Mixed results after one month of use

[northerner33]

            Hello all,

Today marks day 30 of using my ResMed AirSense 10. It's been hit or miss overall and has definitely not been an easy adjustment, but I have seen some positive results (better mood and energy level, etc.). However, for the past week or two those positive effects have petered off and I've been hit with waves of exhaustion lately, much like I experienced before I started therapy.

I have just started using OSCAR and have attached screenshots of last night's results. As far as I know, I'm doing everything correctly and my numbers are pretty good. I have adjusted the pressure settings to 8-15 recently (previously 5-15) and haven't touched any other settings. Am I doing something wrong? Is there something else I can do to optimize therapy? I'm just not obtaining the same benefits that I was getting previously and am keen on fine-tuning whatever I can to make sure I can obtain the maximum benefits out of my device.

Any advice/guidance would be appreciated.

[northerner33]

I just realized I could delete sessions from the summary page on OSCAR, so I've done that for the long session of inactivity. Here are the screenshots. Hopefully it brings added clarity.            

[Deborah K.]

Your events and settings both look pretty good.  I hope someone else comes along who can offer advice on those if it's needed.  I do know that for some folks therapy is uncomfortable and they don't feel any better for a while.  Don't be discouraged; you're not alone in this.  It WILL get better.  

Your Oscar chart could use a little help.  The format you used in your second chart on your second post is the best, but it would be good to delete the calendar so we can see good information further down on that panel.  The chart should show Event Flags, Flow Rate, Pressure, Leak Rate, and Flow Limits, in that order.  In that way, everything we need to see is all there on one chart.

[staceyburke]

Before we try pressure changes I would like you to try changing the response from soft normal and see what that does.  It should get to the apnea quicker and reduce the AHI.

[northerner33]

Thanks to both of you for your suggestions and advice.

I changed the response from 'soft' to 'normal' before bed last night. The chart looks completely different.

Is there anything else I can fine-tune to improve treatment? I feel like my AHI is still a bit high, and additionally I don't know why I'm getting so many central apnea events whereas it seems like not many others do. 

Thanks!

       

[northerner33]

Would there be someone able to tell me if my settings look good and if there's anything else I can do to optimize therapy? I'd really appreciate it because I don't feel like it's optimized quite yet. Thanks!

[PeaceLoveAndPizza]

The only thing I would add is to bump up your min pressure from 8 to 10. You can see the 8 working whilst in light sleep (21:15 to 23:00), but once you hit deep sleep (23:00) things go bonkers and never quite settle down. Starting at a higher min pressure may help smooth things out.

Something like:

Min pressure 10
Max pressure 15
EPR 3 full-time

It may not quite work like I think, so if it does not help just go back to where you were previously and we can work from there.

[Sleepster]

While your leak rate is within the acceptable range, I suspect some mouth-leaking may have started to disturb your sleep when you started experiencing poorer results. You can contact your equipment provider and ask for a full face mask. It's expected that a new user will have to try out several masks, so it's probably covered by your provider's policies or by your insurance.

If a full face mask is out of the question you can ask your equipment provider for a chin strap, or try a soft cervical collar. In my experience, the full face mask is the way to go.

[northerner33]

Thanks to both of you! I will implement your suggestions and see how it goes.