Sp02 Real low Help with pressure settings

[DudleyDoRight]

I have a resmed AirAuto 10  bipap with Nasal pillow, I use a chin strap to keep my mouth closed.
My settings are

PS 4.0 over 9.0-18.0 (cmH2O)


I've been using Bipap for 8 months  took months to find a mask that didn't give major leaks.  Most nights may AHI run between 1.2 to 4 typically close to 1.7. 

Month ago I got a smart ring that measure Sp02 I felt it was off it often shows drop to 82. So I bough a Sp02 monitor that tracks the whole night.  Seems my o2 levels drop between 82 -87   30 to 52% of my sleep cycle . with drops as low as 71 occasionally . I'm 5'8" 280lbs. 

Attached last nights Oscar data.

Suggestions on what I can do?  Do I need to adjust my settings for more pressure?  Tried full face masks  cant seem to get them not to leak.

Help is greatly appreciated.

[Jay51]

Thank you for posting that.  

IMO, the leaks are still so large and last all night, that they are disrupting your therapy and could be contributing to your CA's and SPO2 drops.  

If the full face masks are not working, it might be time for a different style of mask.  There are lots of them on the market now.  

Here are some tips from our ApneaBoard wiki that may have something to help you get a better seal.  Your pressure(s) are not super high, so hopefully we can bring the leaks down more.  

As a stop-gap move, you could try to lower your pressure(s) a bit to help improve your leaks; but if that drives up your events in OSCAR, then abandon this suggestion.  

• 1Mask Primer
  

[SarcasticDave94]

Agreed with Jay. I'll add with desat numbers like you report, you'll need to get the doc involved. At least get them to check your respiratory system over. 82-87% oxygen 30-52% of your sleep session duration is dangerously low, assumed accurate.

Also I think unless the desat is due to CPAP including leaks making it inaccurate, the CPAP machine isn't exactly the best weapon to increasing oxygen levels.