New to CPAP lost with the data. Any help appreciated

[LBTRS]

Hello, what a wealth of information on this board. I wish I would have found it sooner.

I suddenly developed terrible insomnia on 2/1/21 and didn't sleep but a couple hours for the month of February. I had not had sleep apnea for the first 50 years of my life and all of a sudden I would find myself gasping for air while I was trying to fall asleep. I started getting really ill from lack of sleep and was a mess. My primary doctor wasn't in any hurry to figure things out and said he would put in a request of a sleep study after I said I thought my insomnia may be due to sleep apnea due to the gasping, but that was going to take a while due to insurance and scheduling. In desperation I purchased a home sleep study and due to the insomnia it was based off of a small window of sleep (a bit over two hours) and diagnosed with an AHI of 47.33. I purchased a PR Dreamstation and was having some challenges of always waking up with the thing blasting high pressure air. My AHI was always really high between 18 - 21.

Due to the recommendations of this forum I purchased a ResMed Airsense 10 Autoset and will be selling the PR if the ResMed works out. I'm in my third week of therapy and since I'm not working with a doctor I'm lost as to any adjustments I should make.

I would appreciate any help in interpreting my OSCAR results from last night with the new ResMed Airsense. I'm very tired today and did wake up a lot during the night but I didn't have the high pressure air blasts I was having with the the PR. I'm still fiddling with the humidity settings as I get very congested during the day when I'm not using the CPAP but fine while using it.

I greatly appreciate any assistance you can provide.

[OpalRose]

I believe your minimum pressure is too low.  Let's move it to 8cm with an EPR of 3.  You can leave the maximum pressure as is.  This may need further adjustment.

The EPR should help with the flow limitations and Reras which could be disrupting your sleep and causing the fatigue you feel during the day.

[LBTRS]

I believe your minimum pressure is too low.  Let's move it to 8cm with an EPR of 3.  You can leave the maximum pressure as is.  This may need further adjustment.

The EPR should help with the flow limitations and Reras which could be disrupting your sleep and causing the fatigue you feel during the day.

Thank you so much. I'll give it a try tonight.

[LBTRS]

I believe your minimum pressure is too low.  Let's move it to 8cm with an EPR of 3.  You can leave the maximum pressure as is.  This may need further adjustment.

The EPR should help with the flow limitations and Reras which could be disrupting your sleep and causing the fatigue you feel during the day.

Increasing the minimum pressure made a huge difference and I had a much better night. I think I slept for 7+ hours without waking up which I haven't been able to do in a long time. Thank you for that direction, I had not considered the minimum pressure being a factor. Breathing felt much more natural and less forced with the higher min pressure.

I'll upload the OSCAR data after a couple days of use.

Thanks so much, you were a big help.

[OpalRose]

Ok, great! Let us see some data when you are ready.

[LBTRS]

Based upon your recommendation I moved up to a 7 on maximum pressure (didn't want to jump to 8 in one night as I was afraid I wouldn't be able to fall asleep) and slept good at 7 as I reported. I then moved to 8 and EPR of 3 and didn't have a good night so I moved back to max 7 and EPR of 2 and had a much better night. I had a lot more Clear Airway events at 8 with EPR at 3 I noticed.

Any ideas on tweaks or should I hang here for a while?

Again, thanks in advance for the help. You guys and gals are amazing.

[SarcasticDave94]

Any idea if you were waking up about the time of the CA events? If you've got your sleep study info, post reacted detailed versions. If you don't have it, you should get it. I'm fishing for CA info on the diagnostic study.

Otherwise I'm inclined to think those CA could be sleep wake junk / SWJ. Regardless, keep settings like they are as it sounds like you're more comfortable.

[OpalRose]

There's not that much difference between the two settings, so I recommend that you keep your current pressure at 7-12, EPR 2, and keep watch.

I wasn't too worried about the CA's in the early morning hours as that sometimes happens. What you don't want is CA's showing up all through the night.

What's most important is how you are sleeping and how you feel the next day. Your numbers look good.

[LBTRS]

I very well could have been waking up as that is the time my wife's alarm clock goes off. Mine goes off at 7:00 so I'm often partially awake during that time. As far as the sleep study it was a home sleep study so the data is limited.

Okay, I'll keep where I'm at and keep watch. I've been dealing with some mask soreness from the N30i so I'm going to try a N20 tonight and see if I like that better.

Thanks to both of you, appreciate it greatly.

[Gideon]

A simple practice experiment if you please.

A tall glass of water and a straw. A drink from BK or such works too.

Put the straw towards the bottom and pretend you are a kid, that is blow bubbles





You did it right? Assuming the straw was 8 inches deep you just exhaled utilizing the max pressure can produce. 20 cmw.
That was a practical experiment on CPAP pressures. As you noted, not very much pressure. Pressure may be causing you issues, but this is not very much pressure.