New To Apnea Board [confirmation of my data analysis]
Recently DX'ed with Moderate OSA (AH events 23/h, O2 sat <82% at times). Now Using the AirSense 10 Auto and ResScan Software. I'm a side sleeper and mouth breather and that's not going to change. I understand this can affect mask fit and flow. I'm having a lot of problems being awakened (RERA) 2-3X/night. The AirSense is set at pressures of 5 minimum and 18 maximum. I have a heated tube and I set my climate controls to manual because I didn't think the humidity setting was high enough in Auto (lots of dry mouth). I have spent the last three weeks going from a small to a medium Amara View full face mask for comfort and getting the head straps adjusted well to make the mask comfortable, placed correctly and not leaking. I get no perceptible air leaks at the lower pressures and even at the higher pressures (up to 10-12), as far as I can tell.
I use a TempurPedic neck pillow which tends to be hard and with side sleeping presses against the mask causing it to shift. I've started to experiment with a softer pillow. With AutoRamp selected, I fall asleep quickly at minimum pressure but I am usually awakened within 3-4h. In the image below (click to embiggin), we're coned down to 5 minutes where an RERA is recorded. Having watched these RERAs for about 3w, I can see that when an RERA is recorded, there is a lot of mask leakage that accompanies a rise in pressure usually above 14. This typifies the 2-3X per night awakenings. You can see there is also a significant flow limitation due to an obstruction to the airway that starts at 22:19:30 and leads up to the pressure rise and the awakening. So, if I'm interpreting available data correctly, I get this.
The problem is that now, with the CPAP my AHI is down to <3 most of the time but, I'm getting more interrupted sleep and I'm probably not getting to N3 stage let alone REM sleep. My day-time feel-god index is pretty high but because I'm usually awakened by the 3rd set of CPAP pressure/leaks at 5a or so, and get up shortly there after, I'm ready to sleep by 8:30p. Before starting CPAP I was in bed at 10:30p and up at 7a I'd like someone to confirm that I am interpreting the data that is available to me (objective from ResScan and subjectively by experience) correctly and suggest some steps I can take to ware my CPAP and, at the same time, get a good night's sleep within the previously established time frame that was perfect for me before CPAP.
[attachment=4207]
I use a TempurPedic neck pillow which tends to be hard and with side sleeping presses against the mask causing it to shift. I've started to experiment with a softer pillow. With AutoRamp selected, I fall asleep quickly at minimum pressure but I am usually awakened within 3-4h. In the image below (click to embiggin), we're coned down to 5 minutes where an RERA is recorded. Having watched these RERAs for about 3w, I can see that when an RERA is recorded, there is a lot of mask leakage that accompanies a rise in pressure usually above 14. This typifies the 2-3X per night awakenings. You can see there is also a significant flow limitation due to an obstruction to the airway that starts at 22:19:30 and leads up to the pressure rise and the awakening. So, if I'm interpreting available data correctly, I get this.
The problem is that now, with the CPAP my AHI is down to <3 most of the time but, I'm getting more interrupted sleep and I'm probably not getting to N3 stage let alone REM sleep. My day-time feel-god index is pretty high but because I'm usually awakened by the 3rd set of CPAP pressure/leaks at 5a or so, and get up shortly there after, I'm ready to sleep by 8:30p. Before starting CPAP I was in bed at 10:30p and up at 7a I'd like someone to confirm that I am interpreting the data that is available to me (objective from ResScan and subjectively by experience) correctly and suggest some steps I can take to ware my CPAP and, at the same time, get a good night's sleep within the previously established time frame that was perfect for me before CPAP.
[attachment=4207]
