4 Month User hoping to optimize treatment

[maxcamac11]

Hi all, 

Been using my ResMed Airsense 10 for a while now and I've yet to feel as though I've had a good night's sleep with it. My pcp mentioned that my hematocrit levels were high and suspected that I had sleep apnea (father also has it as well). I ran a take home sleep test and my AHI at the time was at 7. I was prescribed the AirSense 10 and a nasal mask (I was also given a face mask to try out if the nasal mask didn't work out). For the past few months, I've been averaging around 3 to 4 AHI, but it never really feels like I get a good night's sleep (mainly feels like I'm being interrupted in the middle of the night) and I definitely get a better night's sleep without the CPAP machine on. 

It's also difficult to keep the CPAP mask on and I suspect this is due to the machine not being optimized for my needs. Last night I managed to wear it for the entirety the night, and here's the data:

RDI: 3.60
AHI: 3.34
O2 Min: 91
O2 Avg: 97

I have a CMS50F Pulse Oximeter that I use as well. 

I suspect that maybe the Max pressure is set too high, or that maybe my mouth is opening while I am sleeping, although the doctor said that this is something that I would get used to and that my mouth would stay closed over time. I can record myself to confirm this if there isn't already an indicator in the data. If that is the case, I would use the full face mask (ResMed AirTouch F20) but it is a nightmare to fit properly as it pushes against the bridge of my nose and I can't get a proper sell at high pressures (although high pressures may not be needed?). I also have chin straps, but they're insanely uncomfortable. I would be open to using tape, however. 

Any help would be greatly appreciated, I hope I am able to provide enough data.

[factor]

Hello and welcome to the forum.

Many great people here and they will help you alot.  

Its a Marathon not a sprint.  It will take 6 weeks to a few months for your body to adapt.  So dont worry to much and don't make changes daily.  

Here is what I see based on the one day you showed.  You might post 1 day from the each of the last months.

If you look at the Median (Med) number its 7.4
So I would bump up your min pressure to at least 7.  The lower starting pressure could cause your body to feel like you cant breath and could be waking you up.  Most Adults need at least 7 or 8.  This could be why you dont feel rested.
You are right the max might be a bit high.  Although it doesn't matter to much.  It is really to keep the machine from running away.
I would set it at 13 or 14.  About 2 more than the 99.5% for you it is 11.56.

You all so have a leak issue.  This could be several things and you will have to experiment.  Most people dont need full face-masks so I wouldn't worry to much on that.
On the mask fit most people think they need to crank it down on their face.  You never want that.  It should feel like it is floating but snug under your nose.  If you wake up with nose pain its too tight.
When you sleep and during the day practice keeping your tongue on the roof of your mouth just behind your teeth.  This will help train you to keep your mouth closed..
It also could be positional maybe you are rolling over and the mask is moving which might mean the mask is to loose.  

Ok thats enough for now and other will have other comments for sure.