Anderson5420's OSCAR Data

[anderson5420]

Last night - I moved the nightstand closer to the bed, not much difference. Don't know what I can do to bring the Large Leaks down. I thought the nasal pillow was well fit but my mask pressure is WAY below the 14.6 setting and bounces around like crazy. I am not a mouth breather when I am falling asleep, but I must be after I have fallen asleep.
 
AHI 8.29
OA 0.31
CA 6.71
UA 1.05
H 0.21 87 
LL 39.72%
RERA 0
CSR 7.13%

OA 3 events
CA 64 events
H 2 events
LL 87 events
CSR 1 event

[Crimson Nape]

How long have you been using the current pillow in the P10? Normally, they only seem to last for a couple of months before they start to leak.

[anderson5420]

How long have you been using the current pillow in the P10?  Normally, they only seem to last for a couple of months before they start to leak.

I have had my Airsense 10 Autoset only since March 5th! I started with a full face mask, then within the 30 day trial period, I switched to the nasal pillows, so I have actually used the P10 considerably less than one month. I started with the medium pillows, and switched to the small pillows (the P10 was supplied with L, M and S pillows).  I might try the medium pillows again I guess. Looking back at the screenshots after the first two days, the Large Leaks with the full face mask were lower than with the nasal pillows, in the range of 0% to about 15%, but the early numbers with the nasal pillows were also much lower. So it is looking to me like the switch to small pillows rather from full fact to nasal pillows is where the LL number started going up

[Crimson Nape]

Usually for the P10, you take Resmed's size recommendation and increase it one size.

[Sleeprider]

I would be looking for you to use a medium or more likely large P10 nasal pillows. I assume that profile avatar is you. My wife uses a medium and let's just say your nose is not petite. You'll be surprised how much easier air flows and the mask will seal better.

[anderson5420]

Here is the message I sent to my PA through the patient portal. I also have called Apria's dedicated Kaiser line and will be getting contacted by an Apria respiratory therapist.

Merealee,

There is another thing pressing on my mind. You said my central apneas might take three months to resolve if they are "treatment-emergent." I do not think I have the luxury of that amount of time to find out. After three months of sufficient use, regardless of the efficacy of the current treatment, I will own the current machine and my Kaiser Medicare Advantage plan will not pay for another machine. I am not getting AHIs under 5, and virtually all my apneas are being reported by the Airsense 10 Autoset as central, even with CPAP mode and 14.6 pressure with pressure relief. By the time of our appointment on the 16th, I will be half way through the three month period. Given scheduling constraints, I respectfully request that we schedule another titration study to determine whether I need an ASV machine, and that if so, my sleep doc gives the order for it within the three month period. Thanks for your consideration.

Pat Anderson

[anderson5420]

I would be looking for you to use a medium or more likely large P10 nasal pillows.  I assume that profile avatar is you.   My wife uses a medium and let's just say your nose is not petite. You'll be surprised how much easier air flows and the mask will seal better.

For sure, I will try the medium nasal pillows, but I very well may go back to the full face mask. After all, while I am asleep, I have no idea what I am doing with my mouth.

[Sleeprider]

Letter to the PA looks good. Hopefully it gets a titration test scheduled, of course it can always be cancelled if your CA events suddenly go missing. Keep us posted.

With regard to masks, these are choices we all make, and my only preference is that you use what is comfortable and works best for you.

[anderson5420]

I have been away for a week. I took my Airsense 10 Autoset with me and used it each night. Here is last night, switching from the small nasal pillow to the medium nasal pillow, not seeing any improvement in Large Leaks, in fact the prior night with the small nasal pillow the Large Leaks were 18.15%:

AHI 10.88
OA 0.96
CA 9.28
UA 0.64
H 0.00
LL 33.96%
RERA 0.00
CSR 0%

OA events 6
CA events 58

[SarcasticDave94]

Maybe try large cushions on the mask. 58 CA doesn't sound like fun. Trainwreck. Hopefully you get the PA to decide to help instead of hinder. I know what I'd do, CPAP ain't working doc. Help or you're fired. You've got 5 seconds to decide.