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jaredtaskin - Therapy Help
#1
jaredtaskin - Therapy Help
Hello all,

Today I will receive my machine and begin my CPAP therapy. I received my at-home sleep test and prescription from an online vendor; the prescription indicates a pressure range of 4-20. My untreated AHI in this test was 33. I also did a sleep lab test several years ago that I had disregarded for a variety of reasons. My AHI in that test was higher, I believe it was in the 50s, I don't recall exactly.

I have been scouring this board for information (really appreciate this resource), and I now understand that 4-20 is just the default out of the box. So I wonder if there are better settings to start with. Based on what I've read here, it seems that at a minimum I should set a min pressure of 7 with an EPR of 3. Should I bring down the max pressure to start, or leave it at 20? I plan to read in bed for a while using the mask tonight. Should I turn on the ramp up feature, or just try to get used to the 7/4 min pressure while reading?

I will be using the P10 mask. I know that my mouth opens occasionally while sleeping, but I'm not sure how much. I have been observed sleeping with my mouth closed, so I know it's not all the time. I have some mouth tape ready to use, but I'm wondering if I should start with that on night 1, or wait and see how it goes without first. If I am mouth breathing, how do I detect that in the data?

I have an SD card and reader on the way, so I should be able to start importing that data into Oscar soon.

Thanks so much for your help!
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#2
RE: Recommended Settings for First Night of APAP
We typically recommend something like

Min pressure 7
Max pressure 15
EPR 3 full-time
No ramp

As a starting point. After a few nights of that post some charts and we an help fine-tune from there. If you have a copy of your sleep study redact your and the doctors personal data, and post it. Every little tidbit of data we can get helps.
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#3
RE: Recommended Settings for First Night of APAP
(01-08-2024, 09:35 AM)PeaceLoveAndPizza Wrote: We typically recommend something like

Min pressure 7
Max pressure 15
EPR 3 full-time
No ramp

As a starting point. After a few nights of that post some charts and we an help fine-tune from there. If you have a copy of your sleep study redact your and the doctors personal data, and post it. Every little tidbit of data we can get helps.

Thank you!

I have attached my sleep study report to this reply. I'm definitely interested in any insights you all have.


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#4
Second night of CPAP, First night of OSCAR
Hi all,

I wanted to share my Oscar data for my second night with CPAP. Obviously the headline is a quite low AHI, which I am happy about. I still woke up several times during the night and don't feel the greatest this morning, which I am less thrilled about. Does anything jump out at you from the Oscar data? Should I change any of my settings or just let it ride?

Thanks!


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#5
RE: Second night of CPAP, First night of OSCAR
Sometimes having a low AHI number doesn't equal restfull sleep.

It appears you are having several arousals.  The leak rate shows at 0, but.... if you look at the leak graph, notice the spikes.  This is probably mask movement from moving around at night.  The spikes in the leak graph line up with the spikes in the flow rate graph.  That many arousals is what's causing you to feel unrested in the morning.

Are you aware of moving or adjusting your mask?  Have you changed the nasal pillow or tried a different size?
OpalRose
Apnea Board Administrator
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: Second night of CPAP, First night of OSCAR
Thanks for the reply! I have not noticed myself messing with the mask at night. I should note that a couple of my wake ups last night were due to my daughter waking me up....not sure how stuff like that would show up in the graph.

Realistically I guess I should probably get more nights of data before making any changes.

I have been using pillow size M. I tried small but it seemed to hurt a bit.
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#7
RE: Second night of CPAP, First night of OSCAR
hi jaredtaskin,

if you look at the flowrate graph you can see spikes across the whole night. These often coincide with some sort of sleep disturbance. In some cases, they may be the result of leaks, which you can line up by comparing them with the leak graph below. Also, when there are leak spikes as we see in the leak graph, those are likely the result of opening your mouth during sleep, which could be for a variety of reasons, but is nonetheless plausible given you are using a pillows mask. To eliminate these, you could tape your mouth, use a chinstrap, use a soft-cervical collar, or try a full-faced mask. That said, they are not too many in number, but they could of course still be waking you up. The idea is to try to eliminate what variables we can, because as we do so we either move closer to the answer or find the answer. You can read up more about these topics on apneaboard.
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#8
Resmed P10: Question about proper fit
Hi all,

I'm using the P10, which I find comfy in most respects. However, I don't like how the mask seems to slump down and rest on my upper lip. When I'm lying on my back it makes the whole thing feel slightly less secure. I seem to still be getting a good seal.

If I take my hand and hold the base of the mask up slightly, off of the skin below nose, this feels like maybe how it is supposed to fit. However, I'm wary of overtightening, and I think I'd have to go pretty tight with the straps to get it to stay in this position.

So how is this mask ideally supposed to fit? I hope this question makes sense. I'm getting a low AHI, but there is some minimal leakage; I wonder if it's related to this?
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#9
RE: Resmed P10: Question about proper fit
it's pretty hard to imagine how the P10 could be worn without resting on the upper lip and against the nares. I have used nasal pillow masks for many years, and remember the Swift LT had a barrel structure that held the nasal pillows and a very sturdy headgear that supported the mask. TThe next mask was the Swift LX which had a better headgear than the P10, but the exhaust was like a jet. The P10 headgear is absolutely flimsy and allows the mask frame to sag and the headgear likes to slip out of place, but I like the diffused vent. I really wish the P10 was available with a more robust headgear and an XL cushion.
Sleeprider
Apnea Board Moderator
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
Humidification Strategy for Airsense 11
Hi all,

I'm just a few days into my therapy.

As I understand it, the "Auto" setting for Climate Control will seek to match the relative humidity of my environment. Is that correct?

However, say my house is very dry in the winter (which it is). Wouldn't that result in the CPAP air supply being quite dry as well?

Would it make sense for me to turn off auto climate control and set a higher humidity level in the winter? If so, how do I determine the correct level?

FWIW, Oscar is saying that my humidity level has been set to 4 each night so far.
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