Please help with my settings

[Sloth]

Hi All,

I'm still learning but have had my Airsense 10 for a few years after two sleep studies. The first was back in 2017 and told i had OSA and underwent surgery where they removed my swollen tonsils, fixed a deviated septum and did something to my tongue to make it smaller. 

Then in 2019 I was still sleepy and and struggling even after what i felt was being dead to the world for 10 hours each night and another study found I still suffered from apneas. I had to relocate for work and just purchased the Airsense 10 and started using it. I have recently been trying to find out why i'm still tired and stumbled across this amazing board and have been reading as much as i can.

I'm predominately a side sleeper and use the Resmed F30i mask. I have tried a nasal pillow and chin strap but handle the feeling of not being able to open my mouth and without it my mouth just opens.

I have tried upping my minimum pressure from 6 but wake to find stomach cramps from aerophagia that lasts a few hours.

I have downloaded Oscar and attempted to follow the setup guide for diagnosis and wondered if anyone could please help me understand if there is anything I can do to improve?

Thanks in advance!! 

[PeaceLoveAndPizza]

You did a fine job with the formatting. The only thing I would change is replacing the tidal volume graph with the respiration rate, but that is purely personal preference.

You are spending very little time at your minimum of 6.4 as you can see in the pressure graph. If there is an aerophagia issue it is not from the min pressure, but likely from the pressure swinging up to 11.

Give the following a try and lets see how it works.

Mode APAP
Min pressure 7
Max pressure 12
EPR 2 full-time
No ramp

What I want to see is if the EPR may be causing the CA's and if reducing it will help. Note you will likely get more flow limitations, but that is a trade-off with reducing the EPR to lower the CA's.

Also, you have some consistent leaks going on which is not uncommon with the F30i. As you turn your head into the pillow whilst asleep, the mask shifts and is likely the root cause. It is possible for your mouth to drop below the bottom portion of the mask, but the is difficult with the F30i. If the opportunity presents itself, you may want to consider trying the F30 or F40 mask as with the additional straps it may hold it better for less movement.