Settings Help as New CPAP User

[alienfrontier]

Hello, my sleep study placed me at AHI 2 RDI 10 (REM RDI 20)  and my primary symptoms have been being able to sleep 2-3 hours and then waking up every hour. On my Resmed Airsense 11 I've been able to find settings which result in a 95% flow limit of 0.0 (99.5% of 0.09) but I find that I am still waking up and my flow rate still shows RERA like patterns. I also see some large leaks despite using a chin strap; my current settings are 9 - 11 and EPR 3 (which makes a big difference for flow limit). Should I continue at my current settings or up the pressure?

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[SarcasticDave94]

Welcome to Apnea Board,

It would be helpful to add the OSCAR chart with left panel info minus the calendar. One we like to start with is a standard view of the daily detail, almost what's here. If you are on Windows, F12 takes the screenshot within OSCAR, Mac and I think it's CMD + F12.

Also, do you have your copy of that sleep study detailed report? You should BTW. You can post it redacted of personal info within a Reply post. These will be added 1 page at a time as New Attachment.

Why am I asking for this? Data drives therapy and answers regarding it. The more data we can get, the more accurate our answers will be.

Adding wiki link HERE for how to use New Attachment.

[alienfrontier]

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[BoxcarPete]

Not every arousal is a RERA. The breaths leading up to the first one you pointed out look pretty damn good, and the second one is most likely a body positional shift in the night. In order for it to be a true RERA there needs to be a pattern of partial blockage which affects total ventilation that causes the body to wake itself up in order to fix it.

That probably doesn't make you feel much better because spontaneous arousals are much more gremlin-y and it can be hard to pin down a cause, let alone make it better.

[alienfrontier]

would you say to stick at these settings since the 95% flow limit is 0 (maybe body needs to acclimate to cpap to reduce awakenings) or keep incrementing the pressure until the apap becomes more proactive and less reactive?

[SarcasticDave94]

Two things you can edit if you would like change, Ramp even at Auto is a no therapy period. You're forcing a pressure of 4 which is very likely not in your therapy needs area as well. I'd consider upping it to 6 or not doing ramp.

You may want to increase the pressure spread a bit 9-13 or so.

How long had you been on CPAP? I missed seeing that bit. It may take several weeks to get adjusted to CPAP usage.

[alienfrontier]

ramp auto has proven pretty accurate in turning on as soon as I fall asleep so I'm not too concerned, but as I up the pressure I will up the ramp pressure

I've only been on cpap for 5 days, which is why I'm not sure if these arousals are just me getting use to it (given the good flow limit), or if the data might not be as accurate as it seems (particularly during REM which is when I wake up hurly. I’ve also been taking it off after two/three awakenings since i’m trying to slowly acclimate.

[BoxcarPete]

Your charts look pretty good from my armchair. It's certainly not a bad option to give it some more time. Your pressure varied only by about 10% across the entire night; the only way to make it less reactive is to set the machine to CPAP mode.