[Treatment] New APAP User with Lots of Questions

[pauldong]

Great forum!! I discovered this 16 days after I started to use a DreamStation Auto CPAP machine. I cannot imagine this forum’s existence without a great deal of selflessness and genuine desire to help others.
 
At age 35, I've been diagnosed with slight degree of Obstructive Sleep Apnea (AHI = 14.2), but the lowest blood oxygen saturation was only 84%. Plus I had been snoring a lot to the point that it impacted the life of my wife, so I went ahead and bought the DreamStation without much comparison. The machine had features like an integrated humidifier and heated tube. After trying on a few masks, I got the Nasal Wisp.
 
After reading the great contribution and analyzing my data with OSCAR open-source software, I still have below questions. Since there are many newbie questions, feel free to address any of them or point me to the right resources.
 
My mid-term goal would be to keep AHI and snoring low, while I hope to lose weight and eventually sleep without a machine.
 
First, I wonder if my current Auto-CPAP range needs to be adjusted. My hypopnea index had been relatively high, and events of hypopnea had been concentrated between 5-6pm, would my current setting minimal pressure of 4 cmH2O be too conservative? What range would serve me better?
 
Judging from the % of time above the Leak Rate Threshold, I think my mask fit is alright – but please let me know if I should dig in more to find out.
 
After buying the machine with the humidifier and heat tube, I’ve never used them because I live in Hong Kong, a relatively humid and hot place. Is there any resource where I can read their main benefits and drawbacks?
 
After washing the tube prior to the initial use, each time I wear the mask, I can still smell plastic. How should I get rid of this?
 
I can see that I am still snoring a bit on the event flags “VS2”, good thing these didn’t coincide with other events – but I am at a loss on how to tackle them further.
 
Appreciate any help!

[ajack]

That's a good chart, If it were me, I'd raise min to 6, it will vent the mask better and probably clean up a lot of stuff. You don't need a lot of pressure. Your 95% pressure was 6. I'd also add flex 1 or 2 for comfort. Then review if 7 would be better after adding flex.

The smell of the tube will fade, as time goes on. Everyone has their own time between cleaning, it depends on your climate, During the humid season would need more, than during the dry season. Moulds and mildew would be the issue. You only have your natural skin and breath bacteria. Normal drinking water in the humidifier I find sufficient.
HK may not need much humidifier, are you getting a dry nose?

[michael9346]

Welcome to the forum Pauldong. I totally love your city. I am also a Dreamstation user and although this forum overwhelmingly will recommend the Resmed machine, your machine is totally capable to do what you need it to do. I don't feel experienced enough to recommend any changes to settings but others on this forum are capable. The first thing I would like to say is don't make your AHI as your goal. Getting off Cpap is a good goal and a great target but the first target is to sleep well.  My AHI is constantly between 0.00 to 0.70. My sleep doctor thinks this is fantastic, however he doesn't even notice I am only sleeping 4 to 5 hours per night which is as bad as sleep apnea. Perception is that only old and fat people get sleep apnea. Although I AM an old fat man, many young and physically fit have sleep apnea as well. You very well may lose weight and get off of it. I truly hope you do. But don't set your heart on that.

As far as VS2, go to the bottom of your charts and press on PB and click on VS2 and it will be disabled. Very few know what it means but I have been told it can pick up noises such as your pooch snoring, dragging the hose across the headboard etc. Pay more attention to VS as that relates more to YOUR snoring. Mask fit is probably the hardest task you will have as all people are different. My doctor recommended a full face mask but it is not the most comfortable to wear. I have worn the Resmed F20 and the Wisp you are wearing. The most successful for me has been the Resmed P10 which is a pillow mask where the mask fits just outside the nostrils. Because I am a mouth breather I had initially taped my mouth with a 3M micropore tape to prevent mouth breathing. I eventually learned to keep my mouth shut and no longer need tape. (taping is pretty controversial and most sleep doctors act as though they never heard of it.)

Your humidifier can be removed from you Cpap if you do not use it. If I am congested it helps to keep my nostrils open. Most Apnea / Hypopnea issues are solved with higher pressure. Your setting of 4 minimum is uncomfortable for most users. Ajack suggested 6 as that is going to feel better. For me, I would try the new pressure and if it reduces the Hypopneas without flex, I would not use it. Sometimes with the Dreamstation, flex creates other problems and that's only my opinion. Finally that smell will dissipate in time. (or maybe we just get used to it) 

Again welcome to the forum. All of your questions were very good questions.

[Gideon]

You are already using flex. I would set your min to 6 for comfort. That should give you inhale at 6 and exhale around your current 4.

The main purpose of the heated tube is to prevent condensation in the tube. It never gets hot, just warm enough to prevent condensation. The very slight heat it provides increases my comfort. If you are not to dry with the humidifier and heated hose off with no water in the humidifier than no problem not using them. They are purely for comfort.

[Dormeo]

Ajack, you wrote: “I'd raise min to 6, it will vent the mask better and probably clean up a lot of stuff.“ I’m curious what would be vented out of the mask, what this might clean up, and how. Could you elaborate? Thanks!