Need Help with F&P SensAwake Setting - Sleep apnea good some nights, bad others

I was diagnosed with moderate sleep apnea in 2020 and have been using a CPAP since. My AHI is low (<1 every night) and my large leak rate is low (<0.2% every night).

Some days I feel great. No sleep apnea symptoms.

But on other days I feel poor. Brain fog, headaches, etc. It's a lesser version of the symptoms I had before I started CPAP.

I compared multiple days of my data and couldn't find any differences between good vs bad nights in the statistics like AHI and leak rate.

The flow and leak rate charts have all sorts of irregularities when I zoom in but I don't know how to interpret it properly.

I'm using a Fisher & Paykel SleepStyle with a ResMed P30i. I wear a chin strap and tape my mouth to prevent leaks.

If I had to guess what my problem is, it would be either that I'm sensitive to slight leaks, or I'm experiencing sleep apnea events that are not flagged as events in the data.

I've included SleepHQ links/OSCAR screenshots for one bad night and one good night.

SleepHQ dashboard from a bad night: https://sleephq.com/public/a7f58ace-ef3 ... 54cfcfe626

OSCAR screenshot of bad night:



SleepHQ dashboard from a good night: https://sleephq.com/public/62fa11dd-207 ... 9bc52bb3a3

OSCAR screenshot of good night.



No clue where to go from here.

Found a video where someone has a similar issue: https://www.youtube.com/watch?v=pCqyc4aWnuk

It seems like my machine underreports AHI events.

Going to increase my min pressure from 9.5 to 13 cmH2O and see what happens.

I'd recommend increasing your minimum gradually; that's a pretty big jump up for someone whose pressure seems to be a steady 9. I also don't quite get the rationale for doing that, but you can't hurt yourself by experimenting.

I'm puzzled why your pressure is always 9. You've set the minimum at 9.5, for one thing; for another, your pressure didn't budge even when you had OAs. I'm not really familiar with your machine, so maybe someone who is can explain what's going on.

I'd suggest you make a note of some other sleep variables every day. Your bad and good days may have nothing to do with the machine or with your breathing. Try keeping track of variables like this: pain; the times you go to bed and get up; disturbances from noise, temperature, pet, bed-mate, light; consumption of caffeine, food or alcohol within six hours of bedtime; amount of time spent outdoors the previous day; amount of exercise the previous day.

You might look on Amazon for a recording pulse oximeter. You can get a decent one for around $30. I found that helpful when my sleep was not so great--the numbers on my machine looked OK, but I was having some desaturations into the 80's. Bumping up the pressure helped.

Miss Emerita wrote: ↑

Thu Dec 28, 2023 12:36 pm

I'm puzzled why your pressure is always 9.

Yeah, strange. The Sensawake pressure setting is 9.0. That must be controlling the pressure as if in Fixed Pressure mode. ??? I can speculate, but we need someone who knows that machine.

MilkmanJohn wrote: ↑

Wed Dec 27, 2023 8:33 pm

MilkmanJohn

Will you edit the subject of your OP to say, "Need Help with F&P SensAwake Setting"? Hopefully, the right person will see your post. Instead of changing the minimum pressure, you might just need a configuration that will let the APAP mode do its job.

Miss Emerita wrote: ↑

Thu Dec 28, 2023 12:36 pm

I'd recommend increasing your minimum gradually; that's a pretty big jump up for someone whose pressure seems to be a steady 9. I also don't quite get the rationale for doing that, but you can't hurt yourself by experimenting.

Ok I'll make sure to do it gradually.

Miss Emerita wrote: ↑

Thu Dec 28, 2023 12:36 pm

I'm puzzled why your pressure is always 9. You've set the minimum at 9.5, for one thing; for another, your pressure didn't budge even when you had OAs. I'm not really familiar with your machine, so maybe someone who is can explain what's going on.

I did some testing just now. The data in the graph is completely wrong. The actual machine pressure is higher than that and it goes up and down over time. Thank you for taking the time to scrutinize the data.

Miss Emerita wrote: ↑

Thu Dec 28, 2023 12:36 pm

I'd suggest you make a note of some other sleep variables every day. Your bad and good days may have nothing to do with the machine or with your breathing. Try keeping track of variables like this: pain; the times you go to bed and get up; disturbances from noise, temperature, pet, bed-mate, light; consumption of caffeine, food or alcohol within six hours of bedtime; amount of time spent outdoors the previous day; amount of exercise the previous day.

Ok will do.

Janknitz wrote: ↑

Thu Dec 28, 2023 2:20 pm

You might look on Amazon for a recording pulse oximeter. You can get a decent one for around $30. I found that helpful when my sleep was not so great--the numbers on my machine looked OK, but I was having some desaturations into the 80's. Bumping up the pressure helped.

Great idea. I'll buy one.

ChicagoGranny wrote: ↑

Thu Dec 28, 2023 2:29 pm

Will you edit the subject of your OP to say, "Need Help with F&P SensAwake Setting"? Hopefully, the right person will see your post. Instead of changing the minimum pressure, you might just need a configuration that will let the APAP mode do its job.

Updated.

Ok. I've made some changes and I sleep well most nights. It feels great and I function so much better in general. Thank you for the help guys.

My solution was:

• Disable SensAwake - noticed all sorts of bugs things with SensAwake so I disabled it.
• Ignore machine AHI readings - the machine massively underestimates.
• Stop sleeping back - that was causing most of my sleep apnea.
• Increase pressure - may have helped - hard to tell as my symptoms are inconsistent.

Posting as it might help anyone else who finds this.

Thank you for coming back and updating.

Sharing some thoughts, hoping to learn.

ResMed's auto-ramp feature does the following: as long as it thinks you're awake, it neither changes pressure, nor reports AHI.
Do you know it F&P's SenseAwake is also programmed to do nothing as long as it "senses" you're awake?

Out of curiosity, I I put my CPAP machine on autoramp with a pressure that is a tiny bit less than what I need.
My smart watch (Polar Ignite 2) tracks sleep and wake modes - I find that for those pre-sleep periods the reports of the ResMed and the Polar are pretty well correlated.
Autoramp will stop after 30 minutes, regardless of whether you're asleep or not.
Does "SenseAwake" function all night long?

If it's not a hassle - do you mind posting a night on your present settings - those that help you feel better?

Are you still on automatic pressure adjustment mode? Do you see the pressure responding to your flow, now that you've turned the SenseAwake off?
Thanks

{Edited to correct the autoramp switch off time - Pugsy noticed I wrote something wrong - I shouldn't have trusted my memory... Thanks, Pugsy.}

Many thanks for coming back. I'm so glad things are going well for you now!

ozij wrote: ↑

Fri Feb 02, 2024 9:40 pm

Does "SenseAwake" function all night long?

If it's not a hassle - do you mind posting a night on your present settings - those that help you feel better?

Are you still on automatic pressure adjustment mode? Do you see the pressure responding to your flow, now that you've turned the SenseAwake off?
Thanks

Yep I'm still on APAP. I can see and feel pressure changing in response to my breathing when I'm awake. That was always the case with SensAwake on or off. But those small variations in pressure don't show up in the OSCAR pressure graph. The graph doesn't display actual pressure, it seems to display some kind of target pressure. Here's what the graph looks like now with SensAwake off:
I can't tell what SensAwake is doing when I'm asleep. With SensAwake off, the pressure displayed in OSCAR is typically at 12 cmH20. With SensAwake on, pressure is typically 4 cmH20. But it's possible the actual pressure during sleep is 12 cmH20 and the machine is just reporting the data wrong or OSCAR is interpreting the reported data wrong.

So SensAwake feature might actually work fine when I'm asleep, but I don't benefit from the feature so better to keep it off so I can eliminate it as a cause of anything.

I'm not going to try to understand what you said. But, how about clicking on the Y-axis and changing the minimum to 4.0.