[Treatment] New CPAP & OSCAR user looking for feedback

[Boba Fett]

Hi All

Another new CPAP user here. I had a home sleep study a few weeks ago and my AHI was 92.4 (!), so the doctor prescribed a CPAP. I picked up my ResMed AirSense 11 AutoSet from the DME on 8/11, so I've had two nights under my belt. I can't believe the difference I feel. I'm still getting used to things, so I don't quite know what to make of all the OSCAR data. The AHI seems higher compared to what I'm seeing from other users, but I am not too worried about this right now as things are still new. I'm working on finding a good sleep position and keeping the leak rate as low as possible. I have a beard, but the F30i seems to be working ok when I have it sitting correctly.

Open to any suggestions and feedback on the attached charts, I'm guessing not to put much stock in them now and give things a few weeks to settle in before messing with settings. I did turn off the ramp as I  found it annoying. Unsure about temperature and humidity settings, I think these are set to 'auto', althought I do wake up with a sort of dry mouth - I am a mouth breather, I try to breathe through my nose but it just seems perpetually mildly stuffy and airflow doesn't seem adequate to me.

Thanks to all for your contributions, looking forward to getting myself back on track towards a good nights rest.

[Boba Fett]

Here's my last three nights.

After a week under my belt, I am feeling an improvement in things during the day. I still feel like there's room for improvement. AHI seems like it could come down a bit and I'm fighting with leaks a little through the night. Currently using an F30i, but I have ordered an F20 to see how that goes. I am a mouth breather and usually when I wake up from the leaks, I find my lower lip has escaped the mask. When I try to breathe through my nose, I feel like I am not able to exhale sufficiently, even at the very beginning when pressures are at 5 and EPR is 3. I'm not sure if I have something else going on here or if its normal. During the day, I have no problem breathing through my nose.

Aside from these issues, can someone with some experience and insight weigh in on how my graphs look? Pressures look ok? Hard to tell because leaks are too high?


Thanks!

[staceyburke]

You know about leaks.  As you know if you have a large leak the machine can not treat the apnea you experience during the large leak.  On the night you had a high AHI you had positional apnea but other nights you did not so that was because you just got into a position where you cut off your own airway by tucking your chin down to your sternum. 

I will comment on your pressures.  The absolute lowest any cpap can go is 4.  Your min (or lowest you have set) is 5.  So your inhale pressure is 5 while your exhale pressure is 4 because you get the exhale pressure by taking min and subtracting the EPR.  Your is 5-3 BUT the lowest the machine can possible go is 4.  In other words your EPR is set at 3 but it really is 1.  Because of this I would suggest a pressure change in the min pressure.

Min 7

That would make the inhale pressure 7 the exhale pressure 4 (min 7 - EPR 3 = 4)

That will help with 2 things.  First it will help minimize your flow limits.  Flow limits are apnea the same as Oa and H events.  How all apnea event are classified is in my signature at the bottom of the post.  2nd thing the min to 7 will help is the ResMed raises pressure when there are flow limits to stop them from becoming larger events.  At min of 7 you will not has as high of a high pressure because the cpap will not encounter as many flow limits and will not raise the pressure.

[Boba Fett]

Thank you. I'll bump the min up to 7 and see what happens, as well as work on leaks and find a position that leads to less positional apnea. Am I understanding correctly that positional apnea events are evidenced by clusters of OA on the graph?