Got Bipap instead of prescribed ResMed Autoset machine. Please help me get going.

[marvin2023]

Hey everyone. I was prescribed a ResMed Auto CPAP from my online sleep study doctor, but I unfortunately couldn't afford one so my cousin gave me her machine that she hasn't used in 1 year. She gave me her ResMed Autocurve 10 S which is a Bipap machine.

I have the settings at IPAP: 8 and EPAP:5. I used that for 2 nights and I was getting .1 AHI on the reading which I believe is good but I was waking up so tired and it took me a while to sleep when I typically fall asleep in 5 minutes without the machine. So I'm thinking that reading isn't enough for me to know if my settings are optimal. I did try a pressure of 10 and my AHI went up to around 1.

Overall, I'm noticing that my breathing seems off (tried an Airfit F20 and a Philips Dreamwear - both full face since I tend to breath from my mouth sometimes). Basically I'm feeling like I'm being forced to breathe too fast. That's the best way I could describe it. When setting it to regular CPAP mode (just started testing that a bit ago before making this post), it's feeling like I have to force an exhale. It's very weird. So I put it back to the S mode where the IPAP and EPAP settings can be adjusted. Is it normal for CPAP mode to feel like I can't exhale? I looked online and people mentioned an ERP setting but that doesn't exist on this machine model. When I'm in the S mode, the exhale isn't a problem. It's easier to exhale the lower I go (3 is the minimum).

I'm just not sure where to go from here. I just want to obviously get my settings right and sleep comfortably. If you guys can help me it would be greatly appreciated. I've had years of terrible sleep and just need to get this fixed.

If it helps, attached is the data that was recorded with my sleep study.

[Sleeprider]

Please download the free OSCAR software which will give much better data on the events and therapy. Your AHI is good, but that kind of summary is not going let us identify why you still fee unsatisfied with the therapy. The Aircurve 10 VPAP-S is a good machine, but we're going to need the data to help you optimize and find the problem areas. The feeling of resistance for exhale is a common complaint for CPAP, and you have a lot of settings we might use to help. With IPAP 8.0, EPAP 5.0 that is the same as using a Resmed CPAP at 8.0 pressure with EPR at 3. OSCAR is the answer to your questions, and be sure you have a SD card 4-32 GB to put in the card slot of your machine.

[marvin2023]

Thank you I will use that ASAP and report back here. I appreciate the quick response.

[marvin2023]

Please download the free OSCAR software which will give much better data on the events and therapy.  Your AHI is good, but that kind of summary is not going let us identify why you still fee unsatisfied with the therapy.  The Aircurve 10 VPAP-S is a good machine, but we're going to need the data to help you optimize and find the problem areas. The feeling of resistance for exhale is a common complaint for CPAP, and you have a lot of settings we might use to help.  With IPAP 8.0, EPAP 5.0 that is the same as using a Resmed CPAP at 8.0 pressure with EPR at 3. OSCAR is the answer to your questions, and be sure you have a SD card 4-32 GB to put in the card slot of your machine.

Hello. It's been some time since I made my first post here. I have no idea why it took me this long to get this done but I have been recording some data for a while now. I loaded my card up into Oscar but at this point, what do I do to figure out why I still feel pretty tired throughout the day? Is there something specific I share on here to have someone take a look at? Thanks in advance.

[bookikiluke]

You’ll want to start by viewing the link for organizing your OSCAR charts in SleepRider’s signature above.

[SarcasticDave94]

You can post an OSCAR daily detail chart and let us see what's going on. Add it as a new attachment after viewing OSCAR daily detail and using F12 to screenshot.

[marvin2023]

You’ll want to start by viewing the link for organizing your OSCAR charts in SleepRider’s signature above.

You can post an OSCAR daily detail chart and let us see what's going on. Add it as a new attachment after viewing OSCAR daily detail and using F12 to screenshot.

Thanks guys. Attached is the screenshot. I watched some videos on how to interpret the data but I have to get more of an understanding.

[SarcasticDave94]

You'll be better served showing this OSCAR chart first without zoom.

No need to redo this OSCAR chart, just show this without the zoom in.

I'd consider removing this 15 minutes of Ramp at 3 cmH20. Base Min of 6 shouldn't be all that hard to start out with. I myself was air starved below 5.

[marvin2023]

You'll be better served showing this OSCAR chart first without zoom.

No need to redo this OSCAR chart, just show this without the zoom in.

I'd consider removing this 15 minutes of Ramp at 3 cmH20. Base Min of 6 shouldn't be all that hard to start out with. I myself was air starved below 5.

Sorry about that. Not sure why it was zoomed in. Here you go.

I will try it at 6 minutes. 

Just to mention a few things:

When I first started using this CPAP, I played with settings for about a month until I saw the AHI on the machine stay at 1 or under. I believe I have seen people on here say not to overthink that number, but so far the setting I have it at (EPAP 6 and Pressure 10) has kept it the lowest with the least amount of snoring according to a recording app I used to record my snores. I also used those specific EPAP settings because I read somewhere....can't remember where exactly...that the Pressure should be 4 above the EPAP. No idea why that is but it's just what I went with.

What I noticed overall is no matter what setting I've tried, when I put my mask on immediately as I get into bed, I find it VERY hard to exhale. It's like trying to exhale out of a thin straw. I have to lay there for at least 10 minutes and rest before I put my mask on. I don't know if that has to do with the machine starting up or if it's just me. When I wake up in the morning with my mask still on, I find that my exhaling is just fine. CPAP mode is even worse so I have not used that mode at all as I mentioned in my first post here.

Also, if it's important at all, I use the Resmed P10 nasal mask. I am going to try the P30i soon since my arm sometimes gets stuck on it as I move in my sleep. I'm assuming that's what happens in those leak areas you see spiking on there. I have tried multiple full face masks and the nasal masks have had the least irritation and leaks so far.

[SarcasticDave94]

That differential between 6-10 pressure would be PS of 4, that's probably part of why static CPAP isn't so good feeling for you. You're used to this exhale relief. That's perfectly fine.

I see a low leak that might be a disturbing aspect. It's not high level, but may factor in.

The difficulty you mention might be a drawback of the S machine. It's static and has no flexibility for you like the VAuto would in setting static pressure, where the VAuto you somewhat set ranges of operation. You might want to trial moving the pressure settings slightly to see if you can maximize that starting comfort. Maybe 7-10, even though that's changing the PS differential to 3. I still think Ramp at 3 cmH20 is really going to starve you of air.