Waiting for new study and doctor

Sorry, I posted in other topic and should have started a new one

Great forum, thanks. My home study showed AHI of 31, just in the "severe" range. Over 10 months, using SleepyHead for data, I was never able to get my average AHI below 10, trying every mask and a range of settings in the process. I just had surgery to correct my deviated septum, and can now breathe thru my nose, for the first time. But this has thrown my CPAP treatment off. Where I used to get my best results with max pressure set to 18 (I would have gone to 20 but could not stop mask leaks), post surgery it was difficult for me to exhale, even at 14. I tried using EPR = 1, but started getting irregular heart beats, indicating distress. My PCP told me to stop using CPAP until a new, in lab sleep test is done in 6 weeks. I have had to figure out things on my own, with help from a friend in the US, and from a friend in Amsterdam. My Pulmonologist was not helpful, and I will get a new one in two weeks. It's been almost a year! Thanks for listening.

As I responded in the other thread what is your ratio of central apnea to obstructive apnea? Central apnea is a very different problem and CPAP pressure alone does not help, and usually makes it worse. EPR while you are sleeping is most often not helpful. It tends to increase the pressure needed to treat obstructive apnea. I use EPR during ramp only, when I am still awake.

How can I see Central apnea? In Sleepyhead, is it the "Unclassified apnea" stat? thanks

Central Apnea is shown as CA or Clear Airway as in Not obstructed.

Here is a picture of a pretty good night prior to nose surgery. After surgery, things seem different.

While I wait for new doc and new study, I'm thinking of trying again with no EPR and a max pressure of maybe 12. What do you think about that?

Here's a better one, from the day before surgery.

That May 1 daily report indicated that you were getting your obstructive apnea events in very close succession right after going to sleep. Some report that when they get bursts of obstructive apnea it can be a sleeping position thing, and get some relief from it by using a cervical collar to keep their head aligned. In your case since it was before surgery it may have been related to your medical condition.

The interesting part is that after those bursts of obstructive apnea you had virtually none for most of the night with the pressure relatively low. That part of the night would suggest you only needed about 10-12 cm of pressure.

There is a bit of central apnea near morning. It did not seem as far as I could see to be related to higher pressure. Sometimes when we are waking up there is an effect called sleep wake junk which can get mistaken as central events by the machine. It may be a bit of that.

When you post a daily report like that it helps to use the orange "Write a Reply" button at the bottom of the screen. That will give you a full page width to display the graph.

last night:

See how the obstructive apneas are clustered. This is in all of your charts, some early when they may be SWJ but others not. This pattern usually indicates a positional apnea caused by your chin tucking and restricting the airway. The best way to resolve this is via either an anti-snoring collar (Dr Dakota is popular) or a loose fitting soft cervical collar (ReLeaf is popular). I would like to see the results from this before I suggest other changes. Here is a wiki article where the user decreased there AHI dramatically with a collar.
http://www.apneaboard.com/wiki/index.php?title=Optimizing_therapy#Positional_Apnea