[CPAP] New CPAP user looking for optimization advice

[rococo.orchid]

Hello everyone. I have been using my CPAP for almost three months now and am not getting any relief despite my machine telling me all my numbers look good. My sleep doctor hasn't been helpful, so I want to ask for another opinion on what my data shows.

My machine is a Luna G3 APAP, and is not compatible with OSCAR, so these charts are all I have. I was ignorant about DMEs, the treatment process, and this website at the time, so that's why I am stuck with a subpar machine.

Here are the charts:

   

   

[Deborah K.]

I don't think most of us can read your charts.  It's possible that you can convince your doctor to prescribe a ResMed machine and have your DME take back the Luna.  I don't know for sure, but it wouldn't hurt to ask the doctor if he can do this.

Good luck with whatever you do!

[OpalRose]

When you say you're not getting any relief... can you be more specific?

From the limited data provided, your numbers look good.  I only see a couple Hypopnea events the entire night.  

However, your leak rate graph leaves much to be desired.  It lines up with the flow rate graph which shows a lot of spikes.  This could indicate mask movement.  How does your mask fit?  Do you move around alot at night?  

Read the Mask Primer

Especially this:  https://www.apneaboard.com/wiki/index.ph..._Jeffy1958

Does your machine report flow limitation?  Can you show that graph?

[rococo.orchid]

Regarding the relief:
I have severe daytime exhaustion where I am unable to stay awake for more than a hour or so without needing a 1-2 hour nap. These naps are not restorative and I do not feel better afterwards, but they are unavoidable. It feels like an extreme hangover is the best way I can describe it to others. The only way I can function is with my 40mg Adderall prescription. This is my most debilitating symptom. Short-term memory issues, an inability to concentrate, and general brain fog also affect me.

These symptoms have not diminished in any noticeable way since starting therapy three months ago. 

I was diagnosed with moderate OSA with an AHI of 17.7 and O2 nadir of 90% during an in-lab sleep study. All of my 90 events during that study were hypopneas, no apneas of any kind.

My mask:
I use a full face mask; ResMed AirTouch F20. I don’t notice any leaks when I put it on or before I fall asleep.

Through out the night I toss and turn to different sides and briefly move it up to drink water.

When I was fitted for this mask, my DME made sure to adjust it properly, so there were no leaks—according to my machine— and showed me how to adjust it so it is sealed properly, but not too tight. 

My CPAP:
To my understanding my machine does not record or show flow limitations. The above images are all the data it provides. I understand it’s limited compared to OSCAR-compatible ones, but it’s all I have. 

[OpalRose]

Have you been diagnosed with narcolepsy?  Your description ..... "I am unable to stay awake for more than a hour or so without needing a 1-2 hour nap"

Your Cpap therapy seems to be treating your apnea, but as far as I'm aware, it's not going to treat narcolepsy, if that is what you suffer with.  Have a serious discussion with your doctor.

[rococo.orchid]

I have not been diagnosed with narcolepsy. My sleep doctor will schedule a MSLT if there are no improvements with the CPAP. That is why I wanted to know if the knowledgeable people here can see something in my data that my doctor can't.

Here are three more days of data.

   

   

   

[PlayerTwo]

Hello my fellow Luna user. (really wish I knew it was the wrong one to get but it was cheaply refurbished compared to 2k versions of other types)

Im going through the same thing and literally theres only a few videos on how to set your Luna correctly.

Starting things to consider Im still working on this myself so I might get things wrong and mine is slightly nicer as a bilevel (but also more complex and has taken me awhile to get things rightish) but I am a gamer and I know how to min max settings and this is right up my alley .. 


First thing to get is React Health App for your phone its not great but it gives you at least an idea that your doing ok or not.

Set up 

Initial P - Just leave it at 4 its for the ramp up setting meaning it starts at 4 and then slowly ramps up to your 8/18 over time. I dont use it.

Your Pressure is solid at 8-10 im guessing your Ipap 95% is 8 based on the chart and never goes over 10
What has been recommended is to go to a smaller gap of settings as much as possible is the goal.

So first thing just to see how it feels Go 7min / 10max I bet you wont even notice a difference but the 7 min sets up your auto settings so you can use Reslex (googled it for your machine I think you have it). It helps you Exhale easier while sleeping so your body isnt fighting the machine as much.

Set Reslex to 3 its in comfort settings in the clinical menu.
What it does technically is lets you go 4-7 if your at your min only on exhale and 7-10 on your max. Its a hunch but i think based on your full face mask is getting a lot of pressure and its blowing off your face or something at the same time your leaking a lot in the charts. 

And sensitivity is the softness of breathing the last thing to set up that you can 1-5. Lower is quicker breathing Higher is slower breathing. I myself am a slower breather so I have the option to go to 8 and its much better for me but it depends on how it feels to you. Maybe go to 5 or try it while your awake and see how it feels to you.

TLDR

7min/10max 
Reslex 3
Sensitivity 5

Just try these first and if they suck go back to where you were before cant hurt.

You could also just try a different mask I started with the full face mask like yours and it leaked a lot sporadically kinda like how yours does from time to time to a Nasal pillow version and now my leaks are gone which means while your sleeping you get less disturbances that even if your sleeping through it.

If you can handle these settings what you want to do is try them for at least 2-5 days so you can share a few more graphs to see if anything changes. Also share your current AHI afterwards you can kinda tell how it is based on the chart but a number would be better.

Alright hope this helps its the accumulation of pretty much anything I have been able to find that matters for Luna users.