Stoaty

I read there was some concern about the dental appliance loosening teeth. That was enough to dissuade me from looking in that direction. I suppose I could buy the Alice NightOne for a few thousand dollars, but that seems like killing a gnat with a sledge hammer.

I have mild sleep apnea (AHI - 6.7) which is strongly positional. Left side sleeping - 2, Right side sleeping - 16, Back sleeping - 56. I have thought about getting a pillow to maintain and optimal position and keep me from sleeping on my back to see if that would bring down my AHI into the normal range instead of using CPAP machine. The problem is that I need a way to monitor to see if constraining my sleep position alone improves my apnea. Is there anything available to do this?

First full night of CPAP with fixed pressure of 7:

Time - 7 hours 26 minutes AHI - 3.09 Central apneas - 2.02 Obstructive apneas - 0 Hypopneas - 1.08 RERA - 0.27

I had 3 separate sessions due to bathroom breaks. They are as follows:

First 3 hours - AHI 5.08 Next 3 hours - AHI 1.95 Last 1 hour - 0.83

Not sure why the score progressively improved as the night wore on. I may try backing off to fixed pressure of 6.5.

Haven't been able to see sleep medicine doctor yet. Had the home sleep test (I have Kaiser), trial of a machine for a couple of days (helped), then machine was ordered. Got machine about 10 days ago. I am going to give another try to getting an appt which will probably be 3-4 weeks from now if I am lucky. Going to get a different mask on Friday from the company Kaiser contracts with to provide durable medical equipment as initial one causing soreness in one nostril. I would be thrilled to see a sleep physician or sleep tech if I could.

I ended up trying different minimum and maximum pressures (I wasn't sleeping very well any way) last night. Setting minimum of 7 and maximum to 8 seemed to work for a while, then got a bunch of central apneas such that the whole section had AHI of 11.89:

I got disgusted and changed from APAP to CPAP with a set pressure of 7. Over a period of an hour and 40 minutes (last sleep section of the night) I got AHI of 0.61 with one central apnea and nothing else. There was a bit more flow limitation, but no hypopneas. Looks like CPAP 7 will be my setting for the whole night tonite.

I am curious what your fixed pressure is and how you arrived at it. Also, what pressure limits were you using with machine on Auto when you had the 3.2 average?

Yes, I will only set the maximum pressure lower if the central apneas continue tonight with EPR off.

Snore chart has one tiny little blip, almost always empty completely so I had hidden it. Why would I want to set a maximum pressure that low if flow is being limited in some way? Doesn't that mean I am not getting the optimal amount of oxygen if there is a limitation in flow?

Here is a graph of a 20 minute "nap" I tried to take just now. Toward the end I was drifting off to sleep. Minimum pressure set to 6, Maximum pressure set to 11, EPR off, ramp time off. Note that the pressure gradually drifted up to around 9. AHI of zero (but I wasn't quite asleep so not a particularly good test). I am a bit surprised the pressure went that high while I was not quite asleep.

I think I was sleeping, but not 100% sure. Here is a section of time later last night when I put the mask back on with minimum pressure set to 8 and EPR set to 3. I am virtually certain I was sleeping then. There are a lot of central apnea events here with AHI of 21.8 for the whole 1 hour 20 minute time span. My conclusion is that with EPR turned on I blow off too much CO2 leading to the apnea. Tonite I will try minimum pressure of 6, EPR off, Auto Ramp off (I like to get the air flowing right away).