Coleman's Oscar Review request

[coleman3]

Hi all, I am new to CPAP, have been going for 2 weeks, one with an SD card to track. My AHI during my sleep study was 5.5, so seeing my number with treatment be higher is alarming. I understand that CA events may go down once my body gets used to the therapy.

I am using a nasal pillow mask AirFit P10, which is very comfortable for me. I was finding that my mouth was open a lot through the night and the dryness would wake me up. This night from Oscar is using mouth tape, which did help keep my mouth closed. I found quite a few times through the night that my mouth was still full of air (cheeks puffed up), as if my body wanted to open my mouth but the tape kept it shut.

I have done a lot of reading on this site and want to thank all those who offer advice and help!

https://imgur.com/a/d8L1Jef

9-10 Sleep Oscar.png (456.42 KiB) Viewed 2591 times

9-10 Sleep Oscar.png (456.42 KiB) Viewed 2591 times

[coleman3]

Here's a link to my sleepHQ if that's better for data display.

https://sleephq.com/public/teams/share_ ... 064b3f6f10

[Miss Emerita]

Welcome! You're currently doing well with leaks, so congratulations on that. And you seem to be spending the whole night with the machine, which is excellent.

For the air in your mouth, try this: Put the tip of your tongue behind your upper front teeth. Then position the main part of your tongue up against your upper palate. Finally, give a little suck or swallow to create a bit of suction. You should now be able to open your mouth while breathing entirely through your nose. Practice this during the day, and see if you can get it grooved in deeply enough to help while you are asleep at night.

What was the breakdown of your AHI in the sleep study? I'll assume you had at most a few CA events. In that case, yes, the CAs are likely to settle down with time.

Many of your events (even some of the OAs) appear to be coming during periods of arousal, either from sleep to waking or from deeper to more shallow sleep. You'll probably experience fewer arousals as you continue to get used to the machine. Did your sleep study yield an RDI number? Was there any breakdown of arousals into those related to respiration and those that were "spontaneous"?

You're not getting the full benefit of your EPR of 2 while your pressure is at 5, since the lowest the machine can go is 4. So you might try setting your minimum (and your ramp minimum) to 6.

Keep us posted, would you?

[coleman3]

Welcome! You're currently doing well with leaks, so congratulations on that. And you seem to be spending the whole night with the machine, which is excellent.

For the air in your mouth, try this: Put the tip of your tongue behind your upper front teeth. Then position the main part of your tongue up against your upper palate. Finally, give a little suck or swallow to create a bit of suction. You should now be able to open your mouth while breathing entirely through your nose. Practice this during the day, and see if you can get it grooved in deeply enough to help while you are asleep at night.

What was the breakdown of your AHI in the sleep study? I'll assume you had at most a few CA events. In that case, yes, the CAs are likely to settle down with time.

Many of your events (even some of the OAs) appear to be coming during periods of arousal, either from sleep to waking or from deeper to more shallow sleep. You'll probably experience fewer arousals as you continue to get used to the machine. Did your sleep study yield an RDI number? Was there any breakdown of arousals into those related to respiration and those that were "spontaneous"?

You're not getting the full benefit of your EPR of 2 while your pressure is at 5, since the lowest the machine can go is 4. So you might try setting your minimum (and your ramp minimum) to 6.

Keep us posted, would you?

Thank you for the reply! My AHI on my sleep study was 5.5, I can't seem to find a breakdown of CA vs OA on there. It was a watch pat one at home sleep study, so maybe that's the problem. My employment is DOT regulated so now that I am diagnosed I have to treat, so I've been forcing myself to use the machine every night.

Thanks for the tip for the mouth breathing. I used a chin strap last night and it seemed to help quite a bit, but I did swallow a lot of air and have some discomfort this morning.

I will try the pressure setting of 6, as 5 sometimes seems a little low while I'm falling asleep too.

Thanks again!

[Miss Emerita]

Look on your WatchPat report to see whether there's a line saying "AHIc." If so, that's your central apnea index.

Let us know how it goes with 6 and EPR of 2. If it goes OK, then after a few nights you might try 7 with EPR of 3. That might help reduce your flow limitations, which possibly contribute to some of your arousals.

And thanks for explaining that you need to show compliance for DOT-regulated work.

[coleman3]

It looks like the AHIc is 0 from my sleep study.

I increased my pressure to 6 including ramp, and left the EPR at 2. I still had about the same CA as before, but I think I stayed asleep more throughout the night.

I will take your suggestion and go with min pressure of 6 and EPR 2 for a few days, and then maybe bump up to 7 and 3 if it goes smoothly.

Screenshot 2025-09-13 at 10.27.41 AM.png (64.26 KiB) Viewed 2226 times

[Miss Emerita]

Good; you didn't have any CAs during the sleep test, so you will probably see those CAs go down with time.

Your RDI index is probably significant. The RDI is an index that combines apneas, hypopneas, and RERAs, which are respiratory-effort-related arousals, and divides by the hours you were asleep. So you had a lot of RERAs. This is consistent with the number of arousals we can see in your SleepHQ charts.

My advice about your settings remains the same, so please do let us know how the changes go.

[zonker]

I will take your suggestion and go with min pressure of 6 and EPR 2 for a few days, and then maybe bump up to 7 and 3 if it goes smoothly.

this is the way. patience wins the day as it takes time for your body to adjust to changes.

[coleman3]

Good; you didn't have any CAs during the sleep test, so you will probably see those CAs go down with time.

Your RDI index is probably significant. The RDI is an index that combines apneas, hypopneas, and RERAs, which are respiratory-effort-related arousals, and divides by the hours you were asleep. So you had a lot of RERAs. This is consistent with the number of arousals we can see in your SleepHQ charts.

My advice about your settings remains the same, so please do let us know how the changes go.

I think it's going better with the new settings. Saturday night I must have pulled the mask off and fell back asleep, as I only used it for less than two hours.

Last night was my best night with the CPAP yet, I slept almost all night, and my AHI was 2.85 and only a handful of CAs.

Would you still recommend waiting a few days and then bumping the pressure by 1 up to 7 and increasing EPR to 3?

Thanks again! It's encouraging to have a community to help and see some actual results.

[Miss Emerita]

I'm glad to hear things are going better! I'd wait maybe another day before making additional changes. Keep us posted!

[zonker]

Last night was my best night with the CPAP yet, I slept almost all night, and my AHI was 2.85 and only a handful of CAs.

[coleman3]

I'm glad to hear things are going better! I'd wait maybe another day before making additional changes. Keep us posted!

I had another pretty good night, AHI was 1.78!

The only real issue I had was a stuffy nose that woke me up earlier than I had planned, which cut my night sleep a little short. Currently the humidity is set to 5, and temp at 81. Should I try to change this to help with nasal congestion?

Thank you all for the help and encouragement.

[Miss Emerita]

Glad to hear good news!

Some stuffy noses want more humidity and some want less, so just experiment, I’d say. If this is a common issue, you might also want to use Flonase spray about one hour before bedtime. Be aware that it takes a week or two to kick in.

[coleman3]

Glad to hear good news!

Some stuffy noses want more humidity and some want less, so just experiment, I’d say. If this is a common issue, you might also want to use Flonase spray about one hour before bedtime. Be aware that it takes a week or two to kick in.

I will try some different humidity settings and see how that goes. I haven't been having major problems with this on a daily basis.

Even with a chin strap I have still been having issues with large leaks, and I think it's because my mouth is opening during the night. I woke up a lot of times last night to my mouth full of air or open and dried out.

If I am going to need a chin strap and mouth tape to counter this, would it be better to try a full face mask or hybrid type mask? I used better night for my sleep study, and the doctor said I could try a Resmed airfit F30i or Phillips Dreamware mask.

thanks again!

[Miss Emerita]

By all means try a full-face mask. For some people, they are just the ticket, and you won't know whether that's true of you unless you give it a try. Finding the right mask can involve some trial and error, so do experiment to find what's right for you.

If you switch to a FFM, change your mask setting on your machine. Also look at mask-fitting videos on line to get your straps adjusted right, and do a mask-check using your machine and lying in the positions that are most comfortable for you.