New APAP user looking for some input

[robr]

About 3 years ago I had a sleep study done and it was recommended I get a CPAP. Someone was supposed to be sent to my house with a machine but never showed up and I ended up not following up on it. I do not have or recall any specifics of the sleep study and a lot has changed in 3 years. Jump ahead and my wife started sleeping on the couch because my snoring was so bad and she was saying I would often stop breathing. So I went and bought a DreamStnAutoCPAPHumCell DOM DSX500H11C as I didn't want my insurance monitoring my usage as I was told would need to happen and frankly I got it for a killer deal so I'd rather just buy it and figure it out myself than worry about copays and deductibles and scheduling people to come to my home to make changes, etc. I did call the sleep study place and they got me in to help select a mask. I went with a full face mask as I have bad allergies and my nose is hard to breathe through.

I've about 7 nights on CPAP at this point and have read a number of guides I found on this forum and would like to get some feedback on where I'm at. I believe these results are saying I should increase max pressure, but I feel like at a max of 16, I really don't want to go higher if I can at all help it, so not sure if there is something else going on causing the machine to go this high, or if I really should increase the max. The higher the pressure, the more often I end up with mask leaks..... I also see in the data (and do recall last night) that I had a leak which woke me up and I adjusted the mask to fix.

FYI this is not my best night, I had lower AHI other nights, less mask leaks and lower max pressure, I just grabbed the most recent data to share as I didn't want to cherry pick.

Thanks for any feedback on this data.

[Julie]

Hi - is it possible for you to get the left hand side of the graph - not the calendar, but the pie chart and esp. the results list underneath it?

[Pugsy]

Can you get me the AHI and statistics on the left side for the night you posted above?
So that everything shows up in one image?
Like this in this thread

viewtopic/t103468/Need-help-with-screen-shots.html

I would try raising the minimum first...often when the minimum is doing a better job the maximum will come down because the machine doesn't have to work so hard. Just a little more minimum.

What position are you usually sleeping in?

[robr]

Sure, I read another post on here saying not to include those, so I closed that part. Give me a moment........

[robr]

[robr]

Pugsy, I sleep on a mix of back or right side. I'd say about 25% back.

[Pugsy]

I suspect that the times you see the pressure maxed out that you are probably on your back.
It's quite common for OSA to be worse when on our backs (or during REM stage sleep) and to need more pressure. REM doesn't normally last as long as you are seeing the pressure maxed out which is why I am leaning towards supine sleeping.

Your AHI on this night isn't really all that bad and there's no urgent need to increase that maximum if you don't want to or it causes a problem.

Now if this is a fluke good night and most of your nights are with the AHI much higher...and seeing more time maxed out...I would still start with increasing the minimum pressure and if you don't want to increase the max you might not even need to.

Unless you are seeing clusters of OAs happening when the pressure is maxed out...there may not be an urgent need to let it go higher.

Why are you reluctant to increase the max?

At any rate...the minimum is what I would look at first...maybe 1 or 2 cm more and I always suggest starting small and working up with the increases because sometimes we get lucky and not need as much as we might have first thought.

[Pugsy]

I am curious though...where did you read that the stuff on the left side...the AHI and statistics was useless? Who said that?
We always need the stuff on the left side and I can't imagine how you came up with that idea.
Now sometimes I will ask for a close up on one of the graphs but that's after I have seen the usual basic stuff on the left and the graphs on the right.

[robr]

I just went and found the post where I saw it said the left side was useless and it was yours Pugsy, but perhaps that was in context of trying to help someone with a very specific problem. I was researching what vibratory snore meant when I came across it and I guess I took it out of context.
viewtopic/t103468/viewtopic.php?f=1&t=1 ... r#p1042503

My AHI is actually lower on other nights, I started with a starting pressure of 4 (once I figured out the machine was in CPAP mode and changed it to APAP) and have been making minor changes as I learn more, but I've had it on these current settings for a few days. I felt like I wanted to spend some time researching and looking at results and going as far as I thought I could before asking for a review here.

[Pugsy]

The "By Pressure" and AHI graphs (on the right side) was what I was referring to as "useless" in that thread. Someone was trying to make out like the time at pressure was critical thing to understand. It wasn't everything on the left side.
The calendar takes ups space and the pie chart also takes up space better used by the statistics.

This thread shows examples of what we normally like to see...the basics in terms of graphs on the right (events, flow rate, pressure and leak) and on the left side we need the AHI and the category breakdown and the statistics first section.
viewtopic/t103468/Need-help-with-screen-shots.html

The minimum pressure is the most critical setting. It needs to do a decent enough job holding the airway open during the night and at the same time allow the machine a good running start when it needs to go higher for whatever reason.

AHI graph on the right is just an hourly graph showing how many events within a 60 minute cycle. We don't really need it because the events graph will essentially give us the same data.

The AHI on the left side isn't the same data as the AHI graph on the right side. The AHI on the left is an overall hourly average plus we need the breakdown into each category to get an idea what all is happening...and there's some stuff that gets flagged on the events graph that isn't included in the AHI numbers.

[Pugsy]

So how are you sleeping and feeling?

[robr]

So how are you sleeping and feeling?

Hard to say... Most importantly my wife is sleeping in our bed again . I had one morning where I felt wide awake and had the energy to go to the gym before lunch. That's unheard of, so I think we're on the right track. I just need to get to bed earlier and get used to this mask.

Sent from my SM-G955U using Tapatalk

[Pugsy]

Which full face mask did you end up going with?

And yes...getting enough hours of sleep can be difficult for any number of reasons. Been battling that little tid bit lately myself.
You've only been at this for a week and actually you are doing really well for being so new to therapy.
At 2 weeks I was still tweaking pressures to get my AHI (was running close to 10) lower.
I think it took me 3 months before my brain was okay with the alien on my face and quit waking me up a dozen times a night just to say "hey dude, do you know that there is a weird alien on your face".
Let's face it...it ain't normal.
But eventually it will become the new normal ....just takes time.

[robr]

The mask is an AIRFIT F20 MED SYS - SLM

[robr]

Last night was the first night I had an issue with water in the hose. The water didn't particularly bother me, but the noise woke up both my wife and me. Time to invest in the heated hose that didn't come with the unit.