Not able to achieve AHI below 1 consistently

[gainerfull]

Did increasing your minimum pressure help?

[aslotaru]

Did increasing your minimum pressure help?

A bit, but not significant, I found Epap not comfortable, especially when starting to exhale, its like braking drastically. if i increase max level to 12, i feel dryness of mouth.

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Do you think the AHI reading of resmed is accurate or its on a lower side?

[aslotaru]

Before addressing ways to improve therapy, let’s back up to what is going on. Do you have a copy of your sleep report? If so please post the summary page (or all pages if short) and redact all personal data. That will help us understand things.

Why go through so many different machines? The ResMeds would be the first we recommend, Dreamstation 1 definitely not, and Loewenstein seems okay but is still new to some of us. If you have a choice stick with one of the ResMeds. Swapping machines does not help adjusting.

I’ll skip commenting on the Loewenstein chart. For the Resmed Airsense 11 set your min to 7, max to 15, EPR to 3. Use that for a few days then report back.

Also, please read the wiki on how to format the charts for us to review. There is a link in my sig…

Don’t chase AHI numbers. Chase quality sleep.

[aslotaru]

my best AHI using resmed s10

[UnicornRider]

my best AHI using resmed s10

I see these are from some time in the past, good job organising the OSCAR display for maximum information on the 29 Sept 2023 therapy session.
 But for the 10 June 2023 session you need to hide the calendar, that will enable the display of additional vital information,

on your ResMed  AirSense 10 Autoset

Turn Ramp Off,  Set pressure minimum 8,  pressure maximum 16,  EPR 3. 

Give it a try for a couple of days, then post a couple of new OSCAR reports.

Expect to fine tune by changing these parameters with help from the members here, we can help guide you to a better sleep session.

Low AHI is not the ultimate goal, sometimes we get better restorative sleep with AHI not at <1. 

I find an Oximeter a better gauge of therapy performance, for myself.

[SarcasticDave94]

I would say the ResMed charts look like a better level of therapy, given the caveat there's several months in the past versus the Lowenstein charts.

The ResMed could probably do better than shown in June with a higher max pressure than 10.2, there you can see the pressure was flat lining at that same 10.2. Occasional leaks seem to be an issue as well ongoing.

To me, the busy looking charts on the Lowenstein looks like it's not helping much nor comfortable, but that's my take.

[PeaceLoveAndPizza]

It is difficult to compare the results of the Löwenstein vs the Resmed as they are at different pressures and point in time. If it was me I would stick with the ResMed.

Both UR and SD said what I would have recommended.

1. Remove ramp unless absolutely needed. No real therapy during the ramp time and the rapid increase in pressure can be sleep impacting.

2. You need more pressure, so follow UR’s recommendation of adding more pressure. I suggest 7-15 EPR 3 on whichever machine you decide to use. You may be able to reduce the pressure once things are dialed in, but for now better to keep a range to see how the machines respond.

3. When on the Löwenstein (10/11/2023) there are quite a few leaks. Something to keep an eye on as it impacts therapy and sleep.

The events look very similar between the two machines. We are more used to the Resmed, but we are seeing a lot of Löwenstein’s as well. I have not used one but they seem to do a good job based on posts.

[UnicornRider]

A bit, but not significant, I found Epap not comfortable, especially when starting to exhale, its like braking drastically. if i increase max level to 12, i feel dryness of mouth.

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Do you think the AHI reading of resmed is accurate or its on a lower side?

    After adjusting your settings of your pressure to the higher levels and EPR 3.  

    Besure to note if you have a sensation of brakes being applied on exhale,  too forceful or insufficient air on inhalation, even dry mouth or rain out in your mask.

    This group will take all of that into account as they recommend timing, tuning, and pressure changes while monitoring the effectiveness of your therapy sessions.

   Comfort and effectiveness of the therapy session are both important.


     AHI is a relative indicator of therapy effectiveness, not an accurate measurement.

[aslotaru]

Why I need to adjust my Pmax? Just heard that lower Pmax will be more comfortable, also regarding EPR, is it better to turn it on? Why?

Thank you very much for help

[UnicornRider]

Then reason to adjust your Pmax is so the algorithm in the ResMed has room to adjust pressure to control your Sleep Breathing Disorders (SBD), which is not being controlled with the previous settings.

Yes EPR should be on, for comfort of the user and to help sweep out CO2 when you exhale.

EPR :  https://www.apneaboard.com/wiki/index.ph...lief_(EPR)

Let us know how it feels, and post OSCAR Reports, so they can help fine tune the therapy parameters.