Hello all! Questions from a newbie...

[Sprocket89]

Hello all!

I've been having abnormally low energy levels the past few years and finally decided to take some action. I went in to my Dr for a checkup and to get some blood labs to help diagnose my issues. He suggested a sleep study, which I then did, and was diagnosed with mild OSA (10.9 AHI). He prescribed CPAP therapy, so here I am! I'm eager to make changes to start feeling better. 

I've received and been using my ResMed Airsense 10 with Dreamwear and Nasal Pillows for a little over a week now. I'm committed to giving this a fair go, so have used my mask, all night, every night since receiving it. I'm new to all this, so looking for some insight on a few issues I'm experiencing this past first week of therapy.

My AHI numbers do not seem to be improving, so I assume I need to take some steps to dial in my settings a bit. After a bit of reading on the boards here, I decided to adjust my pressure from the default 4-20 settings. I bumped my min pressure to 7, made sure EPR is on, and turned off the ramp feature. I don't seem to have too much trouble falling asleep, so not sure that was helping and I definitely didn't feel like I was getting enough oxygen starting at 4!

As far as I can tell, I'm getting a pretty good seal on my mask and don't think I'm breathing through my mouth at all. Occasionally I wake up feeling like I am not getting enough oxygen, and I'm tempted to rip the mask off, but I've generally been able to take a few moments to focus on my breathing and I can settle back down and fall asleep again. 

I am also experiencing some aerophagia problems. I wake up with a feeling like my stomach full of air and need to burp or "pass" gas at an abnormally high rate in the mornings. 

I have OSCAR data for most nights over the last week, but don't want to create too big a post, so will just attach the last few nights. 

Thank you kindly for any insight or advice you can provide!!!
   
   
   

[Gideon]

Welcome to the forum.
Currently you are having 2 issues, aerophagia and central sleep apnea, which I am presuming is treatment emergent.

Any indication of central, mixed, complex apnea on your sleep test? This is to eliminate the possibility of a preexisting central apnea condition. Best if you can post a full copy of your sleep|p test. This would include charts and tables in addition to the narrative.

To try to eliminate the aerophagia we want to limit your max pressure to something below the threshold that your aerophagia starts. The goal is to adjust to not having aerophagia for several days then very slowly increase the max pressure to resolve any Apneas we caused with the pressure reduction. Thus set your max pressure=9.

To reduce the centrals we want to reduce the differential pressure between inhale and exhale pressure. So set EPR=1.

Try this then repost with charts.

[Sprocket89]

Thank you very much for the informative reply! I'll try these settings out tonight.  

I do have a copy of the study, though it wasn't a real in-depth sleep study. I just did an at-home study, where they sent me a pulse oximeter to wear on my thumb for a night, but I've attached the details from the report, just excluding personal info, but there wasn't any detailed charts or diagrams with it. 

Here's the info from my sleep study:
   
   

[Gideon]

Thanks,
They are very confusing in their presentation of the data. Here is the nutshell version.

You have mild (5-15 AHI) OSA, Obstructive Sleep apnea at 10 AHI. Your RDI, Respiratory Disturbance Index is Moderate (15-30 RDI) at 20 RDI..

Your Central/Mixed Anea is present but negligible

Your Oxygen SATs are within normal and not an issue.

Id proceed with the settings I previously recommended.