Sierra

You may want to try the AirFit P10 nasal pillow mask. It has no magnets.

I buy reverse osmosis purified water available at hardware stores like Canadian Tire or grocery stores. You bring your own jug and fill 5 gallons for $3. At home I use the large container to fill one gallon containers which I reuse. No consumption of endless plastic water containers. I think the brand name of the machine is UltraPure.

About all I can think of is trying a fixed CPAP pressure mode. I think I would try something like about 8.0 cm with EPR at 3 cm still set for full time to see if that helps any. More pressure, if it does not cause centrals can be helpful in getting enough air. Personally I have my machine in Auto Ramp with a start pressure of 9 cm.

That is helpful. There is no detected or even minor apnea event which has preceded this disruption. I think it may be as simple as you just were aroused by something and started to breathe more deeply and then you fully woke up. Then I presume you removed your mask..

Those numbers would suggest the APAP is not set up as well as potentially could. Just based on those numbers alone, about the only possible quick fix may be to increase the EPR to 3 cm full time, if it is not set that way already. That MAY reduce the hypopnea. The other big issue is the high number of Clear Airway or Central Apnea events. Unfortunately since the airway is already open, more pressure does not help to reduce CA events. In fact especially with new users of the APAP, the pressure may even be making the CA frequency worse. But, without seeing more detail, I would not suggest just reducing pressure. What are your min and max pressures set at?

This said the best way the I could possibly help would be if you could download your data on the SD card to the OSCAR program, and then you could post your detailed daily report here. First you need a SD card in your machine. Some clinics unfortunately remove them. A 4 to 32 GB card is enough if there is none. Then you need a card reader and a PC or Mac to run the OSCAR software.

This software flags all the events you are having, when they are happening, and what the pressures are throughout the night. With your issues the first think to look for would be when the CA events are happening and what the pressure is at the time.

Post back if you need any help getting OSCAR working for you, and when you do post the daily report here. Save it as an image file, left click on it, and then drag it into an open post.

I don't think you are going to get a response from the OP on this. I suspect this thread was started to get hits on a YouTube channel.

My first question would be what is your breakdown of AHI events into CA, OA, and Hypopnea?

I was also diagnosed at an AHI of 33, but now I average 0.8 for AHI. To get they I initially adjusted the machine in Auto mode, and finally switched to fixed pressure mode once I knew what pressure worked best for me.

Any centrals should be flagged on the events bar if they last 10 seconds or more. I am still not seeing the graphs well enough to see what may be going on. Are you concerned about the area on the first graph you posted with the red arrows on it?

If so can you post that graph again with the Events bar but drag up the Mask Pressure so it is displayed along with Flow Rate and Pressure. Also if this is the area of interest, zoom in a little more so we can see what is happening with the flow and mask pressure in some detail. Show the time slot from 21:55 to 22:02. Zoomed in, any events less than 10 seconds should be visible.

That is a bit puzzling. You are feeling short of breath but are actually breathing more deeply. It may be useful to zoom in on that period of time. Also drag the Mask Pressure, and Minute Ventilation graphs up so they show along with the Flow and Pressure.

Your machine looks quite well set up. You are having no OA events and no Hypopnea. It appears Flow Limitations are driving up your pressure. Your AHI is still quite good. About all I can suggest is reducing the maximum pressure. Sometimes CA event frequency can be driven up by higher pressure. You may want to start by lowering it to 9 cm to see if that reduces CA's without increasing OA or H events. It is kind of a trial and error thing. I have been bothered by higher CA events, which were improved by lowering the max pressure. And I have actually gone to a fixed CPAP pressure now instead of using the auto mode. But, I would start by lowering max pressure. The idea would be to try to reduce the CA's without causing too many OA events.

I am sorry, but your screenshot is so compressed that I cannot read the information in it. The first issue is that you are zoomed in to a very small sliver of time. The second is that the left hand side is scrunched down so much that I can't read it. You could try going into File, Preferences, Appearances and increasing the font size. I also believe you can click on the division between the left side and graphs to drag the division to provide more room for the details on the left.