8 months on CPAP, AHI varies, help w / OSCAR data

[jleica]

Hello,

First off, I appreciate this forum. Thank you for providing this resource. I'm a newbie here — I'm hoping to get a better handle on lowering my AHI (I just switched masks, so I'm troubleshooting), and finding some help with understanding my OSCAR data.

I was diagnosed with moderate sleep apnea (AHI:19) last fall with at at-home sleep test. I'm a 60-year-old female, healthy, not overweight. Overall, I've felt great since starting CPAP therapy. The headaches, fatigue, and brain fog — pretty much gone. I now know what it feels like to be rested!

Some treatment details: I've been using a ResMed AirSense 10 AutoSet for Her (ClimateLineAir heated tubing, humidifier on 4). I'm a mouth-breather and have a deviated septum. (I've had two septoplasty's in the past 20 years. Currently, I use BreatheRight strips when using my mask.)

The pressure settings are still set at what my sleep doc recommended eight months ago: 4-20. I talked with him recently about optimizing settings based on my sleep data, and he seemed confused by this. He has been no help whatsoever in helping me troubleshoot. (Yeah, I'm seeking another sleep doc post-covid.)

I started out with the AirFit F20 mask. Months later, I switched to an AirTouch F20. (Also tried the P10, N30 and N30i masks, but no go.) The AirTouch F20 is above average in comfort — but it feels too narrow at the top of the cushion, making it a little more difficult to breathe through my nose.

I recently switch to an Fisher + Paykel Vitera full face mask, which I find to be the most comfortable of all. Much easier to breathe through my nose. (I practice that as much as I can.)

I start out sleeping on my side, but often roll on my back throughout the night.

My concern now: My AHI has been creeping up lately (beyond 5), and I'm waking up in the middle of the night more than I'd like. Also, I noticed bouts of aerophagia are getting more frequent.

I've attached three days of OSCAR data — July 5 and July 15 (w/F20 AirTouch mask) and July 31 (w/F+P Vitera mask).

I appreciate any troubleshooting words of wisdom you could share. Thank you.

[Gideon]

Welcome to the forum.

A min pressure of 4 is almost always too low. Min pressure should be 4 (min press machine is capable of) + EPR (3) = 7. This min is to allow the EPR to be effective over the full range of pressures. Starting you will have an inhale of 7 and an Exhale of 4 with EPR=3. This should help you.
Min pressure should in general be 6-8 to prevent a difficulty breathing. 4 & 5 typically are considered pediatric pressures.
On July 31 it looks like you are tucking your chin which is causing obstructive events that no amount of pressure will resolve.

[jleica]

Thank you, bonjour! I appreciate your prompt feedback. I will go into those settings and make changes. The journey continues ...