First Time to cpaptalk and questions on some readings

[xathras1982]

Hi All,

My name is Wayne, I live in Chicago and been a CPAP user for approximately 8 years. Never knew I needed CPAP treatment until I moved in with my now wife, who said I was snoring but more importantly stopped breathing in my sleep. I was diagnosed with severe OSA and averaged around 60 events per hour.

I've been using the same device since diagnosed and my doctor said I can replace my current one if needed. Not had any issues with it, noises etc. However, last few weeks I'd been struggling a bit. This lead me to the sit, reading the guides to understand some of the metrics, etc. and wanted to ask some questions.

Here is some background on my equipment:

My device: Philips Respironics System One (60 Series) RemStar Auto with A-Flex
Setting: Fixed at 9
Mask: Resmed Mirage Quatrro Full Face Mask
Note: I use a full face mask as during my sleep study they found i was breathing from my mouth and struggled to use nasal equipment

I have got OSCAR and attached PDF reports for your benefit. My AHI looks good less than 1 event (GREAT). My leaks don't look too bad but did replace the full head gear, mask and cussions as i noticed some leaking around January time frame. But one thing I did notice is my snoring seems a lot more than lets say 3-6 months ago and also compared to last year. I've also noticed may 1-2 times waking up per day (quick to back to sleep) and think its likely the snoring causing it.

I am wondering the following:

• Is it time to replace my device. Its been going since 2012?
  Maybe I need to get a chin strap. One of the things I saw in some posts here since I am mouth breather. If so, any recommendations?
  Could it be that I need to increase the range of pressures? I see in one of the posts someone mentions that pressure maybe treating events good enough but not the snoring.

NOTE: gaps you see of treatment are when I business travel and use my travel CPAP machine

Appreciate to hear peoples thoughts.

All best,
Wayne

[Pugsy]

Could you please redo your report images but do them in the format explained here
viewtopic/t158560/How-to-post-images-for-review.html

You are missing some information that would be helpful in answering your questions with more than a guess.

[xathras1982]

Please find attached as per request. Thanks for the links. Took a little bit of time to find these on Linux

[Pugsy]

Please go to the events flags and turn on everything you turned off if you post reports again make sure they are turned on and showing.
Don't have anything on the events graph turned off...change from red to green.

Why are you using 9 cm minimum and maximum? Any special reason?

All the items you removed from the events graph pretty much pertains to obstructive in nature apneas....your pressure settings aren't doing a good job preventing the airway from trying to collapse. These items aren't included in the AHI but they are all very important because they are the early warning signs that the airway is trying to collapse.

If it were my report I would keep auto mode...9 minimum but open the max up to 20 and see where it wants to go and see if it could prevent all those snores, RERAs, FLs, etc.

[xathras1982]

Hi again,

Thanks for quick responses.

Why the setting fixed @ 9cm? That is what my physian had it set to and has been like that always. I just saw the youtube on how to change the pressure so will set to Auto and set minimum 9 and maximum 20 tonight and test out for a few days.

Regarding graphs:
I am not sure how to set the events to green (unless you mean set them all to green color and ignoring the default colors it picks?). I was able to re-enable them. Sorry for confusion there. I set them to match the link provided and didn't realize i was doing more harm by doing that.

Attached is updated without green. I am using software on linux. If there is somewhere obvious I am missing to enable as green vs red let me know.

[xathras1982]

Just in case thats what you mean't. I changed all colors to green that said were displaying on overview. See below

[Pugsy]

Look down in lower right corner below the graphs for "Event Flags"....click on the little arrow to expand the menu...make sure that all the items that show up on the Events graph at the top are green...if you click on them they turn red or green depending on what it was before.
Red means it is turned off or hidden.....green means it shows up.
The area you posted above....I leave all that to the default settings. What I was referring to that needed to be green was the Event flags from the lower right corner.

A few snores or FLs or RERAs isn't that big of a deal as long as someone is sleeping decently and feeling decent during the day.
Your snores are way more than a few and the FLs and RERAs are more numerous than I would want to see.

So while the AHI is low...there's a lot of stuff going on that might impact sleep quality and points to sub optimal treatment.
Very close though...just a minor little tweak to clean things up a bit.
The machine will very likely want to increase the pressure a bit to better prevent the snores and FLs. The RERAs are a symptom of maybe arousals from those snores and FLs. You may or may not remember those arousals.

[Miss Emerita]

Hello, Wayne. Yes, I think it is time for a new machine. You can keep this one as a back-up machine. I think many people here would recommend that you request a ResMed Airsense 10 Autoset (every word counts), which may be more nimble than another PR machine in addressing your flow limitations, RERAs, and snores. If you get the "For Her" version, so much the better; it just has an additional option for your settings.

[xathras1982]

Thanks @pugsy.. All my event flags were enabled - nothing was disabled

I'll give tonight a go and see what happens.

[Pugsy]

Oh...I forgot...if allowing the machine to try to kill the snores doesn't cause the machine to increase the pressure and reduce the snores...definitely time for a new machine. Sometimes the sensor fails before the motor fails.

It's hard to say right now because the machine set set for fixed pressures and we don't know if the snores are because the machine couldn't increase or it simply won't increase due to getting old.

[xathras1982]

Hello, Wayne. Yes, I think it is time for a new machine. You can keep this one as a back-up machine. I think many people here would recommend that you request a ResMed Airsense 10 Autoset (every word counts), which may be more nimble than another PR machine in addressing your flow limitations, RERAs, and snores. If you get the "For Her" version, so much the better; it just has an additional option for your settings.

Miss Emerita, thanks. Why would you recommend this one? Also, why the her version why is it so much better?

[Miss Emerita]

The "For Her" does everything the not-For-Her version does, but it has an additional mode that will respond more quickly to flow limitations and hypopneas. If you don't like that mode, you don't have to use it.

I recommend the Airsense 10 Autoset because, as I mentioned, its algorithms make it more responsive to flow limitations and hypopneas -- and just generally quicker to respond to all types of events -- than PR machines. Some people who switch from a PR machine to a ResMed machine find that they can lower their pressure settings a bit for this reason.

Another reason is that many people find the ResMed machines follow their breathing more naturally than the PR machines. Again, its a difference in the algorithms they use. Because you are used to your PR machine, this factor may not be as important for you.

A final reason is that the ResMed machines have a better set of options for lowering your pressure when you exhale, which makes for greater comfort for many people. Again, you are apparently doing fine with what the PR machine offers, so that may not matter as much for you.

Hope this helps.

[zonker]

The "For Her" does everything the not-For-Her version does, but it has an additional mode that will respond more quickly to flow limitations and hypopneas. If you don't like that mode, you don't have to use it.

+1

i like the way you put that. "not-For-Her".

[xathras1982]

So, I set the pressure to 20 as mentioned. Around 10:30-11pm I eventually stopped treatment and reset it down to maximum of 14.

Here is my chart. Whilst the AHI went up - you'll see majority of that was actually when I was waking up and just lying in bed and fight on whether to get up or not. I felt like I slept better. I noticed snoring is down - but still there.

I noticed leaks went up quite a bit with the 20cm pressure setting. I have the quattro full face mask, I did recently purchase a F30 so will give that a try tonight. I also purchased a chip strap and will arrive in a few days - i bought that after seeing some recommendations on here for mouth breathers.

[xathras1982]

I also just bought the CPAP machine AirSense™ 10 AutoSet™ For Her CPAP Machine with HumidAir™ Heated Humidifier. Fingers crossed