[CPAP] New CPAP User Looking to Tune Settings with OSCAR

[squaredr]

Hi All,

I've been recently diagnosed with Mild OSA, after pursuing a sleep study due to excessive daytime sleepiness and fatigue. My sleep study reported an AHI of 6.3, which surprised me considering the level of grogginess, brain fog, memory loss and aforementioned fatigue that was diminishing my life at work and at home (it was an at-home test, however, and I've read that those can be dubious). Regardless, I did get a script for a CPAP, and have been using it for 28 nights so far.

I have a ResMed AirSense 10 Autoset, and have paired it with an F&P Brevida nasal pillow mask. I went into this with a positive attitude, and as such I've taken to it really well. I find the pillows very comfortable, and have tuned the mask fit to where I no longer notice it on my face. Due to my strictly regimented sleep schedule, I fall asleep within about 20 minutes on average. I wake gently due to the Hatch that we have in our room. I've never had a feeling of suffocating, and actually I really enjoy the amount of air that I can feel passing into my lungs; everything feels wide open for the first time ever. I've particularly noticed that I dream again! I didn't realize how little I had been dreaming until the past few weeks.

I noticed that for the first week I was feeling great, definitely above average. Reduced brain fog, I was sharp again, was an active listener. However, over the past week or so, it seems that I'm starting to feel like I was before I started the therapy. I'm chalking it up to the change of seasons, but I'd like to think there's more that I can do in terms of tuning my machine, as I'm effectively running it on out-of-the-box settings:

Pressure Range: 4-20
EPR: 1
Auto Ramp

I'd like to let the data from OSCAR drive how to tune it, but I need some help making sense of it. I've attached last night's charts to this post. It seems that my pressure tops out around 8.5, so I'm thinking the large range isn't helping me. Should I bump the range down to 4-9? I'm ignoring the LL for now, as my mouth does open sometimes during the night while I acclimate to keeping my tongue locked. Generally a gentle nudge from my wife clears that up.

My lowest AHI that I've seen was 1.6 (and I felt good that day) - I'm thinking that I'm particularly sensitive to AHI since my actual range is pretty small, so I'd like to get down under 1 if possible.

I greatly welcome any tips to help me dial this in. I'm thrilled and thankful that OSCAR exists, and I've been enjoying looking into all of the information it has been relaying to me.

Thanks!
-Rob

[Gideon]

Welcome to the forum.. your therapy looks great

Because your numbers are excellent I consider the following suggestions as optional.

Realize that your comfort is now the most important issue. At this point it is more important than your AHI. Taking a hit on AHI is fine if it improves your comfort.

You have no need for higher pressures so I'd like to cut back your flow limitations. While a 95% FL of 0.10 we consider bad, yours is 0.06, we like to see it less than 0.03. there is no medical standard here, just our experience with helping many users.

To do this you would need to increase your min pressure setting to 6 and set EPR to 6. Do note that your actual min pressure will be 4 (6-2) and the net effect should be fewer and less severe flow limitations. With the increase in EPR your CA events may, not will, increase so watch them.

Then repost your charts

[squaredr]

Thanks Gideon, this is good info. I'll set that up for tonight and reply back with some results. I'm assuming you meant to set EPR to 2 to get a net 4 psi min pressure, so I'll go ahead with that. 

-Rob

[squaredr]

Welcome to the forum..  your therapy looks great

Because your numbers are excellent I consider the following suggestions as optional.  

Realize that your comfort is now the most important issue. At this point it is more important than your AHI.  Taking a hit on AHI is fine if it improves your comfort.

You have no need for higher pressures so I'd like to cut back your flow limitations.  While a 95% FL of 0.10 we consider bad, yours is 0.06, we like to see it less than 0.03.  there is no medical standard here, just our experience with helping many users.

To do this you would need to increase your min pressure setting to 6 and set EPR to 6.  Do note that your actual min pressure will be 4 (6-2)  and the net effect should be fewer and less severe flow limitations.  With the increase in EPR your CA events may, not will, increase so watch them.

Then repost your charts

Hi Gideon, attached is my chart from last night. I wanted to take a couple of nights for me to get used to the increase in pressure, as it has been noticeable. I've also noticed an increase in larger leaks due to me opening my mouth more often, I believe because of the pressure change. This does tend to wake me up more often, either of my own volition or a wifely nudge - might just be a matter of re-calibrating my tongue lock. CA events have increased slightly as well. Interested in your thoughts regarding the FL, I'm unsure if the change has been significant. I don't feel a daytime improvement, personally, but will be patient.

Thanks!

Rob

[squaredr]

Forgot to actually add the chart...