first night results: not too bad, not perfect

[Shnoozer]

As far as your therapy goes, your machine can compensate for leaks up to 24 and probably up to 30. So from that perspective, your leaks are OK. The question is whether the leaks are messing with your sleep.

It's clear you slept through some of the leaking, and it's equally clear that at several points during the night, leaks and wake-ups were correlated. It's hard to tell which caused which, though. So keep experimenting -- with different masks, different strap adjustments, different ways of keeping your mouth closed.

If you have a strong preference for a minimum pressure of 5, that's OK, but it does look like your flow limitations were better when your minimum was 6 and you could get the full benefit all night from your EPR of 2. I don't know whether any of the FLs disturb your sleep, but it's possible that they do.

I'm still a little unclear about how to interpret the Flow Limitation, actually. Does it simply represent resistance to breathing as detected by the machine? So, that could be obstruction, a kinked hose, partial obstruction, etc?

[Miss Emerita]

Flow limitations are limitations of the flow of air within your airway. If they originate in your nose, there's not much PAP can do for them; the nasal structures are too rigid. But if they originate further down, in your pharynx, EPR can help to stent sagging soft tissues so that the airway remains fully open.

The ResMed machines identify the shapes of the inhalation traces in the flow rate. Trace that are flattened on the top, or very dented, will usually get flagged.

[Shnoozer]

If you have a strong preference for a minimum pressure of 5, that's OK, but it does look like your flow limitations were better when your minimum was 6 and you could get the full benefit all night from your EPR of 2. I don't know whether any of the FLs disturb your sleep, but it's possible that they do.

Last night I put the min pressure on 6.
I reduced the humidity level to 1.
I lowered the hose temp to 72.
I tightened the mask very slightly.

The results were - definitely less leaking. The lower humidity and hose temp might be better for me, I am less congested this morning then on other days. And low AHI. I'm still learning to read the graphs but it's looking pretty good:

https://sleephq.com/public/teams/share_ ... /dashboard

I'm wondering if I don't really need the humidity at all - we shall see.

The only issue today is that my nose is very slightly feeling like it's been under pressure all night, a bit of a squeezed-up feeling. I'm trying a cushion mask instead of pillows tonight so experimentation continues.

[Miss Emerita]

Excellent! Yes, continue to experiment with masks, mask fit, humidity -- whatever is going to make you feel comfortable at night and rested during the day. Your numbers are so good that you can use your subjective sense of these things as your main criterion when you assess changes.

Keep us posted!