First, a bit of background. I am in generally good health, but have always struggled to feel rested after sleep, regardless of the duration, for as long as I can recall. After deciding to do something about it, I had a full clinical polysomnography performed ~6 years ago under guidance of my general practitioner with "inconclusive" results for any sleep disorders, let alone OSA. This set me back somewhere around $2k after insurance between the sleep clinic, sleep doc, etc. They offered to do it all over again, but the cost would be nearly the same. I declined.
Fast-forward to today, and I finally reached the point where I am tired of being tired. Through the magic of telemedicine, I had a home sleep study performed a little over a week ago and the results were honestly frightening. My AHI for the night clocked in at a staggering 58.4 with significant O2 desaturations (dropping as low as 69% at one point). The doc prescribed a trial of Auto-CPAP with a range of 4-20cm, I purchased an AirSense 10 Autoset, a ResMed N20 mask, and that brings us to today. I have combed the forums extensively to understand both OSA and the science behind the therapy and how I can take control of it. There is a tremendous amount of research here, and I'm grateful to have it all in one place and so many helpful folks to offer insight.
Getting to the point, the bottom line is that I managed to survive my first night of therapy even though I didn't actually sleep a lot of the night. My AHI dropped to an incredible 0.94 for the night, and woke up with more energy than I've had in who knows how long. Needless to say, I'm darn pleased with the results so far. I've got a ways to go to get used to having the mask on my face and still being able to fall asleep, but that will come with time. I'm already picking up the next size larger headgear for the N20 to let me loosen the straps just a tiny bit more, and hopefully that will solve my issues with mask comfort.
At the recommendation of some past threads here, I changed the machine settings right out of the gate. I bumped minimum pressure from 4 to 7, with EPR at 3.0. I also started out with the ramp on, starting at 4.0 and found I was struggling to get enough air. I eventually bumped that up to something like 6.6 and that helped. After getting up during the night several times, I decided I didn't like how long it took to ramp up so I turned it off. Perhaps I will use the ramp feature if I end up at a higher minimum pressure, but for now, no ramp.
Upon waking up this morning, I had some minor aerophagia symptoms that went away after a couple of good burps. My throat was a bit sore and felt "raw" - amazing what actually breathing while you sleep can do, I guess! My throat has mostly improved during the day, and the discomfort is tolerable. Nothing alarming on the pressures I have currently.
When I slept, I slept well - but there was a lot of time spent lying quietly on the machine trying to settle down. I had to turn on my ceiling fan to generate a bit of white noise to counter the expiration port noise. I had a good period of sleep from roughly 0:00 to 03:00, and a few other segments that I didn't keep track of. I normally sleep "like a rock" so I anticipate that will improve as I get used to therapy. I did end up on my back from about 05:00 to 06:00 as that was the only comfortable position I could find, and there was an expected increase in events because of that. I need to work on getting to sleep on my side like I normally do - now with a mask strapped to my schnoz.
So, here is my SH data for the first night. It's almost embarrassingly clean, but I'm still looking for any feedback on any additional adjustments I might make to improve comfort and overall therapy. Specifically, does it appear my current minimum pressure of 7.0 a good number to stick with for now? I'm planning to leave 20cm as the top end until I have some history behind me. And I'll obviously continue to compile data and want to make data-driven decisions with a proven track record behind them. (I'm an engineer by trade so a methodical approach is pretty much hard-wired - and one day does not a trend make!) However, if I can get this all dialed in faster from the start, I think I stand a better chance of being more successful with the therapy.
So... any thoughts and/or observations?
A thumbnail will have to do since I can't post an image yet as a new member. ;-)
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