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First, I want to thank the community for being so generous with your time and knowledge. I've been reading through the wiki and random posts here on the board and it is very apparent to me that this is a wonderful community with genuine people; thank you.
I'm late 30's male, healthy and in shape with family history of sleep apnea. A few years back I noticed I would consistently wake-up after 3 to 4 hours of sleep. I did an at home study and a year after that an in-lab study with basically the same conclusion: mild sleep apnea. In-lab study showed:
AHI 11/hr
supine AHI 15/hr
oxygen nadar 92%
I purchased an AirSense 10 AutoSet in APAP mode and have used it on and off over the last year. I recently started taking it more serious as the lack of quality sleep has been effecting my daily energy levels and overall mood on bad sleep days.
Attached are three days in a row where I kept the mask on all night long.
I'm just starting out and trying to comprehend the data. Any help, suggestions, etc are greatly appreciated! Settings, different mask brand or style, etc. I'm willing to tweak and optimize to try to get a setup that is comfortable and provides consistent results.
Mask used in screen shots: F&P Eson 2 Nasal Mask. I also have ResMed AirFit P10 and happy to purchase anything to test.
1. What's up with the massive leaks? Are you aware of when this is happening? Your mouth is either wide open for a lot of the night or your pillows on the P10 are the wrong size but I'd bet the former. Consider taping your mouth at night. Most other recommendations are going to rely on low leak rates and changing pressure makes leaks worse. Target a 95% leak rate of 0.00 if you can manage it.
2. After solving leaks, consider raising minimum pressure to 7cmH20 and turning EPR to 3 full time then try it out for a couple of nights. Ideally you'd want your 95% flow rate to consistently be 0 and not see any obstructive events (light blue) or RERAs scored (yellow).
1. The massive leaks: I am using F&P Eson 2 Nasal Mask. I am not aware of having my mouth open because anytime it happens air passes through my mouth and it wakes me up. It has happened, but it isn't frequent (atleast to me consciously). The Eson 2 seems to fit, but I do notice that I frequently get a small leak that I then adjust the mask. I've tried tightening it more than normal and looser than normal but flipping through the history it seems fairly consistent. I prefer to sleep on my chest, which the Eson 2 doesn't do very well so maybe that is part of the problem is getting on my side and then when falling asleep I start to turn move to get on my chest and a leak happens? I don't know how to interpret the graphs.
I do have the P10 that I can try.
2. I'll address this after addressing the massive leaks. What what "normal" or "expected" leaks look like in the graphs?
On Friday night it was a totally sleepless night of flu based symptoms (no details, just use your imagination). Laid around all day Saturday and felt a lot better than the night before.
Saturday night used the CPAP with the ResMed AirFit P10 and a dose of Vicks Nyquil and I had the best sleep I have had in as long as I can remember. I slept a very long time, little to no wake-up's and felt absolutely fantastic with a lot of energy all day on Sunday.
Sunday night was unfortunately not the same. Same mask, same settings. No Vicks Nyquil.
See attached the two days. The best day ever does show the lowest AHI (1.01) I've ever recorded but to me the pressure and leak rate and stuff look very similar to a mediocre sleep day (the next day at AHI 2.39).
I would absolutely LOVE to figure out how in the world I slept so well Nov 18 (Saturday to Sunday night). See attached.
UPDATE
I have been trying to use the CPAP (AirSense 10 AutoSet) as much as possible and even traveled with it when I went out of town for over a week. I have more energy than I did before, however, I still have some nights where I wake up exhausted. Here are the three past days (4/4, 4/5, 4/6/2024) where I felt fairly good with the exception of last night, 4/6 in which I feel like I was awake frequently and I'm more tired today than yesterday.
AirSense 10 AutoSet APAP Min 6.0 Max 15.0
ResMed AirFit P10 Nasal Pillow
Primarily chest/side sleeper
Welcome back Apneavolt, Having reviewed your thread, I really need to see an additional view of your OSCAR Report that includes your Device Settings of the left hand panel.
Most of your events are Clear airways, which would suggest you reduce your EPR. From your Pressure graph it appears that you currently have EPR set to 3 cmH2O.
For now I would recommend you reduce your EPR to 2 cmH2O. that should reduce the wash out of CO therefore reduce CA events.
When you post back, post two screenshots of the Daily Details to get the Device settings into view, on the second screenshot zoom into an ~ three minute view of closely spaced event flags, preferably ones that include an OA, UA, or H event even if it is doubled up with a CA event.
Could you also post a screenshot of the last six months of your Overview, the top four graphs have the information I am interested in.
You have arrived at the proverbial rock and a hard spot. Your flow limitations would indicate using an EPR even higher than 3, but the EPR is causing your CAs. You've basically hit the limits of your machine. Trying to use what you have will involve a tradeoff. You will need to set the CPAP to a static pressure of 9 and an EPR of 1. Reducing the EPR should help in reducing the CAs. The reason for the static pressure is the lower EPR will increase your flow limits. This in turn will cause the AS10 to try and increase pressure to overcome them. This would cause what I term a runaway machine, because it would never achieve enough pressure and will always go to the highest setting. For this reason, we need to reign it in.
Also, your current pressure range may be causing arousals as the pressure fluctuates.
That's the best I can offer. If I have any epiphanies, I'll be sure to post them.
- Red
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.
UnicornRider see attached the three items you requested. I hope that the 5 minute one is alright even though it is more than 3 minutes. The left side device settings is an AHI of 4.54.
Crimson Nape thank you for the reply. I'll review over the settings and try to understand the difference between the rock and hard space with the settings so that I can pick what I feel would be best for me.
Machine: Remediated Dreamstation APAP-CPAP Mode Mask Type: Full face mask Mask Make & Model: Airfit F20 Humidifier: Built In CPAP Pressure: CPAP 15cmH2O CPAP Software: OSCAR
