Blues, Woes, and Worries of a New APAP User

Hello everyone. New user here.

I have a ResMed Airsense 10 AutoSet APAP with a built-in humidifier and I use an Eson mask from F&P. My prescribed settings are a range from 4.0 at the minimum and 10.00 at the maximum. It was given to me on the 17th of May but I do not have data from my machine starting from that time as I only began inserting my own SD-card beginning on the 1st of June, which is nine or ten days ago from this post. I believe I have all of my equipment listed properly in my profile but please let me know if there are any discrepancies.

I've been trying to keep track of my sleep using Sleepyhead and it seems to show my AHI as floating around 5 -- sometimes more, sometimes less, but usually 5. My apnea events seem to cluster around right after I've fallen asleep as well as when I'm close to waking up. I also notice many events occurring when I'm trying to fall back asleep after sleeping for a full night, whether that be a mid-day nap or attempting to go back to sleep after being awake for about an hour.

I did not utilize an SD-card when I first began treatment and my trackable data only goes as far back as June 1st, which is nine or ten days ago from this post.

On Sunday the 3rd of June, I visited with a doctor regarding poor sleep, who prescribed 25mg of hydroxizine and a 100mg capsule of 5-HTP each night before bed. I feel that my residual daytime sleepiness has improved since, but I am uncertain.

Also, according to my SnoreLab app which I sometimes use to record my sleep, I appear to be snoring again. I did not snore previously when I first started using the machine, but I appear to be lightly snoring at certain times of the evening. The leak data doesn't seem to show a continuous large spike in leakage, so I do not think this is an open-mouth incident.

I'll try to attach some screenshots to show what that looks like. Please bear in mind the inaccuracy of the timestamps -- it seems that my timezone was incorrectly set to six hours ahead of my actual timezone, which I have rectified as of last night.

I suppose what I am worried, wondering, and sad about is... what am I doing wrong?
Should I try to mess with the RX settings on my own to try and fix it manually? My most recent foray with that, evident in the data for the night/morning of Jun 9/10, shows a massive spike in apnea events following my attempt in fudging my settings. I raised my numbers to min-6 and max-12 on my own and tried to sleep for an extra hour, only to have terrible nightmares and a giant spike in AHI to show for it. I went ahead and returned my numbers back to normal afterward. I will try to show what that looks like in my screenshots.

Am I doing something wrong? I appear to be wearing the mask correctly, and I do not thing I have any tremendous leaks that last for very long.
Is my AHI too high? I'm not exactly skimping on using the machine, and I have been told that it takes time to adjust to the machine, but I wonder if whether or not I'm adjusting too well -- that is to say, my body is adjusting to the APAP pressure and has now decided to resist in some way.
Are there any suggestions as to what my next step should be?
Should I try to harangue my doctor into sending me to another sleep study so soon (it's barely been a month) or do I just try to stick with it for now?

What should I do?

I will provide multiple posts with notes and comments as necessary to explain my attached screenshots.

Night of June 1 - Attempted to return to sleep a few times, it seems.
Night of June 2 - Again, attempted to return to sleep
Night of June 3 - Slept through the night

Night of June 4
Night of June 5 - After waking up, I tried to return to sleep
Night of June 6

Please redo your charts ONE per day, like the examples in my sig.

You need more pressure, I'd start with a min of 8 and max 20.

palerider wrote: ↑

Sun Jun 10, 2018 2:01 pm

Please redo your charts ONE per day, like the examples in my sig.

You need more pressure, I'd start with a min of 8 and max 20.

My monitor is not very large. I don't think I can fit all of the information in as you have it in your screenshots. Any suggestions?

spamgoeshere wrote: ↑

Sun Jun 10, 2018 2:08 pm

palerider wrote: ↑

Sun Jun 10, 2018 2:01 pm

Please redo your charts ONE per day, like the examples in my sig.

You need more pressure, I'd start with a min of 8 and max 20.

My monitor is not very large. I don't think I can fit all of the information in as you have it in your screenshots. Any suggestions?

It's only six charts. shrink them down *a little*.

Also, these ARE daily charts. Some of them have gaps only because I attempted to return to sleep, as I posted in my opener. Is it fine? Or do you want different charts PER SLEEP CYCLE?

Please review this thread for examples of how we like to see the reports.
You have totally omitted the stuff on the left side which is important.
You can get all you need to share on one image. If we want something else we will ask.

viewtopic/t158560/How-to-post-images-for-review.html

I feel like I saw a post (admittedly, possibly on another forum) that asked everything on the left to be omitted. I apologize.

I'll post what I took just now. Is this sufficient?

Your current pressure settings (4 min and 10 max) aren't getting the job done because you have limited the maximum. The machine wants to go higher but it can't. It needs to go higher some of the time but not other parts of the night. How much higher is unknown but it's pretty much going up and staying up there probably around at least 8 cm maybe even a little more ...can't really tell for sure with this scale but at this point doesn't really matter because it's obvious the machine wants to go higher but can't.

Starting out the night at 4 cm...it goes up fairly quickly and stays there but to ask you to start much higher after using 4 for a while might not be so easy...
I suggest that you try maybe 6 cm minimum and open the machine up to 20 max and let's see where the machine wants to go and what happens and if you have any problems with those settings we make adjustments based on what happens.

Thank you for the new image...yes, fits my needs perfectly for now.

Not bad screen shot. Next time move the Mask Pressure out and replace it with the Pressure graph. Agree you need more pressure.

Okay. Uploading my batch of screenshots now. Again, I will provide commentary under each screenshot as necessary. Bear in mind the timestamps for the first eight or so screenshots -- again, my machine was set six hours ahead of my timezone.


First night tracking my data. I tried going back to sleep a few times throughout the day.



Second night. After waking up once, I tried returning to sleep.



Third night. Again, woke up, tried returning to sleep. This was the first night I began taking hydroxyzine and 5-HTP nightly.



Fourth night. Slept through.



Fifth night. Returned to sleep briefly.



Sixth night. Slept through.



Seventh night. Slept through.



Eighth night. Two hours prior to sleep, I was at a workout event. By the end of the event, I was covered in sweat and exhausted, and ate heavy right afterward. I then went to sleep. I believe this is why my AHI was high.



Ninth night and today morning. I toyed with my RX numbers this evening to raise my minimum up to 5 and the max up to 10.4. After waking up, I attempted to change my RX numbers yet again to min-6 and max-12 before attempting another hour of sleep to experiment. My results follow.

Set your pressures at 8 and 20. Yes 20. And give things a couple of nites to see how things go. If you tend to drop your head when asleep, get a soft cervical collar to help keep it up (flow rate improves) and airway more open, as well as helping your jaw to stay closed if you mouth breathe.

I'd go with a minimum of 9.

If that's too much to fall asleep to at first, then that's what the ramp's for.

Change your settings like Pugsy suggested or the minimum of 9 that PaleRider suggested. The important thing is to evaluate the settings for a few days. Your pressure isn't high enough now and you will probably need the 9 minimum but you can try the 8 and see if that lowers your events and you sleep better. Last night the hour that you "attempted" to sleep probably had a lot of sleep/wake junk. I think you can take that out of the picture mentally. Or, if you want, you can turn off that session on the left side of Sleepyhead for probably a more accurate picture for yourself.

I'm afraid to set it that high so soon. Especially after the episode I had this morning. What if I have CA episodes? What are the major concerns of such a high pressure roof? Should I try to consult with my doctor first or should I try to meet in the middle and set my numbers to 6 and 15?

What about all my apnea's before waking up/after falling asleep? Wouldn't it be dangerous to wing the numbers willy nilly?