[Treatment] Oscar/ Dialing in Settings / ResMed 11

[Jintyo76]

Hi all,
Longtime lurker, first time poster; Brit living in Japan age 47, 95kg at 172cm.
Unsing an N20 nasal mask with a ResMed Chin strap. I have never used any other mask, it was just issued as standard.


Background:
I was diagnosed with Apnea in Oct 2021, score of 53 and Sp02 hitting as low as 80 (see attached graph, Japanese but I think you can see the important parts. I knew I had it most of my life but assumed it was mild, never really felt unwell with it or felt especially sleepy so just let it slide.
Immediately covered by NHI here in Japan at that level and standard machine was a ResMed 10, no real settings guidance or otherwise, it just came as it would out of the factory. Initial results were ordinary so I dug around and after downloading Oscar and reading on here found a level of about 7-14 was keeping the AHI down, "Jobs a good 'un", I didn't really touch it beyond that. 
I have noticed however that I struggle to sleep through and am waking up, feel OK but noticed some sleepiness on weekend afternoons  recently - and started to have had doubts that I have been optimizing the benefits. Insurance replaced my 2 year old 10 with an 11 yesterday, and I have the urge to dial things in a bit. I turned on the EPR for the first time at 3.

Any advice would be appreciated!

Including a screenshot from my S10 (fairly typical), last nights S11 first reading, and a close up of the flow.

[PeaceLoveAndPizza]

I’m seeing quite a few flow limitations and mouth leaks in the first few charts. Less in the last. Let’s stick with EPR of 3 and a bit more pressure, which should hopefully help get rid of most of the flow limitations and reduce the wild pressure swings.

Try the following:

Min pressure 10
Max pressure 16
EPR 3 full-time

We can fine-tune things from there.

Now onto the mouth leaks. You need to find a way to get them under control as they impact sleep quality and therapy. They are not large enough to trigger the “large leak” events, but still enough to be uncomfortable. Flatter pillow, soft cervical collar, mouth tape, full-face mask, many options to consider there. Sometimes a flatter pillow is enough, but for some of us we need a mix of options to get the leaks under control.

[Jintyo76]

Thanks for the feedback, particularly on the mouth leaks which I had tended to overlook thinking that the chin strap was about as much as I could do.
I shall try those settings tonight and until my next appointment with my doctor here, where I will ask if I can try an F20 mask.