08-04-2024, 01:24 PM
New to CPAP, request for help with settings.
Hi all,
I am brand new to this forum and appreciate any help you can offer as I'm hitting a road bump. If you want to skip the story and go straight to the data, you can skip to the paragraph that starts with "I am attaching two files." I have been using APAP (Resmed Airsense 11) for around a month. I was diagnosed with mild OSA from a home sleep test (AHI around 8, primarily hypopneas but a few obstructive events) about 2 months ago, which I believe explains a lot of brain fog I've been dealing with the past year. According to the study, my apnea is largely positional. I am a back sleeper. I have had little success trying to become a side sleeper and my efforts resulted in lower sleep quality overall. An APAP was ordered for me with generic settings (4-20cmH2O). I was told it could take 6+ months to receive my machine and then schedule follow up. To avoid delays, I bought a machine myself and have been trying to learn how to use it. I have a follow up with a sleep physician, but it's fairly far off. I was also custom fitted for an MAD by a sleep dentist, but have not received it yet.
Since starting therapy, I was initially experiencing more restful sleep. I have primarily been using the Airfit P10 with mouth tape. Brain fog was much better. I was sleeping 5-6 hours but would wake up wide awake with much better mood and energy. However, I was dealing with a lot of leaks that were waking me up using the large nasal pillow, so I went to the medium size. Leaks largely subsided. Then, I was feeling fairly fatigued again. I thought this might be normal this early in therapy, but I also thought I could probably optimize my settings and have been using OSCAR. Using data from OSCAR, I changed my pressures to 6-10cmH2O. I noticed the machine was maxing pressure at times, so I increased the max to 11. Then, I noticed the median and 95% pressures were higher than my minimum and slowly increased my minimum pressure to try and reduce events. When I got to 8-11cmH2O, I woke up early with abdominal discomfort and was pretty crampy for about 2 hours. I figured this was likely aerophagia and realized I had likely experienced milder aerophagia previous nights, but thought it was just something I ate. Therapy became rough for me after that as I lost confidence with CPAP therapy and have experimented with setting changes to try and avoid aerophagia and recapture quality sleep with little success. I am sleeping with it again using the large nasal pillow (I felt like I was not getting enough air at times with the medium nasal pillow) and leaks have fine as far as I can tell.
I am attaching two files. I'd be happy to attach more, but I don't think I can with the size limit. One is last night. I slept with EPR for the first time, because I read that that can help with aerophagia. My AHI looks fine, but I will say I did not feel well rested in the morning. I also attached the night my settings were 8-11cmH20 with medium nasal pillow (7/25) where I had bad aerophagia.
I appreciate any guidance and apologies for the long post. The options feel overwhelming to me at times - increase min and/or max pressure? Use fixed pressure? Wider or narrower pressure range? EPR on or off and what level? Soft cervical collar? Etc. I'm not sure how much help I will get when I eventually have my appointment given that my AHI has been under 5 since using APAP.
I am brand new to this forum and appreciate any help you can offer as I'm hitting a road bump. If you want to skip the story and go straight to the data, you can skip to the paragraph that starts with "I am attaching two files." I have been using APAP (Resmed Airsense 11) for around a month. I was diagnosed with mild OSA from a home sleep test (AHI around 8, primarily hypopneas but a few obstructive events) about 2 months ago, which I believe explains a lot of brain fog I've been dealing with the past year. According to the study, my apnea is largely positional. I am a back sleeper. I have had little success trying to become a side sleeper and my efforts resulted in lower sleep quality overall. An APAP was ordered for me with generic settings (4-20cmH2O). I was told it could take 6+ months to receive my machine and then schedule follow up. To avoid delays, I bought a machine myself and have been trying to learn how to use it. I have a follow up with a sleep physician, but it's fairly far off. I was also custom fitted for an MAD by a sleep dentist, but have not received it yet.
Since starting therapy, I was initially experiencing more restful sleep. I have primarily been using the Airfit P10 with mouth tape. Brain fog was much better. I was sleeping 5-6 hours but would wake up wide awake with much better mood and energy. However, I was dealing with a lot of leaks that were waking me up using the large nasal pillow, so I went to the medium size. Leaks largely subsided. Then, I was feeling fairly fatigued again. I thought this might be normal this early in therapy, but I also thought I could probably optimize my settings and have been using OSCAR. Using data from OSCAR, I changed my pressures to 6-10cmH2O. I noticed the machine was maxing pressure at times, so I increased the max to 11. Then, I noticed the median and 95% pressures were higher than my minimum and slowly increased my minimum pressure to try and reduce events. When I got to 8-11cmH2O, I woke up early with abdominal discomfort and was pretty crampy for about 2 hours. I figured this was likely aerophagia and realized I had likely experienced milder aerophagia previous nights, but thought it was just something I ate. Therapy became rough for me after that as I lost confidence with CPAP therapy and have experimented with setting changes to try and avoid aerophagia and recapture quality sleep with little success. I am sleeping with it again using the large nasal pillow (I felt like I was not getting enough air at times with the medium nasal pillow) and leaks have fine as far as I can tell.
I am attaching two files. I'd be happy to attach more, but I don't think I can with the size limit. One is last night. I slept with EPR for the first time, because I read that that can help with aerophagia. My AHI looks fine, but I will say I did not feel well rested in the morning. I also attached the night my settings were 8-11cmH20 with medium nasal pillow (7/25) where I had bad aerophagia.
I appreciate any guidance and apologies for the long post. The options feel overwhelming to me at times - increase min and/or max pressure? Use fixed pressure? Wider or narrower pressure range? EPR on or off and what level? Soft cervical collar? Etc. I'm not sure how much help I will get when I eventually have my appointment given that my AHI has been under 5 since using APAP.
