Sierra

Hi again, I think the breaks are being caused by the mask slipping out of position long enough for the SmartStart feature to shut the machine down. Then when the mask is back in position it restarts the ramp which in most cases is very short as you are likely asleep or asleep in a minute or so. I don't see it causing any subsequent apnea events though.

About the only thing I see unusual about the Daily graph you provided is that between 1:00 and 1:30 you got some OA events in quick succession. That usually suggests body position or a kinked neck. Perhaps the collar was not as tight as usual or you were sleeping on your back for a while.

Unfortunately like me you are stuck with this complex (mixed) apnea situation. It tends to be erratic with most of the variation in the number of CA events. I seem to have transitioned from having event frequency less than 1 to more like 1.3. I hope the lower levels return, but it is only a hope, as I don't see anything that would help. My current chart below. The magenta bars are the CA events which are most erratic and basically responsible for the day to day variation. I think I get the lowest scores when I sleep between 6.5 to 7 hours, and the worst when I sleep over 8 hours. Sometimes nearer morning when I am not sleeping soundly I thing I get some false CA event indications when I am transitioning between being awake and being asleep. Some call that "Sleep-Wake" junk.

In any case I typically get most of my CA events in the second half of my sleep, possibly during REM sleep...

I don't think it is worth it. Need special masks, has no SD card to capture data, and some get irritation from the humidifier gizmo. My wife and I both have ResMed A10's and travel with them. No cost to bring them on board with you. The travel case is very good. It has a Velcro strap that attaches to the carry on extension handle. The two bar kind is the best so the CPAP bag does not spin on the handle.

We have a Z1 Auto machine that our son did not like and gave it to us. We never use it, and just keep it as an emergency spare.

That sounds like a good plan!

I really doubt hackers would get in, or have any motive to mess with the machine if they could. Seems like a defective machine to me. It may actually be just the power supply and not the whole machine. We had a problem with my Wife's S9 ResMed when we were in the trailer and using the DC to DC power supply. The power supply was tripping out on what I believe was a false overload.

I think at this point I would just leave things as they are to collect more data. The Statistics tab will display a summary of the results since the last change to the settings. When it has been two weeks since that last change we can have a look to see how it turns out. I think you may be at the "Yes" answer to the old question "Are we there yet?".

Agree. Things look pretty good.

Sorry to hear about the TIA. My mother had those issues from time to time. Despite them she made it to 96 without a real stroke. That said, I think it would be prudent to talk to your doctor about it.

The overall AHI is not as low as I would expect but I don't see an obvious way to make a change. I find I go in cycles with CA events. I can be in the low 0.5 or less range and then shoot up to 2.0 or more. I would stick with this pressure for a while.

It would seem strange that the machine did not start when you put the mask on. Perhaps check to see if SmartStart is turned on. The OA and H seems a little higher than I would have expected based on some of your earlier nights. Other than that, not your lowest AHI night, but still OK.

I am very sure that the blank parts are due to the mask being off, and the machine shutting itself down automatically. Then when the mask is back on, it starts up. No way to tell why the mask has come off.

When I get up in the morning or for a P break in the middle of the night I get out of bed with the mask on, then press the button on the top of the machine to stop it, and once I have pressed the button I hold my breath until I get the mask off, or it will start again.

Despite the blank spots the outcome seems quite good for a fixed pressure. The hope is that a fixed pressure all night may be less disturbing to your sleep, compared to the pressure going up and down automatically. Time will tell.

The one thing I noticed is that your Ramp Start Pressure seems to have moved back to 4 cm. You should reset it back to 9 cm for more comfort while going to sleep.

I don't watch the tidal volume much on my OSCAR, so really can't comment from experience, but it seems like you were breathing very deep and erratically for that last part of the night.

My wife does this hold her breath breathing thing. Don't know if it helps with her sleep, but I know when she holds her breath for more than 10 seconds at a time the machine flags it as an OA event, and the more she does it, the more it drives up her AHI score!

My thoughts are that the lower pressure is not helping the frequency of the CA events, but OA events have increased. Perhaps it is time to abandon trying to get the CA events lower, and just focus on reducing OA and H. I think it may be time to switch to fixed pressure CPAP mode and set the pressure at 11 cm to start with.