Looking for tips to dial in my settings

[tomkatt]

Resmed Autoset 10 with a Resmed P30i pillow mask.

I've been testing new masks after some recent issues I had with Dreamwear cushions that I've used for years, and I seem to have hit a winner on the P30i. Looking at my charts, I had a few questions though. AHI in the screenshot below is 5.38, but I've had trouble initially falling asleep lately. If I look at the point where I'm obviously asleep, it's actually more like 1.61, which I'm pretty happy with.


My questions: 

• Should I raise minimum pressure at all? 8.4 seems to be working, but I notice it immediately shot up to around 9.5 when I actually fell asleep. From there, pressure is pretty stable above 9, with the lowest being slightly above 8.5 throughout the night.
  

• Is my maximum pressure okay? I set it at 11 since I'm usually between 9 and 10 pressure through the night, but I notice it hit pretty close to the max for a bit (10.95). Would it be worth leaving some headroom (maybe set to 12 cm?) or is this fine as it is? I used to use 8 - 14 cm, but I've dialed it in a bit tight because I've had issues with clear airway events that seem to be caused by treatment and I understand minimizing pressure changes helps with that (and very much has been the case now).
  

Let me know if any zoomed in detail is needed. I feel like I got a great night's sleep last night for the first time in weeks. Hoping to dial this in and stick with this mask going forward. Thanks!

[Deborah K.]

Your chart (except the CAs) looks good, and your settings are mostly fine. You could drop your high pressure a little if you want to try it.

You have your response set at soft. Most people, especially men, do better with standard.

Your chart would be easier to read if you changed it. Use the fn button to copy your chart. That usually sets it correctly. Just ensure we can read to the very bottom of the flow limits.

[tomkatt]

Your chart (except the CAs) looks good, and your settings are mostly fine.  You could drop your high pressure a little if you want to try it.

You have your response set at soft.  Most people, especially men, do better with standard.

Your chart would be easier to read if you changed it.  Use the fn button to copy your chart.  That usually sets it correctly.  Just ensure we can read to the very bottom of the flow limits.

Fn button? Apologies, I'm not sure where to find that.

Also, looking at it again, today, I'm seeing the same behavior, I'm not spending much time actually at the low end, my pressure shoots up and generally stays in the high 8 to 10 range. I'm probably going to bump the minimum up to 8.8.

Other than that, I dunno, maybe better sleep hygiene? It looks like all the CAs are happening while I'm still awake, and I'm just having a really hard time actually falling asleep.

[Deborah K.]

The fn button is to the right of the ctrl button at the bottom left of your keyboard.

Did you change your response to standard instead of soft? That should help a little.

[Crimson Nape]

tomkatt - To take a screenshot in OSCAR on a Mac system, use the Fn+F12. This key combination will change the F12's normal behavior and produce the same result as the F12 on a Windows or Linux system.
- Red

[tomkatt]

The fn button is to the right of the ctrl button at the bottom left of your keyboard.

Did you change your response to standard instead of soft?  That should help a little.

Doesn't look like my keyboard works that way. I have a Fn button on the right side, but it's for multi-key presses as I use a 70% keyboard. Either way, all of the data should have been included in the screenshots provided, and flow limits were there. I've attached a popout of it on this message in case it helps.  Was there anything else missing that you wanted to see or have me zoom in on?

Regarding the settings, I can try changing it to standard to see if that makes any difference. I've tested with soft and standard, it's never made much of a difference in my experience.

   

[tomkatt]

tomkatt  -  To take a screenshot in OSCAR on a Mac system, use the Fn+F12.  This key combination will change the F12's normal behavior and produce the same result as the F12 on a Windows or Linux system.
- Red

Gotcha. I'm on Linux. Did I miss something with the screenshots I attached to the original post?

[Crimson Nape]

Sorry! You did fine. I saw the post about the Fn button and thought Deborah K. had forgotten to include the "+F12" with it. Please ignore my post, unless you decide to get a Mac.
- Red

[tomkatt]

@Crimson Nape @Deborah K.

For whatever reason, I can't seem to take screenshots that way, it throws an error message when I try to save the file:

   

I was able to print a full report as PDF without my personally identifying data after some fiddling though (attached). Hopefully this is more helpful.

Edit - Nope, I'm wrong, for some reason that file won't upload to the forum. 

====================

Edit 2 -

Okay, figured it out, Wayland just doesn't support QWindow. I switched to X11 and was able to capture it, but I'm confused again, as it looks like the same as what was in my original screenshots on the first post. I've attached it here anyway just in case.

[mlmollenkamp]

Your AHI is all central apneas, effectively no obstructive apneas. Fortunately they are just during transitional sleep, "twilight" sleep. It is worth working on those central events though, you effectively lost a half hour of sleep, and your oxygen level may not be very good during that time. I suggest logging oxygen levels with a recording watch or ring, you may find your oxygen level is dropping during that phase. Mine can drop dramatically during the first half hour of sleep, low 80's, if left uncontrolled. I learned this with a ring monitor that could be set to vibrate at a set oxygen level, it was like a 5 alarm fire. I now regularly use a ring that can import into OSCAR.

I see you are using soft response. In my case this increases the number of central apneas. Try standard response and see if it helps. EPR and ramp also increase them for me, but I see you aren't using them. I also find that using the full face mask setting with pillows decreases my central apneas, you could try it. These settings all indirectly change the blood CO2 levels. You actually want to increase CO2 because it is what drives the urge to breathe.

Finally, what position are you in when you go to sleep? In my case the central apneas are very position dependent. If I'm on my right side I get many more central apneas, especially during sleep transition. Oddly I have a much lower AHI on my back than either side, because with a machine I have no obstructive apneas but quite a few central and hypopnea events.