average of 8.3 to 2.0
Obstructive apneas dropped 1.0 to .5
Hypopneas remained the same at 7.0
The chart shows an immediate effect.
Might be worth a look.
I fully consume a root portion the volume of my thumb the length of my nail, twice daily. Once in the morning and once before bed.
I observed that with one mask/pressure setting my heart rate and volume of breath was increasing throughout the night until I awoke gasping for air.
I surmised that I was re-breathing too much and the CO2 level was increasing.
I punched holes in my mask. The CPAP tries to hold the same pressure, so I get more escaping and less re-breathing.
My requirements change with health, activity and other factors. I would think that regulating the CO2 level would more directly regulate the sensations which trigger breathing.
CPAP regulating air volume treats the need for air, but ignores the trigger mechanisms for breathing. It is a PID feedback loop with too much delay and no direct coupling.
I believe a pressure-proportional bleed valve could be tuned to regulate re-breathing and stabilize periodic breathing. It would not be a direct control from CO2 level, but I suspect exhale volume and pressure may be closely related.