New, confused, help and advice appreciated!

Forgive me if I do this incorrectly, but I am definitely a newbie to this whole thing!

I was diagnosed in September, got my CPAP October 9th.

I did not receive a copy of my 2nd sleep study report yet (I will at my next appointment in November) but the first sleep study showed the following:

Recording time 397.5 minutes
Total sleep time 322 minutes
EEG confirmed total sleep efficieny 81%
Apnea hypopnea index 33.9 events per hour
Respiratory disturbance index 29.5 per hour
Arousal index 50.7 per hour
Total arousals 272
Mean O2 saturation 95%
Lowest O2 saturation 90%

Impression:
Moderate OSA. AHI=20/hour
CSA's also present. AI=12.3/hour
Frequent arousals present with OSA/CSA. Loud snoring present.
Sleep onset normal. Sleep efficiency reduced.
No significant cardiac arrhythmias or period limb movements.
Sleep study did not meet criteria for split night study protocol
Hypopnea's were scored using 3% or greater O2 desaturation criteria

Recommendations:
Weight loss
Driving precautions
Avoidance of alcohol/smoking
CPAP titration polysomnography
Evaluate for CSA
Clinical correlation

When I got my CPAP delivered, the only setting marked/set was 6cmH2O.

So here's my newbie questions (I have read the beginner information and it's a great resource but still very overwhelming so I apologize if I missed anything or misunderstood). Some of these may be VERY basic. I know everyone is different and what works for one may not work for another, but I would appreciate advice nonetheless:

1) I've used it every night except once so far. I was told that if I wake up to use the restroom, to just unplug the mask, but the air is super loud when I do that, so I just turn it off, then back on, That's OK, right?

2) I have a Swift FX Nano mask (not for her) - I'm having a little trouble getting used to the nose mask but it's not too bad, other than slight pain under the nose in the morning. Adjusting it tighter or looser has caused leaks or more pain, so even in the perfect position, it still hurts a bit. I am a side/face sleeper, and I really doubt I can change that. Is there a full face mask that can be used by a side/face sleeper? I tried a nose pillow mask and I just hated it immediately.

3) While I have slept longer throughout the night (waking up 2-3 times vs 5-6 times to urinate) with the machine, I still haven't woken up refreshed or not been sleepy during the day. I haven't experienced that miracle that people talk about. It's only been two weeks - is there a breaking-in period, or is this supposed to happen, literally, overnight?

4) I know it's hard to judge without the final sleep study data, but I was told I had moderate apnea, then given a 6 pressure? Add to that, not feeling refreshed, and based on the data below, still snoring and having a lot of arousals... I plan on talking to the doctor about this at my follow-up in two weeks, but I would love to be more educated about what to bring up.

I apologize for only 8 days of data - I traveled and apparently the SD card became unseated during the trip and stopped recording after the 17th.

Any insight into this data would be much appreciated. Again, this newbie is just trying to educate herself and be proactive in her own health, but it's all so overwhelming...

Also wondering why my machine is showing up in my profile? It's in there, just not appearing the signature area of the post. It's a REMstar Pro C-Flex+

Look on the bottom of your machine for a 3 digit model number with maybe a DS or REF in front or behind the 3 digits.
It's likely going to be 460...and you have chosen the model 450 and that link is broken and won't show up.

The 60 series machines replaced the 50 series machines (which have been discontinued and that's why the broken link).

While not impossible for you to have been given a 50 series machine they have been discontinued over 2 years now so most likely you have a 460 machine and you just have chosen the wrong machine from the equipment list.

If you have the 460 machine the correct equipment choices in the profile menu is
Machine...PR System One 60 Series Pro CPAPxxxx
Humidifier...PR System One 60 Series heated tube humidifier with heated tube (even if you aren't using the optional heated hose)

Now if you do have a 450 machine then you will need to just add it to the comments section of your equipment profile and leave the humidifier choice as it is since it is pointing to a 50 series humidifier and the 50 & 60 series machines won't work with the other series...60 series humidifier won't work on 50 series machine and vice versa.

Forget the "Remstar" part of the model name..it's useless for denoting model name...Respironics has used Remstar on all models ever since they started making machines. It means nothing.

Pressure needs have nothing to do at all with the severity of a persons sleep apnea.
Pressure needs are dependent upon the patency of the airway tissues...a person can have a really severe OSA diagnosis with AHI of a 100 and maybe only need 6 cm pressure and conversely someone could have a nice "mild" low number AHI diagnosis like 7 AHI and need 20 cm or more. It's not about the AHI numbers..it's about how floppy the airway tissues are.

When you put the SD card back in the machine it will write most of the missing data back to the SD card. You only really lose the flow rate graphs when the card isn't properly seated. The bulk of the data is stored on the machine and the machine will put it on the SD card.

Looks like your snoring is still pretty bad. Are you sleeping on your back? That can make OSA worse.

While your AHI is nice and low the snoring is really ugly. The snoring usually means the pressure is not quite keeping the airway open like it needs to. So some low level obstruction that isn't enough to earn an apnea flag...the snores along with the RERA (Respiratory Event Related Arousals) point to not quite optimal therapy or sleep.
I would suspect that you need a little more pressure to prevent the snores and RERAs...probably not much...maybe 1 cm or there abouts.

If it is related to supine sleeping you might get by just sleeping on your side if you are sleeping on your back primarily now.

So from what I see here...verify sleeping position to see if it impacts things and/or a little more pressure to better prevent the airway collapsing which is what the snores are telling you and the RERAs are telling us that there's a good chance you had some arousals from sleep that you may or may not remember.
Both point to sub optimal therapy but only a little sub optimal since your AHI is great and your leak is to die for good.

Thank you so much for the replies! Fixed the equipment issue on my signature and it's great to know that the machine will re-write the missing data to the SD card when re-inserted properly.

I don't sleep on my back at all - I'm 100% on my side/almost a 45-degree angle to my stomach. My airway tissues must be pretty floppy then (I actually almost snore while awake during the day if I'm really relaxed). I hesitate to change the pressure without my doctor's approval if it's just the first 2 weeks of therapy (I have my first re-check in 2 weeks) but I will definitely bring it up with him and mention being able to do it at will later if need be. I did just use my 30-day warranty on the mask and call to order a full-face mask to see if that may make any difference (I do notice a bit of dry mouth but not as much as I used to) in snoring or RERA. They said they are sending an Amara full face mask with gel cushion.

I so appreciate your replies, and all of the work you put into the newbie information as well - it's SO helpful!

You're doing great! Some people have that "miracle" and some don't - things will improve with time as you continue to use CPAP. The numbers you posted and the fact that you've gone from 5 or 6 pitstops per night to 2 or 3 is also good. I was surprised that they found significant CSA's in the sleep study, but they aren't present in the data you shared - that is very good news.

You are off to a great start. I hope your doctor does more than look at your hours of use and possibly your AHI and nod his/her head. I hope he/she helps you fine tune things a bit.

You still don't quite have the correct machine choice..close though.
You are showing the PR System One 60 Series Plus CPAP...that's model 260
And the one you need is the PR System One 60 Series Pro CPAP
I think they are side by side in the choices so it's easy to click on the wrong one.

Totally understand the desire to wait before changing anything. It's not a critical urgent thing anyway.
Some people are okay with doing it themselves and some people aren't and that's okay. Don't ever do anything else you are totally comfortable doing it.

Nick Danger wrote:I hope your doctor does more than look at your hours of use and possibly your AHI and nod his/her head. I hope he/she helps you fine tune things a bit.

Thank you - me too, which is why I am here, to try to get as informed as possible. I will definitely ask about the CSA's, and get a copy of the 2nd sleep study as well.

Pugsy wrote:And the one you need is the PR System One 60 Series Pro CPAP

Did I get it this time? Sorry. :/

You got the right machine this time.
The reason I mention it is mainly to avoid confusion later. People may not remember this thread later if you post another question and not realize you have a full data machine and spend time giving you the "you got a brick" speech when they could be spending time answering your question.
Plus different models of machines have different options available and it really helps us to know exactly what machine is being used so we can mention the appropriate options applicable to that machine.

Like this one...did you know that your machine has some limited APAP capabilities and there's a way to renew those capabilities later if needed? We don't want to do anything now while DME s are still needing compliance usage but your machine has 30 days of APAP capabilities (total and not necessarily consecutive) and we can give it more 30 days with a little trick I know about but we don't want to do that trick while DME is needing compliance hours.

Or the heated hose feature if you didn't get one and your machine isn't set up for it (need a different lid and power supply as well as hose)..that is also easily fixed should you need or want the heated hose and not able to use one right now.

Interesting stuff! And thank you for your patience and help - wading through all of this is overwhelming, but this forum is making it seem much more manageable.