Newbie Seeks Help

Hi All!
Thrilled to learn that sleep apnea may be the culprit for my health problems (neuropathy, heart, fatigue). Now to get this machine working optimally!
I'm working on getting a report through sleepyhead (a little afraid of losing data on card??)...and will post if you need it. I'm thinking though my question may be straight-forward. I'd like to get to an overall reading of 1 - 2 AHI. I think I need to adjust my settings...? OR, do I just need to be patient? (I'm heading on a three month road trip in less than a week and would like to figure out as much as possible before then )
Equipment Philips Respironics DreamStation Auto CPAP Machine with AirFit P10 Mask with Headgear
Settings are set at:
- Min Pressure 4.0cmH20
- Max Pressure 20.0cmH20
- 90% Pressure - 11.0cmH20
- Device Mode - AutoCPAPwithAFlex
- Ramp - on
- Ramp Time - 30 mins
- Ramp Start Pressure - 4.0cmH20

Nightly readings:
1: 6.5 (total clear airway apneas - 16, total obstructive apneas - 23, total hypopneas - 14)
2: 2.4 (total clear airway apneas - 1, total obstructive apneas - 13, total hypopneas - 6)
3: 3.9 (total clear airway apneas - 7, total obstructive apneas - 16, total hypopneas - 10)
4; 3.6 (total clear airway apneas - 6, total obstructive apneas - 12, total hypopneas - 7)
5: 4.2 (total clear airway apneas - 6, total obstructive apneas - 20, total hypopneas - 10)
6: 2.5 (total clear airway apneas - 4, total obstructive apneas - 7, total hypopneas - 7)

Mask fit: 100% every night
Average - 8 hours of sleep

THANKS in advance!!!! What a service you're offering as a community

Welcome to the forum Kate. There is very little chance of losing data from your SD card while using Oscar or Sleepyhead. these programs simply copy the data from the card. You could in fact set the card to "write protect" if you are that concerned, however you must remember to "unprotect" it so the machine can write new files to it prior to putting it back in the machine.

You seem to be close to getting your AHI under 2 (where most of feel much better) with your current settings of 4-20. You probably just need a little more minimum pressure to prevent some of the episodes. Without seeing a chart, we cant tell what pressures the machine is running at thru out the night. You minimum pressure of 4 - 20 is the machine's default pressure. Most people don't do well with such a low minimum pressure. If you can post a chart or two, our resident experts can help you fine tune your settings.

Thanks so much for your reply and encouragement, Thumper68!
I've (successfully!) created and attached three reports thru Sleepyhead. Looking forward to any and all suggestions on fine tuning the settings!!
Very secondarily, I've noticed that there are days when my nostrils feels sensitive. I've even looked in the mirror to see if they're red or swollen. (I'm using a humidifier and pillow type mask; size small which seems best). Does one just get used to wearing the skin (picturing calluses on my nostrils )? Thinking maybe ease up on the tightness since I'm not leaking at all...?
Again, thanks so much!!!!!

Great job on the charts! You can turn off the pie chart on the left side to make the other information easier to read. In Sleepyhead go to "file, preferences, appearance", and uncheck the box beside "show event breakdown pie chart".

I would try bumping up the minimum pressure to 6 if I were you. Are comfortable making your own changes? If so you can get the clinicians manual for your machine at apnea board. Here is the link https://www.apneaboard.com. You will have to register on apnea board to be able to get the manual.

If going from 4 to 6 seems like too big of a change you can work up your minimum pressure in increments.

For your sore nose try some lanolin cream on it. A common brand is Laniosh. It is used by nursing mothers. It really helps. The cream and loosening the straps of your head gear should work good. If you get some leaks from loosening the head gear, then you know what to fix then!

I'd definitely increase your min. setting to 6 (it's still very low, just a bit easier to breathe with and a bit more effective at addressing events. And BTW that cream is Lansinoh... not whatever is in the last post.

The GOOD news is that I figured out how to change my min pressure to 6 and had no trouble adjusting. The lousy news is that I forgot to take the disk thing out of my PC so I can't generate a report. However, AHI was 3.1 last night with total clear airway apneas of 7, total obstructive apneas of 9 and total hypopneas of 4.
Wondering if I should change the ramp time as well? Ramp time is set at 30 minutes with a start pressure of 4.
Anything else? I wouldn't press it...but I'm leaving on Sunday for a long trip (and admittedly, I'm a little obsessive about perfection ) I'd still really like to get to AHI of <2. (Is that realistic?)
Muchas, muchas!

Hey, terrific!

Little secret - most stop using the ramp altogether within a very short time unless their min. pressure's very high (>10) and they can't take it.

Have a great holiday!

When first starting cpap therapy we can have some trouble falling asleep and staying asleep and when this happens we tend to toss and turn and hold our breath (small pauses in our breathing that we don't realize we are doing) but the machine can and will sense the change in the air flow (after all that is all it can sense because it doesn't know if we are asleep or awake). Often these pauses in our breathing end up with some sort of flagged event getting scored. Often a central/clear airway event gets flagged but it can also be either OA or hyponea as well.

We have to be asleep for these flagged events to matter and be worth worrying about. Wake stuff simply doesn't count.
Watch the videos here
http://freecpapadvice.com/sleepyhead-free-software
and you can get an idea what to look for in figuring out if those events you see flagged are worth worrying about.
Not long ago I had a night with the AHI being 3.6 and that's unusually high for me....so I took the time to zoom in and look at all the events. It was a nice mixture of Centrals/CAs, OAs and hyponeas. Every single flagged event was related to an arousal or awakening...not a one was real. It happened to be just a crappy night of sleep due to extra bad back pain. I remembered waking often and tossing and turning because of the back pain.

So before you start down that road of watching the numbers and striving for perfection (it can drive you crazy because you can't do anything about awake/arousal related flagged events except hope to sleep more soundly) learn to determine which events are actually worth worrying about.

Even if you have some real centrals....a few here and there is normal and no big deal and you can't do a thing about them with your machine. So don't even try...more pressure won't fixed centrals with your machine.

Ramp use is your personal choice.....use it or not but a starting pressure of 6 cm most people can handle easily without using ramp but if you find you need it to go to sleep...use it because you have to go to sleep for any of this stuff to matter. It's a comfort feature...and we need to be comfortable to be able to fall asleep.

Ramp = gone!
And thanks for the video. I'll definitely check it out. And give myself some time to see the trends before I mess with settings too much.

Hopeful Kate wrote: ↑

Thu May 30, 2019 7:46 am

Ramp = gone!
And thanks for the video. I'll definitely check it out. And give myself some time to see the trends before I mess with settings too much.

good work! when you get the chance, could you go to your profile and fill out your equipment? that way, it'll show up at the bottom of each of your post, as it does on mine.

thank you.

Doing much better with my numbers since changing from min pressure of 4 to 6 and eliminating ramp up. Question: got even better after leaving on a trip to ALASKA (averaging 1.83 now vs. 2.90 AHI). Everything changed when I started using my APAP without the humidifier (because I need to use a battery when we're off the grid). Is that a clue about how I should reset my heated humidifier when I start using it again? (Can't attach reports cuz I'm on the road )

Hopeful Kate wrote: ↑

Wed Jun 05, 2019 6:33 am

Doing much better with my numbers since changing from min pressure of 4 to 6 and eliminating ramp up. Question: got even better after leaving on a trip to ALASKA (averaging 1.83 now vs. 2.90 AHI). Everything changed when I started using my APAP without the humidifier (because I need to use a battery when we're off the grid). Is that a clue about how I should reset my heated humidifier when I start using it again? (Can't attach reports cuz I'm on the road )

thanks for filling in your equipment, makes it handier for commenters.

could be a coincidence regarding lower ahi in alaska. though, tbh, i've often had lower ahi away from home. better ahi, but worse sleep. so maybe i'm not the best example!

humidity is a tricky thing. what's good for me isn't necessarily good for thee. but i see no harm in trying the experiment when you get back home.

meanwhile, sounds like you are progressing nicely!