AHI or SPO2

[ajack]

As whyme said, epr makes it easier to breathe out. The other reason was to see if it improved your tidal volume a bit, the 3cm difference is like a mini-bpap. Not adding the 2cm to the min pressure when you changed the epr to 3, can be easier to workout in the long run. You may find there isn't an improvement by the chart and o2 tomorrow. It will help you see the change as you add more min pressure, as you go along. You may finish up on 12 epr 3, which may be around your new 95%. If the o2 needs it, this will be what dictates the pressure. Your AHI is fine. You would have thought it strange, if I suggested min 12 epr3 as a first choice.

Do you have a ffm you use when you have a cold? It's easier to set the machine up without leaks, it removes a variable. You can return to nasal afterwards if you wish. After this many years, I would assume you are adapt at mask fit. Though it wouldn't hurt to do a refresher from my link below.

[drgrimes]

Thanks for all the good advice.  I really appreciate it.  I learned in the beginning of cpap that we can't rely on the doctors to guide us through this maze of confusion.  I never met my sleep doctor.  She wrote an RX for the cheapest single pressure machine and hammered me with constant pressure of 15.  I suffered greatly, found this forum and began to fight my way through it.  I asked for a change of RX and the doctor became defensive.  I finally begged one of the technicians  to help me get a better machine and she did.

The guys at my DME helped me more than anyone except for this forum.

So, my AHIs are terrific almost always less than one since my deviated septum surgery.  I suffer little or no obstructive apnea anymore.  I have a bit of clear airway or hypopnea now.  I can't help but wonder if i could possibly someday get off cpap.  Only thing is that the oxymeter shows low oxygen in spite of low ahi.  I will stay on cpap forever if need be to stay healthy.

[ajack]

I'd like to hammer you with 12 epr3 all night
I think it's a good idea to get the o2 sorted. It's a matter of raising the min pressure and see if it does the job. As you would know, there is also supplemental o2, if there is a lung issue. It may warrant a sleep study to see. The machine says you need cpap. Although the chart isn't shown, there may be leaks that need sorting, going by the stat column

[drgrimes]

Ajack last night my AHI was 1.5, that being a bit high for me, but last night was a bad night for thunder storms here and didn't sleep well.  I will start raising my min. pressure bit by bit as you suggest.  I see your point in that it may push me to breathe deeper and maybe improving my O2.

I'm still having trouble syncing SPO2 into Oscar.  No matter what i do, it is skewed off to the right .  I've tried linking it to the cpap session without  entering a start time.  I've tried entering the approx start time that i began cpap, but it never appears directly underneath the other graphs.  I'm sure i am doing something goofy.

[ajack]

See how it goes. Once the AHI is sorted, the proof is in the spo2 charts. It is possible that you may need the 15 that was originally set. In any case the epr 3 will make it easier.

[drgrimes]

   
i have switched  mask to ResMed AirFit™ N30i Nasal Mask . My AHI has risien to 2.X but leaks seem less.  Still not sure about how to interpret my SPO2.  It doesn't look great.  Anyone got an opinion?

[drgrimes]

The new mask seems to be working well.  AHIs are now back to less than 1.0  I am still  not sure if i should be worried about SPO2.  When it says "95% is 95.  Does that mean my oxygen level was 94% for 95% of the time?  Is that good even though the level dropped below 88%?

[Dormeo]

I believe that for all data, the 95% measure means that 95% of your values were at or below the figure given in the 95% column. For O2, that doesn’t tell you much that you want to know.

[ajack]

I don't know how much I would trust oscar with the numbers. I would use the software with the spo2. the 95% in oscar is the at or under o2 level for the night. You want to look at specific periods not general averages. You want nearly everything above 90-92% for starters.
I think they use the term basal o2 in the software, as the Mean or average o2 %.
The rest I have said.

[Sleeprider]

Drgrimes, I'm going to side with Ajack on an increase in pressure, and my focus is on EPAP, and in particular on Positive End Expiratory Pressure (PEEP). You can research this topic and will find that PEEP is used by anesthesiologists and respiratory and pulmonary types to improve oxygenation or SpO2 results. Some people think in bilevel pressure that it is pressure support that improves ventilation and therefore O2, but it is actually the PEEP. The mechanism for improved oxygen includes better gas exchange at pressure, and improved maintenance of alveolar space, which is similar to keeping the upper airway patent, but targets lung volume.

With the Resmed S9 set to a minimum pressure of 8.0 and EPR 3, your bilevel pressure is 8.0/5.0. This is a relatively low PEEP for someone that has SpO2 hovering near 90% and a tidal volume in the low to mid 300 mL range. Although you do not need higher pressure to control AHI, higher PEEP may help your SpO2 results without the addition of supplemental oxygen. You might want to consider using a minimum pressure of 11.0 in order to achieve a minimum PEEP of 8.0 and see if this results in an improvement in the SpO2 median and 95% results. This gets into pretty advanced stuff is normally in the purview of bilevel, and is not usually associated with CPAP. This may or may not affect your particular results, but I though I'd put it out there as a something to consider.