First week with Resmed Airsense 11

[Papinator]

Greetings all, I just finished my first week with a CPAP/APAP.

I've strongly suspected that I had SA for years. Never refreshed, wake up with wet shirts from sweat, three day headaches, inability to sleep on my back. My sleep doctor was skeptical, because I did a sleep study years ago but was never able to finish it with standard CPAPs. 

Anyway, my recent home sleep study revealed an AHI of 32.2.

So after my first week of the Resmed, this morning my AHI was....0.49. I've only used the SD card for two nights (but the Oscar report has AHI #'s from previous nights - should I ignore?)

After trying sleeping on my back and having some difficulties, I went to all side sleeping last night and only woke up twice, which is something I haven't done in years (I'm usually up 4-5X to pee).

I'm still not feeling totally refreshed, but I take a sleeping pill for anxiety that leaves morning fog and I'll be weaning off of it.

But from a health perspective, this has to be considered a success.

I bought an Apple Watch, but it seems too complex for non-geeks to import into Oscar. I have a Nonin 3150 on the way, which supposedly can bluetooth connect to the Resmed.

BTW, my timezone is off, but it requires Clinician Mode to change. If I change it, my sleep doc will know I've been tinkering where only High Medical Priests are supposed to go, haha. I did enable advanced user mode so I can see AHI on the Resmed first thing in the morning.

Any advice based on this Oscar report? I'd imagine some of you will encourage me to turn off the training wheels (auto ramp) haha.

Anyway, this forum is great. I've learned a ton in a very short time. I can't believe I waited until 57 years old to deal with this.

[hawkbox]

So I've had my 11 since October and I'm in a similar situation learning wise, I'm just 43.  My home test said 49.1 apparently but I struggled to actually sleep with the setup on me the whole night.

Your initial description seems a lot like mine in ways I hadn't considered until you mentioned it. I sweat a lot in my sleep, felt like a can of smashed assholes most mornings, etc... things that I haven't felt since I started.  I seem to sleep more than I did before and I don't inherently feel better in the morning but all of the previous negatives have more or less gone away and my wife said I stopped snoring almost entirely. Also most of the time no dry mouth. But the water tank was empty every morning except the last 2 which I find a bit weird.
Clinician mode is just hold the two LCD "buttons" together for 3 seconds.  Don't change anything without taking notes though. I had an issue with the heated hose that had me mucking about in the settings until I realized it was an autodetect situation and the pins weren't making proper contact.

I have a friend who was literally at risk of brain damage from low o2 overnight so I went into things with probably unrealistic expectations, I bought a fitbit charge for the o2 monitoring and it basically never seems to deviate from around 96% which doesn't shock me.

I've also found it really educational though I definitely have a long way to go myself.

[Millstone50]

You'll want to look at that EPR setting as it's only on during ramp (also please don't use ramp once you're able to wean off it, as it limits therapy effectiveness).

You may also want to experiment with increasing EPR to see how you like it.

[hawkbox]

Really... the ramp setting makes the setup worse?

I did notice the EPR set to ramp did seem to negatively affect me.

[PeaceLoveAndPizza]

Overall I think things look quite grand. Not bad for a first go at it.

I suggest getting rid of ramp as you get no therapy during that time and when it "ramps" up to actual therapy pressure it may affect sleep quality. I would also suggest dropping EPR from 3 to 2 as excessive pressure support may contribute to other issues.

Try the following for a few nights.

Mode APAP
Min pressure 7
Max pressure 12
EPR 2 full-time
No ramp

That should tell us a few things and we can tweak further from there after you post a chart or two.

[hawkbox]

Cool, I don't want to hijack this so I'll start my own thread but that is definitely something I can test out.

[staceyburke]

You said you don't want to change settings because the Dr. will know.  I'm sorry but virtually EVERYONE here changes those settings.  That is what the site is about, knowledgeable users helping set the pressures and options in the clinicians menu.  So I will give a short explanation why I would make a couple small changes to your settings that should help you.  It is up to you if you would like to try them.  You can always change them back if they do not help.

Suggested changes.

Min change to 7
EPR on Full time
EPR 3

The changes are for you to do better on flow limits.  Flow limits are apnea just like O and H events BUT are not long enough (at least 10 seconds) to be an 0 or H.  The machine ramps up to a higher pressure to stop flow limits.  So if you can have lower (or less) flow limits the better.  Flow Limits are NOT counted in the AHI but  they drive up pressure which can cause more leaks and stops you from getting into deeper sleep causing you NOT getting as much rest as you should.

Again, you can put the setting back to what you have if you don't feel like it helps.

[Dormeo]

To elaborate on staceyburke's post: you have the right to change your settings. If you've been told not to, and you're worried about your relationship with your sleep doctor, you could notify him or her in advance of the changes you will be making (no ramp, min 7, EPR of 3). You can say you believe these settings will be more comfortable for you. Or you could go ahead and make the changes, then if the sleep clinic hassles you about that, you can tell them the changes have made your therapy more comfortable (if that's true, of course). These are very modest changes, and your sleep doctor really shouldn't regard them as dial-winging.