New to CPAP, need Help

[PAZ99]

New to CPAP (5 weeks) and struggling to get used to it and get to decent numbers. Dreamstation (probably one of the last sold before recall) and Phillips FFM. Dr. set pressure 5-12, after 3 weeks set it to 9 and also removed Flex access.  Main issues seem to be very dry mouth (even with Humidity at 5 and tube heat at 3) and some dives below 90% on SpO2 (based on Viatom O2 ring), although the SpO2 is improved over pre-CPAP.  I do get up 3-4 times per night (pre-CPAP and also now) and have low resting heart rate (due to Metoprolol for anti-Afib).  Attaching 2 OSCAR screen shots from last night.  Dr. and DME provider have been minimally (at best) helpful.  I expect to try to switch to a ResMed machine down the line. Delighted to have discovered Apnea Board and its helpful members.  Would appreciate any advice on what to focus on in OSCAR info and possible options on changing settings and equipment. Thank you.

[Gideon]

The readings you have and the machine you are using and an RDI of 7.66 say you need more pressure. Try 11

BETTER, these readings say that you will do better with a ResMed (AutoSet). ResMed's EPR will much better treat the flow limits and hypopnea demonstrated on the machine. Initial setting on the Autoset
Mode: Auto
Range 6-20 cmw
EPR=3, FullTime
Ramp=Off

Utilize the current recall of your machine (PR has said it is a health and cancer risk and DO NOT USE it) to get a new AutoSet.

[SarcasticDave94]

I'd agree, use the recall to get the ResMed AutoSet. You'll be better treated and no concerns over the foam.

[PAZ99]

New to CPAP, about 8 weeks.  Got rid of Phillips Dreamstation machine due to recall and now have ResMed 10 Autoset for a week.  Still struggling, especially with mask leaks, and actually worse with the ResMed machine.  Perhaps coincidence. For masks, have tried Dreamware FF, F&P Vitera, and now using ResMed F30i.  Masks usually fit o.k. initially but then start vibrating/pulsating type of leaks.  Have tried the various adjustment techniques mentioned on the Forum.  Will keep trying.  Attaching OSCAR screen shots from last night in case somebody spots some other issues to correct.  Still learning about interpreting OSCAR data. Ironically, I felt fairly good (for a change) subjectively about last night but then saw the miserable (worst yet) leak statistics in OSCAR.  One thing that has improved considerably and generally over pre-CPAP is improved blood oxygen readings, per Viatom data.  Would greatly appreciate any expert data interpretations or recommendations.  Thank you.

[Melman]

Changing EPR from 2 to 3 should reduce flow limitations, RERA, and possibly hypopnia. An increase in min pressure to 10 or 11 as recommended by Gideon in your other thread should also be helpful.

[staceyburke]

Yes your large leaks need to be addressed. Even when they are not in the large leak category they are high. These will be throwing off your real AHI.

Full face masks tend to leak the most followed by nasal and least are pillow masks.

Do you need the FF mask or did the supplier just give it to you?

[Crimson Nape]

PAZ99 - Your two threads, this one (New to CPAP, need Help) and New user seeking help, have been merged because they both relate to your therapy.  This provides better continuity and reference information for anyone wishing to provide help.

[S. Manz]

New to CPAP (5 weeks) and struggling to get used to it and get to decent numbers. D

Considering your AFIB a=medication and the low end heart rate that goes with it, your Spo2 levels average 95% which is pretty respectable (even with downs spikes).

[PAZ99]

Thank you for the comments.  I will change EPR from 2 to 3.  As for pressure change,  I thought that going from original 9 (on Dreamstation) to a 9-13 (on ResMed) would address that.  If I change minimum to 10 or 11, what might be a reasonable maximum to try?  Does my OSCAR data suggest higher than 13 max?  Doing something like 11-13 seems perhaps too narrow of a range?

Type of mask, per Dr. (and I agree on this) I do need full face mask.  Very much a mouth breather, eliminating that seems to big of a challenge right now.  So I think I need to keep working on full face mask options.

Thanks for merging my two threads; I should have done that to begin with.

Any further recommendations, esp. any based on the OSCAR data, would be most welcome.  I'm learning but don't yet have a full grasp on interpreting OSCAR data.

[notam2]

Personally I'd set the pressure range to 11-14 with EPR at 3 and then evaluate the results.