[CPAP] OSCAR data review help - can I get better sleep somehow?

[da38]

Hello!

I'm looking for any recommendations to get better sleep. I've been trying to get a handle on my sleep apnoea for a year and a half now and I think I could do better. I can definitely feel the difference when I don't use my machine, but I still feel groggy in the mornings and can feel tired in the afternoons as well.

Recently I had COVID (or maybe a really nasty cold) - whilst I was really ill I didn't use my machine and I really felt rough after a few days without it. I got back on it and my AHI was all over the place - it used to be 2 - 6 and then went up to 10 - 15!).

My setup is:

- Resmed F20 full face mask (no mouth tape)
- Phillips Dreamstation 2 Auto (8 cmH20 w/ Ramp+ on 15 and Humidity 5)
- Side or front sleeper (would love to sleep on my back but I suspect I apnoea more when I do) with a folded over pillow (probably a stupid way of sleeping)

Attached is my OSCAR data from 3 different nights. 

25/07/24 - Good night's sleep, low AHI. Would like this to be every night
   

08/08/24 - Near end of horrendous cold / COVID - horrendous night's sleep
   

13/08/24 - Latest night's data - humidifier would not turn on and I decided to turn off the Ramp function. Not an ideal night's sleep
   

If anyone could check my data over and offer suggestions I really would be most helpful as I'm running low on ideas and kind of don't know where to start!

Many thanks in advance

[Narcil]

Sleeping on your back is the worst position for sleep apnea so definitely try to avoid it if you can.

Have you tried APAP before? I think you should start with a 8-15 pressure range see if the machine can get rid of the remaining apneas. i think your graphs also suggests positional apnea but apap should give us a better idea. The folded pillow (or any large pillows) might cause chin tucking, try to keep your airway straight and avoid "kinks" in your airway.

Not sure how to read the leak graph to be honest. Your max leak rate is 0 in the stats but the graph suggests 24-25L/min all night? quirk of the DS2?

[Phaleronic]

Welcome to the forum da38!

You have lots of OAs and Hs and with 8cm on cflex+ @ 3 you need more pressure right now (and please try to sleep on your sides and use a flat pillow). So raise it to 12cm and try this for a few nights-if it helps and you feel better we can raise it a little more with small values over more time.

[da38]

Great advice - thank you both for taking the time to respond

I'll definitely try to sleep on my side and not on my back. I've always been a front sleeper and am in the process of retraining myself to sleep on my side with the use of a pillow down my back and a duvet behind it to stop it moving around (otherwise I 100% end up on my back!)

My leak rate appears to be a constant 24-25. As you said @Narcil, I've no idea if this is a quirk of the machine or because I've been sleeping on my front? 

I'll up my pressure tonight to 12 and see how I go. My humidifier has come up with a maintenance error stating "Contact Support. There may be a problem with your humidifier. Therapy will run without humidification". 

I don't suppose anyone has come across this before on the Phillips DreamStation 2's?

[Phaleronic]

The DS2s are not wonderful machines but resmed is also having humidifier issues on their AS11s, have you done a factory reset on this yet? Also, how is the pressure change feeling for you?

[da38]

I spoke with my provider and they upped my pressure to 9, agreed that turning off RAMP+ was a good idea and issued me with a new DS2 as the old one's humidifier went wrong.

My AHI for the last few nights has been super low with is a massive result! Also, I've changed pillows to the flattest pillow I can find and tried to build a pillow / blanket fort that props me on my side when I sleep.

Here are 3 of my latest results since the change:

15/08/24 - Lowest AHI in a while, good night's sleep on the new machine
   

18/08/24 - Amazed with my AHI on this one - all time low. Felt brilliant in the morning!
   

20/08/24 - Went to bed waaaay too late due to a business trip to London - all time lowest AHI - can this be correct?!