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Starting Out - Guidance Please
#1
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Starting Out - Guidance Please
First, I want to thank the community for being so generous with your time and knowledge.  I've been reading through the wiki and random posts here on the board and it is very apparent to me that this is a wonderful community with genuine people;  thank you.

I'm late 30's male, healthy and in shape with family history of sleep apnea.  A few years back I noticed I would consistently wake-up after 3 to 4 hours of sleep.  I did an at home study and a year after that an in-lab study with basically the same conclusion:  mild sleep apnea.  In-lab study showed:  
AHI 11/hr
supine AHI 15/hr
oxygen nadar 92%

I purchased an AirSense 10 AutoSet in APAP mode and have used it on and off over the last year.  I recently started taking it more serious as the lack of quality sleep has been effecting my daily energy levels and overall mood on bad sleep days.

Attached are three days in a row where I kept the mask on all night long.

I'm just starting out and trying to comprehend the data.  Any help, suggestions, etc are greatly appreciated!  Settings, different mask brand or style, etc.  I'm willing to tweak and optimize to try to get a setup that is comfortable and provides consistent results.

Mask used in screen shots: F&P Eson 2 Nasal Mask.  I also have ResMed AirFit P10 and happy to purchase anything to test.

Thanks


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#2
RE: Starting Out - Guidance Please
Welcome to the board!

1. What's up with the massive leaks? Are you aware of when this is happening? Your mouth is either wide open for a lot of the night or your pillows on the P10 are the wrong size but I'd bet the former. Consider taping your mouth at night. Most other recommendations are going to rely on low leak rates and changing pressure makes leaks worse. Target a 95% leak rate of 0.00 if you can manage it.

2. After solving leaks, consider raising minimum pressure to 7cmH20 and turning EPR to 3 full time then try it out for a couple of nights. Ideally you'd want your 95% flow rate to consistently be 0 and not see any obstructive events (light blue) or RERAs scored (yellow).
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#3
RE: Starting Out - Guidance Please
1.  The massive leaks:  I am using F&P Eson 2 Nasal Mask.  I am not aware of having my mouth open because anytime it happens air passes through my mouth and it wakes me up.  It has happened, but it isn't frequent (atleast to me consciously).  The Eson 2 seems to fit, but I do notice that I frequently get a small leak that I then adjust the mask.  I've tried tightening it more than normal and looser than normal but flipping through the history it seems fairly consistent.  I prefer to sleep on my chest, which the Eson 2 doesn't do very well so maybe that is part of the problem is getting on my side and then when falling asleep I start to turn move to get on my chest and a leak happens?  I don't know how to interpret the graphs.  

I do have the P10 that I can try.

2.  I'll address this after addressing the massive leaks.  What what "normal" or "expected" leaks look like in the graphs?
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#4
RE: Starting Out - Guidance Please
*BEST SLEEP for as long as I can remember*

On Friday night it was a totally sleepless night of flu based symptoms (no details, just use your imagination).  Laid around all day Saturday and felt a lot better than the night before.   

Saturday night used the CPAP with the ResMed AirFit P10 and a dose of Vicks Nyquil and I had the best sleep I have had in as long as I can remember.  I slept a very long time, little to no wake-up's and felt absolutely fantastic with a lot of energy all day on Sunday.

Sunday night was unfortunately not the same.  Same mask, same settings.  No Vicks Nyquil.  


See attached the two days.  The best day ever does show the lowest AHI (1.01) I've ever recorded but to me the pressure and leak rate and stuff look very similar to a mediocre sleep day (the next day at AHI 2.39).

I would absolutely LOVE to figure out how in the world I slept so well Nov 18 (Saturday to Sunday night).  See attached.


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#5
RE: Starting Out - Guidance Please
Do not worry about minor differences in AHI.

   I believe Oximetry is a better measure of therapy.

   But how did you feel? Carries a lot of weight.

    Turn your ramp to OFF, you derive no therapy from delayed start or ramp time,

     Set EPR to ON, at EPR 3 cmH2O
      Set pressure Min  to  7 cmH2O
      Set Pressure Max to 15 cmH2O
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