Three months into therapy and no change

[liamfirth]

Hello all

I was diagnosed with mild sleep apnea at the end of last year with AHI of around ~5.5 I've been consistently using the Lowenstein Prisma Smart Auto CPAP machine since then with the Philips Dreamwear nasal pillow mask, given to me by the doctor.

Despite using it consistently for three months I've not really noticed any effect -  still feel very sleepy in the daytime, needing naps, feeling distracted/"drunk" feeling on waking up etc. The sleep doctor that reviewed me was "puzzled" because I needed a much higher level of pressure than he was expecting with a mild case. Early on I raised the minimum pressure to 9 because my machine would almost always get to that level anyway and anything below that was difficult to breathe. The doctor was also unsure since I have normal BMI (under 25). Average AHI is now 3.79, so not a massive change. 

I've attached a couple of OSCAR screenshots.

[Deborah K.]

I see a couple of issues. You need to set a new pressure range: 11.4 to 17. This is because your median pressure is over 11.4, so 11.4 is a good choice. You are bumping against your high setting, so 17 is good to give you some headroom.

You are also having some Positional Apnea. PA shows up where you see Obstructives and/or Hypopneas clustered together. Your chin is dropping toward your chest, causing air flow resistance, much like a kinked hose causes water flow resistance. Some can fix this by sleeping on a flatter pillow. More need to wear a soft cervical collar that holds their chin up.

I see that your doctor prescribed a Dreamstation. The ResMed machines are much better. You can tell your doctor you want to swap for a ResMed Airsense 10 if an Apap works for you, or a ResMed AirCurve 10 Vauto if you need a bilevel machine. Many of us switched to the ResMeds and are much happier with the better machines.

Again, welcome and best wishes for great therapy and comfort!