[Pressure] New User: Help w/ Optimal Settings for ResMed AirSense 11 with Airfit N20 Nasal Mask

[textureofthings]

Hi and thanks to everyone in advance for your assistance with this. I recently got a ResMes AirSense 11 (been using for 1.5 weeks), which was set to standard settings of 4-20 with nasal pillows. I couldn't get the nasal pillows to work for me, I kept feeling a resistance when trying to take slow deep inhales and exhales (on the tail end of the breath) and it was driving me crazy. I also felt this sensation of the air undulating at the tail end of the breath, that my doctor couldn't understand and I haven't been able to find anyone else with this issue on the forums. I tried increasing the EPR, but the higher that was, the issue was more intense. I'm finding that the lowest setting of EPR works for me.

I switched to the nasal mask Airfit N20 and that was overall better, but not without its minor issues. I often feel mild chest discomfort in the morning, like there's been too much air. My setting is 5-20, which I upped to 6-20. Ramp is off. EPR is 1. Last night, my mouth kept falling open and breaking the pressure which woke me up. I will try mouth tape before I can get either a chin strap or a new mask that also covers my mouth. 

Would anyone be able to review my last 3 charts and opine on optimal pressure settings for me? Any other insights would be greatly appreciated. For instance, I thought I had OA, but mostly am seeing CA and some Hypopnea. What does this mean?

Thank you so much in advance 

[simplychillin]

Hello!

I'm very new to ApneaBoard and the treatment of sleep apnea in general, so take anything I say with a grain of salt, but I personally would be curious to see your original sleep study data in order to determine if the centrals are treatment-emergent. As to how to get your sleep study: great question, and as I don't want to give you bad advice on how to interact with your doctor, I'll let someone else handle that (sorry). As to what you can do if they are, I don't really know: normally the recommendation AFAIK would be to reduce the pressure, but your machine already seems to be pushing it higher than your minimum and maintaining it there.

Also I noticed that the charts you attached were for December 10 to December 12 - in my experience I had a couple centrals the first day or two, then they went away, so I'd be curious to see a more recent chart as well. Of course, if the charts you posted are most representative of your therapy overall and the more recent ones are outliers, then ignore this.

With regard to the "undulating", I experienced that the first few nights and then it went away with EPR. It's interesting that EPR makes it worse - I'm totally out of my depth on this and will yield to more experienced people on this forum.

With regard to the mouth tape: While I like mouth tape, I don't have enough experience to be able to recommend it, but my mother, who has been on CPAP for at least a decade, recommended it to me as a permanent solution. And, at least for the ~5 days I've used it, it works great. So maybe try it for a bit before you commit to a full face or chin strap? That's just my opinion though.

Finally, just one more thing: Welcome to the forum! Here's hoping your issues improve.

(PS: anyone who is more experienced than me, I'd love it if you could critique my thought processes on this; I'm trying to get better and if you let me know where I've messed up, that makes it much easier to improve.)

[jdougc]

Can you post your sleep study with personal info concealed? I am asking to see if you had CAs, Central sleep apneas during the sleep study.
You only show 1 obstruction, a hyponea in your graphs.
Other people with knowledge can help you here.

[Deborah K.]

Your pressure is a little too low.  I suggest you change it to 7 to 12.  

Did your sleep study show a lot of CAs?  If you don't know, post a copy of the study.  If you don't have a copy, ask your doctor's office to provide one.  By US law they have to give it to you if you request it.

Lots here like Cover Roll Stretch tape or Hypafix tape, both of which work quite well.  I prefer kinesiology tape as I find it more comfortable and better able to fit facial contours.

Again, welcome, and good luck with improving your therapy and comfort!