Newbie question - starting tx

I have decided to bypass the sleep study (mostly for financial reasons). I’m fairly certain I have OSA (let’s just say it’s family curse of ours). It’s not weight related, just bad airway genes Both my parents were marathon runners and had OSA. I wake up gasping for air, am UTTERLY exhausted when I wake up, and because I’ve put this off for YEARS, am now feeling additional symptoms like extreme anger/irritability, endless sugar cravings and not feeling full after I eat, and peripheral neuropathy. Yikes! I’ve spoken with my doc and we’ve ruled out all other conditions.

Anyhoo, here is what I have in my possession or en route:

ResMed Airsense 10 for Her machine
1 n20 mask
1 AirTouch f20 (memory foam) mask
(I’m hoping one of these masks will work; mouth breather)
1 package of air filters
Non-alcoholic wipes
Distilled water

Is there anything else I need to get this party started?? My doc thinks my OSA is mild to moderate, so I’m setting the machine to 4-13...but open to feedback!!! Any first night tips? I should have everything in by later this week!

ChristineR40 wrote: ↑

Sun Jul 07, 2019 2:24 pm

I have decided to bypass the sleep study (mostly for financial reasons). I’m fairly certain I have OSA (let’s just say it’s family curse of ours). It’s not weight related, just bad airway genes Both my parents were marathon runners and had OSA. I wake up gasping for air, am UTTERLY exhausted when I wake up, and because I’ve put this off for YEARS, am now feeling additional symptoms like extreme anger/irritability, endless sugar cravings and not feeling full after I eat, and peripheral neuropathy. Yikes! I’ve spoken with my doc and we’ve ruled out all other conditions.

Anyhoo, here is what I have in my possession or en route:

ResMed Airsense 10 for Her machine
1 n20 mask
1 AirTouch f20 (memory foam) mask
(I’m hoping one of these masks will work; mouth breather)
1 package of air filters
Non-alcoholic wipes
Distilled water

Is there anything else I need to get this party started?? My doc thinks my OSA is mild to moderate, so I’m setting the machine to 4-13...but open to feedback!!! Any first night tips? I should have everything in by later this week!

yes. you need software to track your therapy.

please see my link below for the oscar software.

and you'll prolly find a minimum of 4 hard to breathe against. you want to try at least 6-7.

good luck!

Thank you! Folks have told me to download the MyAir app - but some have had issues not being able to register previously owned machines (which mine is). Are you familiar with this? I will start with 6, thank you!!

ChristineR40 wrote: ↑

Sun Jul 07, 2019 3:01 pm

Thank you! Folks have told me to download the MyAir app - but some have had issues not being able to register previously owned machines (which mine is). Are you familiar with this? I will start with 6, thank you!!

myair app is useless for actually tracking the events that make up your ahi. so stick with oscar. with it, you'll be able to post data here for review and suggestions.

also, read my other link below for newbies. it has heaps of info and will help you get started.

ChristineR40 wrote: ↑

Sun Jul 07, 2019 2:24 pm

Distilled water

Unnecessary, the only reason to use distilled is the debatable 'convenience' of not having to do a vinegar rinse now and then to remove mineral buildup.

ChristineR40 wrote: ↑

Sun Jul 07, 2019 2:24 pm

My doc thinks my OSA is mild to moderate, so I’m setting

There is zero correlation between the AHI *frequency* and the pressure needed to overcome that apnea. (how hard it is to hold the airway open).

ChristineR40 wrote: ↑

Sun Jul 07, 2019 2:24 pm

the machine to 4-13...

I suggest 6-20, the vast majority of people need more than 4, and many people feel they're not getting enough air at 4.

Lowering the max from the factory default just possibly prevents the machine from responding to your needs, and shouldn't be done except in unusual circumstances, like if you're suffering from aerophagia.

myair is useless for improving your therapy, you need to use OSCAR.

My understanding is that 98% of people fall into the 5-15 range. 20 feels wayyy to high to me. I will start with 5-13 and adjust accordingly based on my numbers. Thanks!

Thanks! - Is Oscar free?

Looks like I’ll have to wait until my new PC comes in for the OSCAR download - will I be able to view data right from the machine initially? Thanks again!

OSCAR is free.

You need to be sure your APAP machine has an SD card installed prior to using it - pretty much any off-the-shelf SD card will work if your machine doesn’t come with one. All of your detailed data will be stored on the card, and can be imported into OSCAR when you get a chance.

The information that is stored on the machine without the SD card or that is viewable just from the machine, is all summary data and not particularly useful for therapy evaluation.

ChristineR40 wrote: ↑

Sun Jul 07, 2019 3:51 pm

My understanding is that 98% of people fall into the 5-15 range. 20 feels wayyy to high to me. I will start with 5-13 and adjust accordingly based on my numbers. Thanks!

The machine would only go to higher pressures if it needs to in order to clear an obstruction. You really aren’t doing yourself any favors limiting things before you see how you are doing. In other words, if you don’t need a pressure higher than 10, the machine won’t push past that point, regardless of where you set the max.

If you set a low limit and you need higher pressures, you will eventually need to increase the pressure anyway, in order to have effective therapy. There is no downside to starting with a max of 20, but there are downsides to starting lower.

ChristineR40 wrote: ↑

Sun Jul 07, 2019 3:51 pm

My understanding is that 98% of people fall into the 5-15 range.

So?

ChristineR40 wrote: ↑

Sun Jul 07, 2019 3:51 pm

20 feels wayyy to high to me.

8 feels "wayyy too high" too night for many people at the beginning. Your machine won't go up unless it *needs* to.

ChristineR40 wrote: ↑

Sun Jul 07, 2019 3:51 pm

I will start with 5-13 and adjust accordingly based on my numbers. Thanks!

Whatever you wish.

There is some limited data available on the machine LCD screen but you have to change a setting in the clinical setup menu to see it.
Essentials setting has to be set to "Plus"...the default is for "on" and all you get is hours of use.
Changing it to Plus gives you AHI, leak and pressure 95% numbers along with event category breakdown.
Go here and request the clinical/provider manual for your machine....all this is explained in the manual along with how to get to that special setup menu area.
https://www.apneaboard.com/adjust-cpap- ... tup-manual

It’s great that you’re starting therapy, and you have an excellent machine. There are some other settings to consider.

EPR: this lowers the pressure when you start to exhale. I would suggest that you start by turning it on and setting in to the max, which is 3.

Ramp: this gives you lower starting pressures that ramp up over a period of time, theoretically while you’re falling asleep. I would suggest that you start by turning it off. After your first night or two, you may decide you’d like to try it.

Mask type: be sure it’s set properly.

Humidity: you might start with 3 and see whether you want to go up, down, or off.

A few other ideas: watch videos about fitting your masks. And try first using the machine during the day, while you’re reading or watching TV, so you can get used to it.

Do get an SD card and Oscar. Read the download advice before you set it up. By posting charts, you’ll be able to get great advice here.

Best of luck for a smooth start!

With all dues respect, your approach seems like it could be more informed.

In terms of supplies, I would only add a SD card (installed in your machine), computer and SD car reader. I assume you have chosen the correct mask sizes (and have confirmed the fit and know how to adjust the mask). Yes, you can get certain basic info directly from the machine (anything you can get from MyAir). But that is not the level of detail you (or a medical provider) need to be able to evaluate your treatment; especially without any sleep study.

So, lets assume that you get an AHI reading of 8.7 with 5.4 hours of use.
a) Are the interruptions of the type reduced with more pressure or the type that will tend to increase when pressure increases?
b) Are the interruptions real or do they tend to be happening when you are awake (more of a false positive)?
c) Are the interruptions likely because your min pressure is too low? Or likely because your max pressure is too low?
d) Are there leak issues that tend to come and go during the night?
e) Are the interruptions clustered or scattered through the night?
f) Are things that are short of a full apnea (not enough to trigger being in the AHI calculation) but still impacting you?

All of these are things Oscar can tell you but the MyAir cannot. I personally think you can self titrate (not a medical professional here) but it requires some effort and education on your part.

How will you adjust based on your numbers if you don't know anything other than a few averages? In the end, your treatment and your choice, your responsibility. It just seems like you are coming at this with no medical input, are disregarding most of the advice here, and don't seem to have the ability to track the data...