Poor sleep quality

[slabsi]

Hi,

i am hoping if someone could check my OSCAR data to determine what settings would be best for me. I have had a ResMed Airsense 10 for 3 years but still have poor quality sleep, I average around 10 mins deep sleep a night and wake up several times a night according to my Apple Watch. I left the settings on default until last week as I was unaware they could be changed. Please see attached data for 3 nights. Thank you.

[sptrout]

I recommend the following:

1. Reduce the max pressure to around 13 and maybe keep reducing it.
2. The high pressure is likely causing the leaks. The leak goal is "0" with minor exceptions.
3. Make sure that you do not open your mouth. Again excessive pressure can cause this problem.
4. If the above does not help with the leaking then tape your month shut.
5. Turn EPR off. It can cause a lot of problems and solves few it any. If you do not want to turn it off, reduce it 1 number per night. Your breathing will likelly improve; the less EPR the better.
6. Are you using ResMed's P10 Pillow Mask? I used this brand of mask for years until it they started leaking (tried multiple P10s; with the same results) and I had to switch to another brand to stop the leaks. No idea why P10's worked for years until they didn't anymore.
7. Expand the Flow Limination line so you can see each breath. I will bet that you will find many obivous apneas that are NOT being flagged by your machine. If so, your real AHI may be much higher than calculated. Missing events is not unusual. Notice your good breathing periods. They will probably be best when the pressure is lower.
8. Finally, after fine tuning your results, then switch your machine to CPAP mode at the pressure determined above. APAP can cause problems and really is not needed once you get good numbers. A fixed level will improve breathing, and likely reduce leaks, and increase comfort.

A lot of things can cause problems. You have to become a detective to find all the AHI landmines. Good luck. (BTW - - All of the above itims are based on my experiences,)

[SarcasticDave94]

What I would consider leaving EPR 3 full time on. You're dealing with flow limits, and in my opinion you'll need EPR 3 to give you bilevel like treatment.

You have some occasional leaks that want to be watched.

[quiescence at last]

the first thing most of us point out is that obstructive apnea is caused by obstructions. obstructions are caused by something in the flow path or relaxed throat muscles allowing throat to collapse during sleep or sleeping in a way that chokes off the air supply. it can be a combination of any or all of these.

sleep can be disrupted by obstructions, but also sleep can be disrupted by noise, being shaken, tickles, heat or cold, having unsolicited limb movements or mask leakage, or some other atmospheric or environmental conditions.

sleep may not be restorative, you sleep seemingly well, but the body and/or mind seems to deteriorate.  The type of sleep needed you may not be getting. (you reference low percentage of deep sleep)

I wouldn't start on sptrout's list until you figure out positional apnea (sleeping in a way that chokes off the air supply) and leakage (if disturbing).

You can turn on the event count for VS (snoring) as well to see a mark when that occurs.  That can indicate when throat partially collapses to the point of vibration even if you don't stop breathing.

QAL

[Phaleronic]

Welcome to the forum slabsi

Looking at your pressure range and your 99.5 percent pressure you'll likely sleep much better on a bilevel machine. Resmed's EPR at max is a pseudo bilevel therapy but it's not going to be the best for you-I'd really consider looking for one - I will DM you. I would neutralize the leaks by sleeping on your sides on a flat pillow with another one to use as a wedge between your chin and chest (to prevent chin tucking). I would also like to see you on a narrower band of pressure.

[slabsi]

Thank you all for the recommendations. I followed sptrout's list and felt I slept better, I had a lot less wake ups but still low deep sleep.

I did also have large leaks throughout so it might be time to try a new mask. Are they any recommendations, I would prefer a nasal pillow type mask.

[Deborah K.]

None of your leaks are high enough to interfere with your therapy and especially with your low AHIs I wouldn't worry about them at all.  I suggest that for now, you bump your starting pressure to 13, as your last two median pressures are at least that high.  Leave your upper setting where it is.

With your ongoing high flow limits and sometimes maxing out at the highest pressure your machine offers, I think you need to look into getting a ResMed AirCurve 10 Vauto, the very best bilevel machine.  I was able to get my regular doctor to prescribe it for me, with help on this forum from SleepRider.  If your doctor prescribes a different type of machine, your insurance will cover it even if it's not 5 years old. Here's a link to my thread on this in case you want to check it out:

 https://www.apneaboard.com/forums/Thread...ts+bilevel

[Phaleronic]

Thank you all for the recommendations. I followed sptrout's list and felt I slept better, I had a lot less wake ups but still low deep sleep.

I did also have large leaks throughout so it might be time to try a new mask. Are they any recommendations, I would prefer a nasal pillow type mask.

That's good, can you please generate a new chart as well?  I can't use nasal pillows since I'm a mouth breather and cannot tape or handle a chin strap-there are others here though that have tried most of the nasal setups and can offer good advise