Dewberry Therapy Thread: Autoset 11 to Aircurve 10 ASV

[Sleepless in Dewberry]

        [attachment=46636][attachment=46636][attachment=46636]I have been using my Apap for 3 weeks and I am struggling with it. I am seeing very limited improvement.
My sleep test  score was 37.6 AHI. My DME hasn't changed anything since getting my Airsense 11.
I am getting very little rest, I feel exhausted every day.
Any help would be greatly appreciated.

[Expat31]

Firstly you need to post just the 5 key graphs as indicated below ow at this early stage. 

We can't discern too much in their present form. 

In order of priority is :-

1. Events
2. Flow Rate
3. Pressure 
4. Flow limitation
5. Leak Rate

Secondly from a very cursory look of what you have already sent indicates two things, minimum pressure is too low at 4, but most importantly you have a ton of apnea clusters that are the probably the main culprit of your difficulties 

Did your sleep test AHI of 37.6 show the breakdown of this between left side, right side, and sleeping on your back. Maybe a clue here

So are you now as a preference sleeping on your back?

There is a treasure trove on the board's wiki pages. We'll worth the time delving in to this. Lots of information available.

[Sleepless in Dewberry]

I hope this what you want.

It shows I was in Supine 62% 5:28 and non supine 37% 3:16
I prefer to sleep on my side because of a back injury and multiple surgeries.
If you want I will post my sleep study.

[Gideon]

You are suffering from what looks like a positional apnea. Basically a tucking of your chin. Think of a garden hose with a kink in it. Low flow until you straighten it out. Sometimes a simple pillow change will fix it. Think 1 vs 2 pillows, flatter, less form. Otherwise a properly fit soft cervical collar. See the link in my signature. The tell is the clusters of obstructive events.

[Sleepless in Dewberry]

I bought a CPAP pillow for when I side sleep to stop leaks, it is a flatter than I like but oh well.
I will look into a soft cervical collar.
Sure am wondering why my DME hasn't mentioned this.
Thanks I sure appreciate your help.

[Gideon]

Simply because they don't recognize it.

[Ockrocket]

Starting CPAP is the beginning.. refining settings and accessories such as mask type, cervical collar, suitable pillow and so forth is the progression towards a full long term solution.

Don't expect an "instant cure", don't make multiple changes all at once.. adjust one thing and give it a few days to settle to it, then if that works do the next adjustment and see how that goes for a few days - by doing that you can improve your treatment with less confusion over what actually works than by multiple changes all at once.

Good luck going forward, some of the experts in assessing your charts will chime in soon no doubt (I'm not one of those   ).

[Expat31]

It's the breakdown of the AHI values making up the total 37.6 that would be interesting to see.

A good place to start would be your sleep report. 

Yes, can you post it, but of course redact any personal identification. 

I think we all agree on positional apnea, however there is more than one cause and one solution. 

We shall see how things unfold, in a step by step approach, now we have a good presentation of your data.

Thanks

[Sleepless in Dewberry]

my sleep apnea test.

[Expat31]

Hi, thanks for the sleep report. 

Firstly I am just a forum member, without medical knowledge. 

However I like looking at figures,  analysing and try to hopefully find explanations. 

I guess what you have sent is the first page summary, which is absolutely fine, as it contains the breakdown of AHI. 

It was not quite what I expected. It seems to appear that sleeping on your back, for this one particular night is not as such a dominant impacting element impacting your total AHI. I expected the gap to be much greater. Let's look at the figures.

Breakdown of Total AHI of 36.7 events/hour:-

Supine AHI            39.5 events/hour. 
Non-supine AHI    32.4 events/hour
Upright AHI.          23.6 events/hour

On the other hand, 62% and 32% positional time duration respectively for supine and non-supine does not follow the same pattern. I thought there would be some kind of correlation. 

Your report of 2022, produced I guess in the US, is under the analysis criteria of  AASM 2012

My report was produced in France in 2021 based on AASM 2017. The layout of the summary page, the first page (apart from the language) is quite different and more detailed. The second page drills down to even more detail, and the third and fourth pages give the graphs backing up the results.

Unlike your report, for my results there was a pretty close relationship between positional time and the AHI breakdown. 

In short, in my report, the overwhelming culprit was supine AHI together with and supine time. 

A nice neat convenient answer for me!

With these reports I am not sure if I am comparing like with like, and the applying of the criteria  may be quite different. 

(The sleep test was just a home test, not a polysomnographie in a hospital). 

Anyway, these tests are based on just one sole night, one tiny sample. Over a week (say), it could be quite different.

Sorry I could not be of more help. Could not find any smoking gun. 

Anyway, our reports are just history. Luckily we have Oscar helping us in the here and now! 

Early days for you, there is lots of common sense advice on the forum availible based on real life experiences. 

All will be well