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JoelMC - Therapy Advice
#1
JoelMC - Therapy Advice
Hello all,

Brand new here. I need some help/advice. 

A quick history... 

 Diagnosed Moderate OSA in August 2024. Study showed 25 AHI, during study cyclical oxygen saturations during study showed lowest at only 93%.
Follow up with the Dr assistant we agreed/advised to do a 3 month conservative approach without treatment because the Dr said my oxygen levels remained in a "safe" zone.

*Please note I have almost no symptoms... moderate snoring occasionally which seems to increase only when I have alcohol. I wake up several times a night but always fall back to sleep. Most days I feel pretty good. My apple watch shows more wake ups then I generally remember but I do flip sides a lot in the night. Always have.

2nd follow up I have decided to give CPAP a try simply to see if I notice any difference in my sleep and how I feel during the day/in general. They want to do a 2nd titration study, which is booked in March (it's free as I am in Ontario)... In the mean time I was given an almost brand new Airsense 10 Autoset from a family member. I have no mask yet but have been researching different types.

So here's my questions.

1. Should I try this on my own in the mean time before the titration study? What sort of starting pressure range might be appropriate? I need help here..
2. I'm a side sleeper, flip back and forth. As far as I know I'm a nose breather/sleeper. Odd time I wake up on my back with mouth open but seems rare. Any mask recommendations?
3. Is a 2nd titration sleep study even necessary? I've been reading some real mixed opinions on this. I would rather not as it's not the most fun I have had before lol 

Any advice is greatly appreciated! Thanks!! : )
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#2
RE: Need some advice
Welcome

Since your sleep study showed an AHI of 25, we can help you with your settings without a titration study.  Post a redacted copy of your sleep study and we can give you lots of useful information.  If you don't have a copy ask your doctor's office for one.

In the meantime, I suggest you set your machine pressure at 7 to 20. That's a good place to start. Also, set EPR full time at 3.

As to masks, there are lots of choices.  I prefer nasal pillow masks as they generally leak less than other mask types.  I am currently using the F&P Nova Micro mask and I like it.  Right before that I used my old ResMed P30i, but it leaked a lot and I found it uncomfortable.  My first choice is the Bleep no mask system, but my skin will no longer tolerate the tape on my face, so I had to find something else.

My husband likes his nasal mask. These generally leak less than full face masks but more than nasal pillows.

There are many types of full face masks and many people like them.  My first mask was full face and I did not like it at all and it leaked a lot. Lots prefer them because they mouth breathe and a full face mask covers the mouth.

Many who use nasal pillows or nasal masks wear mouth tape to stop the mouth breathing.  That's what my husband and I do.

Once you have your own machine you can get all your equipment from a DME (company that sells cpap related gear) and your insurance will pay whatever amount they cover.

I hope some of this helps you.  Smile
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution and F&P Nova Micro

Link to thread about switching from Autoset to Bilevel:
https://www.apneaboard.com/forums/Thread...+a+bilevel

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#3
RE: Need some advice
Many people self-titrate with an Auto CPAP rather than clinical titration. The Resmed Airsense 10 is very good at providing a pressure that prevents obstructive apnea, and titration rarely evaluates the EPR feature that can resolve flow limits, RERA and hypopnea at lower pressures. I self-titrated many years ago, and today you have access to fantastic data through OSCAR, and help from the members of this forum to optimize quickly. I would not hesitate to setup your device for Autoset Mode, Minimum pressure 7.0, maximum pressure 12.0, EPR full-time at setting 3, and posting results the next day for some optimization coaching.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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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.
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#4
RE: Need some advice
Thanks SO much for your reply and advice! : )

Attached are my study results. Should I post these on the main board too?

Yesterday I ordered a mask, should be arriving today. ResMed Airfit P30i nasal pillows. Going to give it a whirl and see...if no good I'll try a full face one. I also ordered a chin strap in case? I'm willing to try tape too if need be.

I think I will set everything up on Sunday and try the mask in the afternoon first to get a feel for it. Thanks again for your help! I'm feeling less stressed about it all now : )

Thanks so much! : )

I just ordered the ResMed Airfit P30i mask. Going to try and get everything set up this weekend. : )


Attached Files Thumbnail(s)
       
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#5
RE: Need some advice
Most of your events were hypopnea which suggest upper airway resistance syndrome (UARS). The settings I suggested above will maximize the amount of pressure support your device can provide to help with the severe flow limitations that usually cause this. Hope you will put those into your Autoset and post back with a chart of the results.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
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#6
RE: Need some advice
Thanks!!! : )
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#7
RE: Need some advice
Thanks for reviewing! I will post back for sure. I'm assuming OSCAR is pretty user friendly?
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#8
RE: Need some advice
Just curious... I see what you mean regarding the hypopnea events. I'm wondering why the the follow up they didn't mention UARS as this makes sense to me know. I was diagnosed OSA or this all the same? Is UARS treatment the same? Sorry... too many questions! haha

I should also mention I have an appointment booked with an ENT in April which was recommended by the sleep Dr.... they didn't say why. I'm assuming its to see if their are any structural reasons.

Thanks again!
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#9
RE: Need some advice
Hypopnea like yours is generally obstructive, but we don't often see such prolific numbers and almost no apnea. We can infer quite a bit from that result, but looking at the flow rate charts would tell us more. It likely arises out of a restriction in the nasal or upper airway, and benefits greatly from positive pressure stenting and is especially responsive to bilevel pressure support (increase in pressure from end of exhale to peak inhale) which actually provides an assist to your inspiratory effort. Fortunately, your Autoset provides up to 3-cm of pressure support in the form of exhale pressure relief (EPR). We have a wiki article on flow limitation that you should read to better understand. https://www.apneaboard.com/wiki/index.ph...limitation
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply
#10
RE: Need some advice
Fascinating. Thanks again and thanks for the link... I will investigate further. : )

I'll attach the document with the charts from my study as well if that helps... sorry about the bad scan. I hope it's readable.


Attached Files Thumbnail(s)
   
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