Introductions

[andygev35]

Hello everyone.  I decided that since I've been a lurker on here for a couple of months, I might as well create an account and introduce myself.  My name is Andy, I'm a 51 yo male, 6' 195lb.  I may be in the minority here, but due to years of complaints from my wife about my snoring and nightly elbows to my ribs, I decided that rather than go through the hassle and cost of a sleep study (no medical insurance),  I would just go ahead and go out of pocket and slowly treat what I'm sure was at least a moderate case of OSA.  Thanks to many users on here with their equipment reviews, and some perseverance, I've been very successful using a pre-owned Resmed AirSense 10 Autoset with an array of masks to get an average nightly AHI of 0.5 - 2.5 with 0 OA's and a sprinkling of Central Apneas here and there.  I feel better than I have in years, but the search for the goldilocks mask is still ongoing, and as I'm learning, may be a never-ending process.  At this point, I'm only about $650 into it, but I'm more than pleased with my results.  I look forward to interacting with you guys.

[Gideon]

Welcome to the forum Andy

You know what to do. Post your OSCAR nightly charts and we can look at them.

Oh, and provide the coffee!!!

[andygev35]

Here's my Oscar chart from last night.  If I read it right, I think I knocked off my P10's at a little after 3am.  Also had one OA that I'm pretty sure was me talking to the wife while blocking off my nose.
   

[Sleeprider]

Andy, chart looks great. I see you are using your Airsense 10 Autoset in CPAP mode at a fixed pressure of 8.0. Unless you have a reason for doing that, I'd like to suggest using Autoset mode and adding some EPR into your therapy. The EPR will act to reduce your flow limitations, which are pretty significant with 95% at 0.26. I like to see flow limit under 0.1. Doing this should eliminate the RERA and hypopnea events you're recording. Since your results are already exceptionally good, any change made should target comfort, so this is something to try, and if you find it disrupts your sleep, then we can go back. My suggestion is:
Mode: Autoset soft
Minimum pressure 8.0
Maximum pressure 10.0
EPR: On Full Time
EPR setting: 2

The rationale is to give you some exhale pressure relief starting at 8.0/6.0 (inhale / exhale), and topping out where exhale pressure is equal to your current CPAP pressure at 10.0/8.0. The EPR should make breathing easier and more comfortable and reduce hypopnea RERA and flow limitation.

[andygev35]

I see you are using your Airsense 10 Autoset in CPAP mode at a fixed pressure of 8.0.  Unless you have a reason for doing that, I'd like to suggest using Autoset mode and adding some EPR into your therapy.

I appreciate the support and suggestions.  Really, the only reason I decided to try cpap mode is that I tried apap early in my trials, but there were too many variables and I wanted to establish a minimum effective baseline pressure as simply as possible.  I will certainly give your suggestions a try and post back tomorrow.  I've been using the AirFit P10's for about three weeks and have been battling some intermittent soreness in one of my nares, which I've been treating with Lansinoh.  That stuff is magical.  I do have a Dreamwear Nasal Cushion and FFM on the way (arriving today) to try out and add to my rotation.

[andygev35]

Mode: Autoset soft
Minimum pressure 8.0
Maximum pressure 10.0
EPR: On Full Time
EPR setting: 2

Attached is last night's chart with your suggested settings applied.  I must admit that the comfort level was much better.  Still had a couple of RERA's and a half dozen Centrals, but I've noticed that Centrals tend to be very inconsistent from night to night.  Is that normal?

   

[Sleeprider]

First of all, I have a standard saying that, central apnea is consistently inconsistent, and at this level we are NOT going to even give them a second thought. Let's talk about your progress. Compared to your last chart, your 95% flow limitation has dropped from 0.24 to 0.03. That's a big win for comfort and it means your inspiratory flow is now free to follow your respiratory effort rather than trying to flow through a restrictive airway. I notice that on both this night and the previous chart you have a sharp spike of flow limitation where the RERA events occur, in fact they look remarkably identical. I think that is positional. It's not worth chasing, but be aware that sometime in the middle of the night you manage to tuck your chin or something that nearly obstructs your airway, and you seem to be aware of it and back off. Some of the CA events seem to coincide with spikes in leak rate, and that suggests you may simply be turning in bed or arousing, either of which can cause a CA event to be triggered by holding your breath. I'm not concerned about central apnea with this pattern.

[andygev35]

It's not worth chasing, but be aware that sometime in the middle of the night you manage to tuck your chin or something that nearly obstructs your airway, and you seem to be aware of it and back off.

I'm mostly a side/stomach sleeper and I do often try to bury my face into my pillow.  Since the Airfit P10 is a nose hose, I've found myself trying to bury my face unsuccessfully and wind up doing a chin-tuck from time to time.  I'll keep posting nightly charts.  Thank you for the response.

[andygev35]

Had a little bit of a rough night last night.  Tons of tossing and turning and I feel like I got very little sleep.  Had a little bit of a backache that was nagging at me most of the night, so I just couldn't seem to get comfortable.  Also tried out the Dreamwear with nose cushion.  My God this is a comfortable mask.  I'll be needing the strap covers to help alleviate facial scarring, but it'll definitely help my nose by giving it time to recover from P10 usage.  This may become my go-to mask.  Anyways, here's my chart from last night.  Lots of CA's, but I'm guessing this is from holding my breath while tossing and turning? Also wondering if the Dreamwear nasal cushion should use the pillows or nasal setting in the AirSense 10 Autoset?
   

[Sleeprider]

Big improvement on leak rate. Restless nights happen, and they often have some CA events.