Fairly new user wondering what to try next?

Hello

I am fairly new to CPAP, have been using about 16months. My study showed 52 OA, zero CAs. I now have an Airsense 11 and with input from people here a year ago
I learned I have positional apnea, so by side sleeping I rarely have any OAs. Most of my events are CAs. I have no idea if they are real or are mostly occurring when I'm awake as I suspect.

I found by having min pressure, close to 12 it holds off any OAs and when I ran with NO EPR, I always had the best results usually less than 1.0 but a fairly high leak rate
of 25-30. I never had much luck with EPR as when I tried it (at various levels) my CAs increased significantly and scared me off.

Of late I have been using EPR figuring the pressure reduction would help with leaks, I'd be less inclined to open my mouth and that does seem to be the case.

Yes I have tried mouth taping, but really don't like it. and I get pretty good results with a Resmed F30, but my preferred mask remains the N30, no mouth tape.

Fairly typical results are attached. If I increase EPR to 3, leaks will go down but CAs will further increase. If I go the other way, reduce or eliminate EPR,
leaks increase but CAs will reduce with AHI 0.5 to 0.9 often, but a leak rate above 24L more often than not.

Any suggestions?

don't have an answer for you, i'm merely replying so your post gets a bump.

good luck!

Thank you for the bump.

I snugged up my mask more than typical last eve, so leaks were down to 14L, but CAs resulted in a 2.2AHI, (OAs were still 0.0) my worst result in a long time.
So tonight I am dropping EPR to 1 and will see if the snug mask/EPR combo helps with leaks. Anytime I have turned EPR ON my CAs go up significantly. I have only recently tried EPR for the purposes of hopefully reducing any tendency to mouth leak. That does seem to work at the expense of increasing CAs.

I really don't want to use tape or a FFM although I have tried both with good results. I did have a period 6 months or so ago where with the N30 mask, and NO EPR
my AHI was typically 0.4 to 0.8 virtually every night. But then that increased with extremely dry mouth, large leaks etc from what I gather was mouth leaks for reasons unknown.. I still rarely ever go above 2.0 AHI, usually 0.9 to 1.5 most nights though. Just trying to fine tune and not quite sure if the CAs are of concern or always real.

Any insights, or suggestions appreciated.

Bob H.

1. Don't worry about the CAs. They probably happen when you are awake. In which case, they are harmless. You do NOT have central apnea.

2. Don't worry about the leaks unless they are above 40 lpm for lengthy periods. Are they awakening you?

3. 24 lpm leak might be the "official" standard, but wise Pugsy uses 35 lpm as getting near the limit where the treatment might not be effective.

4. Quit overtightening your mask. Find your mask model on youtube for instructions on how tight/loose it should be adjusted.

5. How well do you think you are sleeping? If you look back at the end of the day, have you been energetic without excess sleepiness?

6. Look at your OSCAR charts from time to time. But think more about how you feel. The goal is to feel good, not have great stats.

+1 to each comment ChicagoGranny made.

Thanks so much for the input. I do get my best results and feel better when I keep EPR OFF. AHI is more often than not, less the 1.0 with leak using the N30
at 25-30L, rarely above 30L. So I will just run with that. I did see some posts with regards to CAs being erroneously recorded hence my posting.

My OAs are virtually 0.0 everyday at the pressure range I use, but if I lower it to maybe reduce leak they start to creep in. I was only diagnosed with OA, not CA.

Its been about a month now using EPR as an experiment, but I have it back off for tonight.

Thanks again.