04-15-2025, 04:20 PM
Time to optimize treatment?
I'm new to APAP. I've been using a Resmed AirSense 11 Autoset machine with an Airfit F30i mask for the past three weeks. Overall I would say I can tell it is helping me in that I am not fatigued to the point of uselessness all day. I don't feel wide awake, but overly tired. At some point during the day I do hit a wall and have to lay down for a few minutes, but then get through the rest of the day the way I start it. So I'm hopeful with more time I'll be feeling even better - I have been told it might take up to a year. The real test will be after I once again try and rid myself of my Mountain Dew addiction.
I was diagnosed with moderate sleep apnea, an AHI of 24.6. And spent 108 minutes with blood oxygen levels below 90. This data came from an at home sleep study and all I received is a summary. I was "prescribed" and APAP with settings of 5-15 cmH20 and 2 cmH20 of EPR. The machine I received was also setup with autoramp, but I have since changed that to 5 minutes. Could probably turn it completely off but figure that time can be used to get into my preferred sleep position letting the mask do its thing to seal onto my face. I have been sleeping on my side more lately usually sleep in a prone position (almost never on my back.)
I did wade through a thread on pulse oximeters and did find posts from stew51 and Pierelly about using code provided by klimd on codeberg that works with the Contec CMS50f. I purchased one and use it every few nights. It is very uncomfortable; I have made a wristband to provide a bit of cushion that helps some. On occasion the download fails, I have a theory as to the sequence of events that trigger this situation. On the nights I do get get data I now see that my oxygen levels only briefly dip low (3-5 minutes.)
There have been a couple nights in which my AHI has been between 7 and 8, but most nights it is below 5; OSCAR shows a median AHI of 3.07. The predominate events I have most nights are clear airway. I have been reading the wiki on optimizing therapy and have learned that they may be treatment induced. They do seem to occur at lower pressures as well as when they are higher.
I will be meeting with my doctor in a few weeks to discuss the efficacy of my treatment. But he is just a general practitioner and I'm sure the discussion will be limited to if I'm feeling better and meeting the conformance requirements for my insurance (which I am.)
I'm wondering if I should just leave things alone or whether I should make some changes to optimize my treatment. The wiki does mention that the treatment induced CAs might resolve themselves after several more weeks as I adjust. I have also read some threads mentioning decrease the amount of EPR or turning it off completely. Also wondering if I should adjust my levels. There seems to be a consensus on the threads I've read that indicate the minimum should be 7 for an adult. As to the maximum pressure it is below 11.5 most of the time. I wonder if in part the higher pressures are due to my deviated septum and congestion in my other nostril (or my mask becoming misaligned.) I'm considering lowering the upper limit to 10 or 11.
I'm attaching five screenshots from last night's session - four of them show all the graphs for the entire night and one of them is a closeup of a cluster of CA events. Oops, just see there is a three file attachment limit: I'll just post two of them.
I was diagnosed with moderate sleep apnea, an AHI of 24.6. And spent 108 minutes with blood oxygen levels below 90. This data came from an at home sleep study and all I received is a summary. I was "prescribed" and APAP with settings of 5-15 cmH20 and 2 cmH20 of EPR. The machine I received was also setup with autoramp, but I have since changed that to 5 minutes. Could probably turn it completely off but figure that time can be used to get into my preferred sleep position letting the mask do its thing to seal onto my face. I have been sleeping on my side more lately usually sleep in a prone position (almost never on my back.)
I did wade through a thread on pulse oximeters and did find posts from stew51 and Pierelly about using code provided by klimd on codeberg that works with the Contec CMS50f. I purchased one and use it every few nights. It is very uncomfortable; I have made a wristband to provide a bit of cushion that helps some. On occasion the download fails, I have a theory as to the sequence of events that trigger this situation. On the nights I do get get data I now see that my oxygen levels only briefly dip low (3-5 minutes.)
There have been a couple nights in which my AHI has been between 7 and 8, but most nights it is below 5; OSCAR shows a median AHI of 3.07. The predominate events I have most nights are clear airway. I have been reading the wiki on optimizing therapy and have learned that they may be treatment induced. They do seem to occur at lower pressures as well as when they are higher.
I will be meeting with my doctor in a few weeks to discuss the efficacy of my treatment. But he is just a general practitioner and I'm sure the discussion will be limited to if I'm feeling better and meeting the conformance requirements for my insurance (which I am.)
I'm wondering if I should just leave things alone or whether I should make some changes to optimize my treatment. The wiki does mention that the treatment induced CAs might resolve themselves after several more weeks as I adjust. I have also read some threads mentioning decrease the amount of EPR or turning it off completely. Also wondering if I should adjust my levels. There seems to be a consensus on the threads I've read that indicate the minimum should be 7 for an adult. As to the maximum pressure it is below 11.5 most of the time. I wonder if in part the higher pressures are due to my deviated septum and congestion in my other nostril (or my mask becoming misaligned.) I'm considering lowering the upper limit to 10 or 11.
I'm attaching five screenshots from last night's session - four of them show all the graphs for the entire night and one of them is a closeup of a cluster of CA events. Oops, just see there is a three file attachment limit: I'll just post two of them.
