New BiPAP User - hello & help wanted!

Hi everyone!

I was diagnosed with Sleep Apnea (AHI 35.3, which was very surprising) a few months ago via a ResMed ApneaLink Air Type III at-home device. BUT I slept rough when I used the testing device and it only recorded for 5 hours and 30 minutes (and I am sure most of those hours were not sleeping since it was a rough night). But, they did consider it a valid report so my Dr. wrote an RX for a CPAP machine.

I got a ResMed AirSense 10 Auto CPAP machine, but couldn't really adjust to it. The exhale pressure (even with EPR at the max) was too much for me, and I would wake up gasping or feel like I was suffocating. I spoke with my Dr. and he agreed to write an RX for a BiPAP machine, and I now have the ResMed AirCurve 10 VAuto.

The dual level pressure of the BiPAP has made a all of the difference! I am able to use the machine comfortably and have been doing so for the past month!! I use a ResMed AirFit N30i mask and like the way it feels. I'm sized right in between S and M cushions, so I sometimes swap them on certain nights, but I think Medium might be a little more comfortable.

The reason for my post (besides saying hello and thanking you all for the great info to get me to this point!) is that I want to make sure everything is going well and my machine is dialed in.

Can someone help guide me on what I need to post for you to help me (I set up OSCAR and have my last month imported) and after I post my info, please let me know if everything is optimal or if I should tweak items?

3 concerns I have:

1) Is a higher or lower PS (Pressure Support) setting better? My RX for PS is 6, but I have been tweaking and adjusting that number and it seems like a lower number works better for my compliance, but I want to make sure that lower number isn't bad for my apnea. If a higher number is better, I can try to persist and adjust to it. But i want to know how much this number matters based on my reports.
2) Can you guys look at my report after I post it and see if I am mouth breathing? I *believe* I am, but I want to see if there is evidence from my reports to say I am or I am not? For example, last night the AHI was super low but I feel like I might have been mouth breathing. However, the leak value was very low, but I have no idea how to interpret the data.
3) Is there anything in my reports to indicate that I need to change some other settings like Ti or the auto detection sensitivity levels?

Thanks in advance! Being able to fix a life-altering problem with technology is very cool to me and having a community of experts who want to help each other is even cooler.

See that first post on the first page, where it says "NEWBIES, READ THIS BEFORE POSTING"?

Go read it, do what it says.

palerider wrote: ↑

Mon Sep 02, 2019 1:04 am

See that first post on the first page, where it says "NEWBIES, READ THIS BEFORE POSTING"?

Go read it, do what it says.

At least I got the username right! haha - OK, I updated my profile. I have OSCAR installed and everything is imported, ready to go.

What screenshots do you want to see to see how things look? My main questions and concerns are in my post above, but I'm happy to answer any question you have. I'm especially interested in what Pugsy has to say! Thanks!!

I'll attach a screenshot now, but let me know what else you want to see. One weird thing is the first 26 days my AHI would vary between 5 and 2 and the past 2 days it has been below 1. That seems strange to me. I did adjust the PS setting every now and then, but if this is simply good news and everything is good, then I'm done!

Good job on the chart! If you post again, the one change to make is to move the mask pressure down out of sight and move the flow limitations chart up.

Your EPR of 3 is essentially what you had available on you first machine. But in any event you now have a machine that has more capability, which is never a bad thing.

Your numbers are excellent, and it’s possible you’ll have fewer CAs as time goes by. But that’s nothing to worry about. I’m not an expert, but if I had results like this, I’d leave the settings alone.

I do think you had some mouth leaks, especially starting at around 4:30. Do you think they woke you up?

I wouldn't change a thing in terms of settings.

Actually a higher PS isn't always a good thing....keep it around 3 or 4 whatever feels good to you. Higher PS is used more for when people have ventilation issues and not so much for obstructive apnea prevention. It's actually that minimum EPAP that is your most critical setting in terms of OSA prevention and not PS or IPAP so much.

If you are mouth leaking/breathing...it sure isn't enough to show up as much of a large leak or large enough for the machine to have trouble compensating for it.
If you aren't waking up with leaks...don't worry about them. If you do have a large leak from mouth breathing or whatever...the machine will flag it.

Thanks, Miss Emerita and Pusgy! Here is last night's screenshot with the columns the way Miss Emerita asked for.

I have also attached 2 other shots from past nights where I had a PS of 3 where the AHI was a bit higher and the PS being at 5 which made the AHI the highest.

I really want to make sure this data is valid and either leaks or mouth breathing isn't causing anything wrong. How many other nights would you like to see where my AHI was higher? I would like to give you all the data you need to make a reasonable guess.

Thank you again!!!

For some people when PS is a bit higher it can actually trigger central apneas (those CAs you see flagged so much and causing the higher AHI).
It varies where the line in the sand it where centrals can pop up when using PS...look like for sure 5 might do it a little bit for you.
For sure I wouldn't go any higher with the PS if I were you and there's no urgent need to do so anyway.

I have a friend who gets 17 to 20 centrals per hour with PS of 4....and essentially none with PS of 3....go figure but sometimes it works out that way. You might do better with 3 like her or you might tolerate 4 well enough.

Having PS cause centrals....not extremely common at all but it can happen.

I stand by my first comment.....if that was my report I don't know that I would go changing anything and if I did it would maybe be try PS of 4 and see how I liked it and watch for centrals popping up.
A few random centrals....normal and no big deal but you don't want to see them consistently all night long and you know you were asleep and can't blame them on false positive awake flagging.

Apneanewbie wrote: ↑

Mon Sep 02, 2019 8:53 am

palerider wrote: ↑

Mon Sep 02, 2019 1:04 am

See that first post on the first page, where it says "NEWBIES, READ THIS BEFORE POSTING"?

Go read it, do what it says.

At least I got the username right! haha - OK, I updated my profile. I have OSCAR installed and everything is imported, ready to go.

What screenshots do you want to see to see how things look? My main questions and concerns are in my post above, but I'm happy to answer any question you have. I'm especially interested in what Pugsy has to say! Thanks!!

I'll attach a screenshot now, but let me know what else you want to see.

You know, the answer to "what do we want to see IS IN THAT POST.

palerider wrote: ↑

Mon Sep 02, 2019 12:01 pm

Apneanewbie wrote: ↑

Mon Sep 02, 2019 8:53 am

palerider wrote: ↑

Mon Sep 02, 2019 1:04 am

See that first post on the first page, where it says "NEWBIES, READ THIS BEFORE POSTING"?

Go read it, do what it says.

At least I got the username right! haha - OK, I updated my profile. I have OSCAR installed and everything is imported, ready to go.

What screenshots do you want to see to see how things look? My main questions and concerns are in my post above, but I'm happy to answer any question you have. I'm especially interested in what Pugsy has to say! Thanks!!

I'll attach a screenshot now, but let me know what else you want to see.

You know, the answer to "what do we want to see IS IN THAT POST.

Right, and then I posted screenshots and somehow everyone else was helpful and kind, yet you still want to talk about rules rather than being kind or helpful. Got it.

Apneanewbie wrote: ↑

Mon Sep 02, 2019 2:22 pm

palerider wrote: ↑

Mon Sep 02, 2019 12:01 pm

Apneanewbie wrote: ↑

Mon Sep 02, 2019 8:53 am

palerider wrote: ↑

Mon Sep 02, 2019 1:04 am

See that first post on the first page, where it says "NEWBIES, READ THIS BEFORE POSTING"?

Go read it, do what it says.

At least I got the username right! haha - OK, I updated my profile. I have OSCAR installed and everything is imported, ready to go.

What screenshots do you want to see to see how things look? My main questions and concerns are in my post above, but I'm happy to answer any question you have. I'm especially interested in what Pugsy has to say! Thanks!!

I'll attach a screenshot now, but let me know what else you want to see.

You know, the answer to "what do we want to see IS IN THAT POST.

Right, and then I posted screenshots and somehow everyone else was helpful and kind, yet you still want to talk about rules rather than being kind or helpful. Got it.

Because you *still* didn't give us what was asked for.

It's not a "rule", but if you don't give the data that's asked for, it is often a waste of everyone's time, yours included.

You asked "what else you want to see",but that is *already answered* in that first post... If only people would *read and follow it*

Forum members have a right to request that report images be in a format that suits their needs to be able to offer ideas.
Different forum members have different ideas on what format makes them happiest or what they like to work with.

I could see enough to offer my opinion. I don't need the snore graph...it's going to not show much and I can tell that by the statistics for snores....or the 0.0 which means lack of snores.

I am not going to have this thread get derailed by name calling and I am going to remove said name calling when I see it.
No warnings....just the facts.
And yes...one such name calling event just got removed. I am sick and tired of it.

Palerider simply stated how he prefers to see the reports...he wasn't ugly or hateful. He has a right to prefer report images suit his needs.
Yes, blunt and to the point but blunt and to the point is the way a lot of people are here on this forum. Nothing wrong with it.

I thought that the forum's owners believed in free expression. Thanks for the PM Pugsy.

bombayone wrote: ↑

Mon Sep 02, 2019 3:57 pm

I thought that the forum's owners believed in free expression. Thanks for the PM Pugsy.

Not when that "free expression" cuts into someone else's rights. Harassment is not allowed. Name calling is not allowed. Stalking is not allowed.

Your comment helped no one...it was done just to do nothing but to incite...which of course is what you wanted to do but it's not going to be allowed anymore.

No one died and made you moderator...and you don't get to decide who gets to be called names or gets their hands slapped just because you don't like the tone.

Knock it off.

Everyone....back on topic...further off topic stuff like this....will be removed without warning.

Apneanewbie, I just want to be sure we don’t lose the question whether you think your leaks might be waking you up.