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As promised, here are my results. I was going to post these in my previous thread "CPAP or Mouthpiece", but I couldn't find a way to revise the title of the thread. Anyway, since I have no idea how to read these results, and alot of you folks do, please take a look and let me know what you think. FYI, after gathering info on a few different units, and getting advice from some of the senior members here, I'm leaning towards the ResMed AirSense 10 Autoset. I was able to gain a ton of valuable knowledge, in the short amount of time ive been here. (Just joined yesterday!) Thanks again to everybody here.
Interesting results and impressive hypopnea. The first question is why are you not getting a titration evaluation to identify the best effective CPAP pressure?
You have relatively little apnea, and had only 11 apneas. The concern here is that 5 were obstructive, 4 central and 2-mixed. That means the remaining 172 hypopnea (nearly 30/hour) could be obstructive or central. There was no determination. Your diagnosis is obstructive sleep apnea, and regardless of some central elements, we have to go with that for treatment. Even if you had a titration exam, a CPAP or Bilevel would almost certainly be prescribed anyway. There is a lot of information the study does not provide.
I agree with your inclination to use the Airsense 10 Autoset. It has a more responsive auto algorithm to head-off obstructive events and to keep pressure high enough to avoid hypopnea. The Philips machines tend to let more events occur due to a slower response and faster return to minimum pressures. In addition, the exhale pressure relief in the Airsense 10 is more like bilevel with up to 3-cm of exhale pressure relief. This can be used to significant advantage in treating obstructive hypopnea. Because the Airsense 10 Autoset behaves like a bilevel, we can use the exhale pressure (EPAP) for treatment of obstructive apnea, then use the higher inhale pressure to make breathing easier to encourage more complete breathing and avoid hypopnea. Overall this can be very comfortable and effective. The fact you had some central events raises the concern that CPAP pressure may increase those events, so the objective will be to use enough pressure for OA and H events without using so much that CA events become prominent. Many people end up getting an auto-CPAP and using the default wide-open settings of 4 minimum and 20 maximum. I think you might find a more limited range of 6 to 12 adequate to learn what your needs are. It's easy to increase pressure if needed, and the lower maximum pressure avoids discomfort in new users. A minimum pressure of 4.0 is rarely effective and can feel like you're coming up short on air volume.
In addition to a machine, you will want to consider what mask to use. I like to coach new users to start with a minimal mask like nasal pillows, and to move to a full-face only if they cannot overcome leaking pressure through their mouth. A smaller, lighter mask is logically more comfortable and less obtrusive, and is generally easier to prevent leaks due to minimal surface contact area. I like the Resmed Airfit P10 (for her if your head is small), and try to use a larger pillow size than you think you might need. Read the Mask Primer in my signature links for more.
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