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[CPAP] New to CPAP - Recommended Airsense10 Settings
#1
Question 
New to CPAP - Recommended Airsense10 Settings
Hello,

I recently had a home sleep study done that confirmed my suspicions that I had some form of sleep apnea, with a diagnosis of Moderate Sleep Apnea. Since August 2019  I have been feeling like I've not been sleeping soundly, and have been waking up tired. I have been suffering from daytime fatigue, brain fog, difficulty concentrating, some anxiety, etc.

The study came back with:

AHI: 16.1 - 14.2 of which are Hypopneas
OAI: 1.9
CAI: 0.0
MAI: 0.0
ODI: 16.0

- O2 Desat Max - 6%
- Desat Max Dur (sec) - 83
- Lowest SP02% - 89%
- Mean HR - 71BPM
- Highest HR - 108BPM
- HR Drop and Rise Index - 24.4/hr

The study also said I snored throughout which is interesting as my wife doesn't seem to think I snore loudly.... anyway - I hope that's enough info - I can post the graphs from the study if needed. (It was a Phillips at home sleep study)

Based on this I have taken matters into my own hands and purcased a ResMed Airsense10 Autoset and a nasal pillows mask (P10) to try and sort this out myself, due to the long wait times on the NHS (at least in my area), after an initial 6 month wait, due to covid my NHS appointment was then cancelled with no ETA for rescheduling, so I decided to take action myself, I'm tired of feeling tired.

With my numbers above (particularly the fact that most events are Hypopneas), what settings (pressure etc) are recommended on the Airsense10 to start? I read somewhere the EPR setting is important to help prevent Hypopneas.

My machine should arrive tomorrow, I should be able to provide OSCAR data once I get up and running.

Many thanks!
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#2
RE: New to CPAP - Recommended Airsense10 Settings
Welcome to the forum, and it's so great you got the best machine to treat your hypopnea dominate sleep disordered breathing. The answer is very simple. In Autoset mode, minimum pressure 7.0, maximum pressure 14.0, EPR full time at 3 with ramp off. We can fine-tune settings based on your Oscar data after you have a session or two in.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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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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#3
RE: New to CPAP - Recommended Airsense10 Settings
Buffeh, welcome! Congrats on those great purchases, on taking your apnea treatment into your own hands, and on coming to this forum for advice. Once you have an Oscar chart to post at the settings Sleeprider recommends, stay in this thread to post it, because your initial post contains some useful information.

When you get your machine, try setting it up outside your bedroom during the day or evening, and use it while you watch TV or read -- something mildly diverting. This will help to speed up your adaptation to a novel experience. Try using it at night when you feel you're ready. Don't worry if you don't go all night with it. That will come with time.

Also work on mask fit. Watch a video or two. Try fitting the mask while you're lying down in bed and lying in your favored sleep positions (side, back, stomach). The P10 is an elegant, minimalist mask. As you'll find, you tighten or loosen it by repositioning the straps. If you got the S/M/L pack of nasal pillows, try them all. You want the wide part of the pillow to rest on the outside edges of your nostrils, so make sure the pillow size is large enough to do that. You also want to avoid annoying leaks, so make sure the pillow size is small enough to do THAT.

Keep us posted!
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#4
Question 
RE: New to CPAP - Recommended Airsense10 Settings
Hello again,

Thank you so much for the help, I really appreciate it Smile

I got the machine all set up with the exact settings Sleeprider suggested and decided on the medium size for the P10 as it seems to be comfortable enough and doesn't seem to leak particularly easily as far as I can tell. I spend some time sitting and reading with the machine running and then eventually went to bed.

I went to bed with the mask from 12am to 7am (it took me a while to get to sleep) then took it off around 7am and had what I felt was deeper sleep for another 1h30m! I am hoping I will just get used to it.

I wouldn't say I feel like I had a great nights sleep, I think I kept waking up as I'm not used to having the mask on my nose (it's not UNCOMFORTABLE per se, but it's not as comfortable as wearing nothing!) / the hose in the bed, I do feel pretty tired this morning, I've definitely felt more well rested without APAP, but I suppose it's early days.


I've attached the OSCAR data from last night.

Thanks again for all your help Smile


Attached Files Thumbnail(s)
           
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#5
RE: New to CPAP - Recommended Airsense10 Settings
Those are pretty great results for a first night, and no changes are needed. A little bit of flow limitation at the beginning that cleared up and pressures stayed near the minimum the rest of the night. The CA events are not a problem, and most likely indicate sleep disruptions as you described. I think you're off to a great start and it will take some time to get fully accustomed to the critter on your nose. Don't hesitate to give the size large nasal pillow a try. Most people find it flows better, but your leak rate as-is looks great.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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: New to CPAP - Recommended Airsense10 Settings
Well done, buffeh! I'd suggest you continue with the day/evening use to speed the process of adaptation. It really is an odd set of sensations, isn't it?

It's good to see that these settings knocked your hypopneas way down. As Sleeprider says, it's quite likely the CAs are what some people call SWJ (sleep-wake junk). Our breathing while awake is much less regular than our breathing while we sleep, and it's quite common for us to pause in our breathing for 10 seconds or more. Of course, the machine doesn't know whether you're awake or asleep, so if you've had a little arousal and have paused your breathing for 10+ seconds, it'll drop a flag.

Don't worry if you don't feel magically restored early on. It can take some time, so patience will be your friend.

Keep us posted, would you? You're off to a great start.
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#7
RE: New to CPAP - Recommended Airsense10 Settings
Hello again,

I'm getting on OK(ish), I think.

I have found when comparing the Medium and Large P10 pillows, I find the large ones more comfortable to breathe through (the Medium ones feel like they are restricting my breathing, in comparison), however the Large ones do not sit as comfortably - the medium ones feel quite comfortable resting on my nose, but the part of the large ones that sit outside the nose are so big they dig into the skin just under my nose which is now quite tender. The large ones also seem to leak slightly more but not enough to be a problem I think (looking at OSCAR - I can provide the screenshots - my AHI seems the same either way)

I think with the medium ones the restricted feeling of airflow is causing me to sometimes start breathing through my mouth during the night (according to my wife) which doesn't seem to happen with the large ones.

Any ideas? From a comfort against my nose perspective the medium ones are definitely nicer but the large ones I feel I don't need to make any extra effort to breathe. I was going to persist with the large ones for now and hope my nose toughens up and they start to feel more comfortable....

Many thanks
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#8
RE: New to CPAP - Recommended Airsense10 Settings
Several things you might try. One is to stick with the medium but raise your minimum from 7 to 8. You can do this gradually if you like. That might be all you need to get the feeling of easy breathing and adequate air.

Another approach would be to use the large pillows and treat the sore area during the day with something soothing or healing. I don't know if it's available in the UK, but a fair number of people swear by Lansinoh, which is made for nursing mothers. That bit of skin under the nose isn't used to being rubbed, and it may take a little while to adjust.

Like you, I was twixt and tween with the P10 medium and large, though for different reasons. My eventual solution was to switch masks; the sizing isn't standardized across brands, so you might find a better fit with a different brand.
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