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First time poster here. I was diagnosed with OSA with AHI of ~35 about a year ago. Started using a Resmed Airsense 10 Autoset with an F40 mask and symptoms have improved considerably. I started wearing a Garmin watch and I noticed my lowest recorded SpO2 tends to be around 80%, sometimes as low as 70% despite AHI always being 1 or less now. I know the SpO2 sensors on these watches aren't very accurate, but the fact it is consistently low leads me to believe I am in fact having some degree of oxygenation issues at night. I do still have residual sleep apnea symptoms - daytime drowsiness, memory issues, etc. on most days. I plugged some of my data into chatgpt and it seems to think I may have some hypoventilation issues. I have begun to start playing around with my settings again - my settings over the last year have been min pressure of 11 with EPR of 2. I recently switched the EPR to 3 and the next day my SpO2 was at 89% (I know only 1 data point but seems promising). I tried the following night switching the pressure to 12 with EPR of 3 and I sadly did not get the SpO2 data from my watch. I'm attaching screenshots of my OSCAR data from the min 12 pressure with EPR of 3 for review to see what you guys think I should do. I want to really dial in my settings and make sure I'm getting the most out of my therapy. Any help would be much appreciated!
Welcome to the forum,
Can you post a copy of your sleep report with your personal info redacted?
We only need the 1st char you posted without the snore chart, just these charts.
1.Events
2.Flow rate
3.Pressure
4.Leak rate
5.Flow limitations
Since EPR is already at 3, you may need to raise your minimum pressure and see if that helps.
Try 13.cm for minimum, since that is your medium pressure, you are at that for half the night.
Raise your ramp pressure to 12, if you can and set the ramp time to 5 or ten minutes, not auto.
What do you mean be sleep report, the statistics page? Also, last night I bumped the pressure up to 13 while keeping the EPR at 3. I will post those results when I get home this evening.
You said that "I was diagnosed with OSA with AHI of ~35 about a year ago." There is a report that shows this info and other data. You need a copy of this for your records, if you don't have a copy, request it and post a copy with your info redacted.
Try 13.cm for minimum, since that is your medium pressure, you are at that for half the night. Raise your ramp pressure to 12, if you can and set the ramp time to 5 or ten minutes, not auto.
Your flow limitations, airway restricted breaths, are still high, this can lead to your daytime sleepiness issues. These machines are really terrible at scoring flow limitations, so there might be more of them.
If you want to zoom-in and scroll around your Flow Rate chart and see if your breaths are flattened or squiggly or misshapen in any other way. You can post 3 minutes screen-shots of anything you have a question about. This is a good article about the daytime sleepiness caused by flow limitations.
I will try the ramp changes you mentioned above tonight, however, here is the data from last night using 13 as the minimum pressure. I also included a few examples of my flow rate chart at 3 minute intervals. These do not look normal to my untrained eye. Anecdotally I actually felt a lot worse today but I don't know if that's the change in pressure or just a bad night of sleep due to other reasons.
You had a few sessions of gentle breathing around 3:30, 4:45. and 7:40. The rest of the night was full of large breaths, which might indicate PLMS, do you move your legs as you sleep?
It is ok to have rough breathing when we dream during REM sleep, but the rest of the night's goal is the gentle breathing.
The 1st zoomed in chart is ok even though it looks strange. I have that type of breathing a lot during the night. The tail, after exhaling, is still under the red "zero" line and the tops of the breaths are nice and round.
The 2nd zoomed in chart has more flow limitations where the tops of the breaths are flattened and there is quite a bit of squiggliness. That is the issue that if it occurs throughout the night, you could be drowsy the next day. https://pubmed.ncbi.nlm.nih.gov/38530665/
We use EPR to deal with flow limitations but these machines have a max EPR of 3.
The 2nd way is to slowly increase the minimum pressure and to make the range of pressures tighter then.
In that case would a BiPAP be more appropriate? As far as moving my legs during my sleep I have no idea, not sure how I could figure that one out unless I setup a camera or something. I read the article you posted and I definitely don't have RLS, and the only meds I take are Flonase and Esomeprazole (Nexium), which looks like neither are considered an antihistamine. I just got a trial of SleepHQ and can share the link to my data if that would help any.
A bilevel machine is almost always a great choice, but getting your doctor to provide a script for one could be tough. I bought a slightly used one and have had success with it as a test. In a couple of months I will present my data and hope to get a script for a new bilevel.
