Autoset vs Vauto

[Ken Kong]

YAY! Finally!

[Pugsy]

Now...what are your questions?

Did you sleep on your back the last half of the night above?

[Ken Kong]

I just have to say, Palerider you are rude! Don't bother posting in my thread anymore, I don't want any help from you. I don't recall specifically asking you for anything, so just pipe down and stay out of my thread if you are going to be a condescending little pr_ck. Were you an expert the very first time you opened Oscar? I doubt it.

[Ken Kong]

Hi Pugsy, I always start off on my side and usually wake up on my back so I would assume so. The main thing I was wondering is if my settings are optimal? My Rx is 4/20 and someone earlier in this thread said my settings were probably not optimal. I do have a vauto (spare machine) that goes up to 25 max pressure (Airsense only goes to 20, but I'll bet you already knew that). Honestly, I sleep well with the machine right now, but I am always looking to do better if I can. I mean if i can switch up some settings to get a lower AHI, etc I would definitely do it. Thanks!

[palerider]

I just have to say, Palerider you are rude! Don't bother posting in my thread anymore, I don't want any help from you. I don't recall specifically asking you for anything, so just pipe down and stay out of my thread if you are going to be a condescending little pr_ck
. Were you an expert the very first time you opened Oscar? I doubt it.

Speaking as a member of the Oscar development team... yes, I probably was an expert the first time I opened it.

That aside, I *am* able to follow multiple "how to" pages.

But, if you don't want my help in the future, I certainly won't offer any more of it.

[Pugsy]

Your snores and FL graphs show a little activity...compare yours to mine on the report I posted above and you can see what I mean.
It's fairly constant through the night. They are warning signs that the airway is trying to collapse and grow up to be full grown OAs or hyponeas. They don't seem to finally grow up though until you are on your back...that second half of the night. This is quite common though....to need even more pressure when we are on our backs sometimes. It is also common to need more pressure when in REM stage sleep and the second half of the night is also when we are more apt to have more REM.
So maybe your OSA is worse on your back and possibly also during REM.

Your settings show 5 minimum with EPR of 3 and it looks like once you get to sleep your pressure goes up and stays up around 11 ish for IPAP and that makes 8 ish for EPAP (EPR of 3 drops your exhale down 3 cm).

Are you experiencing much nasal congestion that might be impacting that FL graph? A stuffy nose will also cause increased activity on the FL graph.
While more pressure will usually help reduce FLs in the airway...not so much when it's caused by nasal congestion in the nose itself.

So how to reduce that AHI that is mainly from the second half of the night when we assume you were on your back?
Either more minimum or stay off your back (easier said than done). Probably substantially more minimum than what you are using now since once you go to sleep the machine pretty much establishes its own new minimum during the night and doesn't really go back down to 5.

Since you are reporting sleeping well and I assume feeling decent (since I didn't hear that complaint) and only questioned the AHI itself...probably not an urgent thing to increase that minimum but if you are seeing this sort of report often then it is something that I wouldn't personally be happy seeing at least that second half of the night. A nice low AHI isn't the end all goal IMHO....feeling good and sleeping good has always been my primary goal and not just the AHI. Heck one of my best days in terms of how I felt followed a night with the AHI of 10.2. Go figure that one. If I could have felt that way every day I would gladly have been happy with the AHI of 10.2.

I don't know why your machine isn't being more aggressive that second half of the night. That bugs me a bit because your machine normally would go up even more trying to kill those FLs and snores and the OAs wouldn't happen. It's already up at a higher minimum and it isn't limited by a lower maximum. So there is some reason it isn't increasing enough and we don't really have any way to know what is going on. All I know to offer is try an even higher minimum than what the machine is doing now but that means using substantially higher minimum all night and that may not be very comfortable. It might impact your sleep quality and even cause aerophagia issues.

So....is the report above something you see often or just randomly?
From the big overview graphs it appears that you do have an occasional low AHI night but most of the time you are running with a 3 to 4 AHI and about 2/3 to 3/4 of the AHI is Obstructive in nature. We ignore the CAs/centrals when they are so low.
I would bet money the lower AHI nights you stayed on your side more.

Now back to the AutoSet vs the VAuto thing.....technically you probably don't actually need the VAuto in terms of pressure needs...your AutoSet isn't wanting to go to the max of 20 so you sure don't need 25 but if you decide you want to try to be more aggressively prevent whatever is going on when you are on your back...that VAuto might be more comfortable to use because it will allow more than 3 cm drop during exhale and it's the amount of drop that offers more comfort when dealing with higher pressures. The timing is also just a bit different for that inhale/exhale thing with the VAuto.
I have both an AutoSet and a VAuto...just got the VAuto a couple of weeks ago. I didn't technically need it either but I have used bilevel in the past and discovered that I just like the exhale relief timing thing a little better. I got it in hopes of it working a miracle in terms of my own sleep quality. Fixing a problem that it really wasn't designed to fix kind of miracle. Hey, a girl can wish. I knew it was a stretch but since I already knew that I really liked the way bilevel felt...I wanted to at least give it a try.

What do you want to do? Try to stay off your back more? Be more aggressive with the pressures and sleep in any position you want?
Just ignore things and be happy sleeping well and feeling decent and having a little higher than you might want AHI during the second half of the night?