New User - How am I doing?

I've got mild sleep apnea. At my first sleep study, which was a home study, I had 15 apneas (10 of which were central apneas) for an apnea index of 1.8. I had a total of 36 hypopneas (0 of which were central) for a hypopnea index of 4.4. The total AHI was 6.2. The lowest oxygen saturation level was 81% with an oxygen desaturation index of 1.9. I had oxygen saturations greater than 89% for 71.8% of the time and less than 88% for 87 minutes, in the 80's 18.4% of the time and nothing lower. Based on this study, I was prescribed a CPAP and I went to the hospital for a titration study. Do I really need a CPAP? At the titration study, I had a total of 8 apneas (8 of which were central apneas) for an apnea index of 1.2 and a total of 41 hypopneas (0 of which were central) for a hypopnea index of 6.4. AHI was 7.6 at the titration study, higher than my home study. The lowest oxygen saturation level was 92%. The report says I had 180 arousals, which seems like a lot.

I have been on the CPAP for a week now. I get good mask sealing at 99-100%, but my AHI isn't showing the kind of improvement I want to see to warrant all the trouble of adapting to a CPAP. Perhaps it is too soon. My AHI was 5.4 today, but I had one day at 3.4. The respiratory tech at the DME is no help and doesn't act like he wants to answer questions. I am using the AirFit N30i mask and need a chin strap to keep my mouth closed.
I imported my data into OSCAR. Any information you can give me about why my AHI is still over 5 would be appreciated and also, how mild is my apnea? Thank you so much.

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Your machine is set to fixed pressure of 7 more pressure is needed what is the model number from the bottom of the machine it will help us to offer more optimised settings

The model is DSX500T11C. There are a lot of numbers on the bottom. I hope I gave you the right one. Your help is much appreciated!

Welcome, Katerific. Your events here look mostly obstructive, and I think you will get some good advice from the experts here on fine-tuning your settings. One request: when you post your next chart, would you turn off the pie chart (File - Preference - Appearance, uncheck the box), and would you scrunch your charts a little so that the snore graph shows completely? You can do that by grabbing the gray horizontal bar between the graphs. This will help the experts see all the potentially relevant information.

I love data! Oscar shows snoring isn't a problem I guess. What does the vertical line at approximately 1:30 and at 3:30 mean in the snore section?

Katerific wrote: ↑

Wed Jan 22, 2020 5:50 pm

What does the vertical line at approximately 1:30 and at 3:30 mean in the snore section?

Just a couple of snores which are also shown on the Events graph....VS...that's vibratory snores.
One maybe two snores (real close together) at each time interval.

You don't have a problem with snores.

You do have quite a few hyponeas and OAs which mean the airway is still either collapsing or seriously trying to and getting close.
More than most of us would be happy with...points to sub optimal therapy. You need a little more pressure to better hold the airway open and prevent the collapses.

How are you sleeping? Soundly or waking often? How are you feeling?

I still wake up in the night a few times. I'm not sure if it is because I'm still getting used to the mask or the breathing problems. I feel slightly better during the day and not as exhausted upon waking. I'm also diabetic and for years have had hypoglycemia in the mornings. Since on the CPAP, I don't wake up shaky and low blood sugar. I didn't anticipate that being related. I'm not overweight (BMI 21) and have both sleep apnea and type 2 diabetes. Ugh!

Please resize the charts so that all that shows on the right is

Flags
Flow Rate
Pressure
Leaks.

I'd change your settings to auto mode, min 8, max 20 on pressures.

I got into the clinical settings on Wednesday and made some changes. AHI on Wednesday night was 3.07, better than I had been doing. Last night was 7.99. I put a Breathe Right Nose strip on last night and thought I was breathing better through my nose. I woke up at least 6 times. Horrible night. I set the pressure max at 12 and maybe I should make it 20, but the auto didn't go above 10 last night. On Wednesday night I started out with the Resmed N30i mask but stuffed up and couldn't breathe through my nose hardly at all, so I switched masks to the Philips Amara View Minimal contact mask. Last night I wore the Amara View all night. I don't know why I would have more events when I can breathe through both my mouth and nose. Thoughts and suggestions?

Hi, did you change the mask-type setting when you switched from nasal to full-face?

I didn't change the mask type, but will do so. You guys have been the only help I've received. The DME company hasn't done any kind of follow-up and when I asked if they would, said no. I don't have an appointment with my doctor until 90 days in. No wonder so many people give up!

Respironics don't have a mask type setting that encompasses full face, nasal or pillows like the ResMed machines have.
What they do have is something called Resistance control which sort of accomplishes the same thing but it goes by a number and only Respironics masks are given a number to be used. In real life those numbers don't really make much of a difference if they match up exactly (if you have a Respironics mask) or if it is turned off.

It is quite common to need more pressure with a full face mask than with a nasal mask though. That lower strap on most full face masks can pull the lower jaw back ever so slightly which alters the airway a bit causing a need for more pressure.

I suspect the bulk of your ugliness last night is SWJ false positive arousal/awake related flagging of events.
Lots of clustering at or around known awake times and you admit you slept horribly.
While it wouldn't be impossible for some of the apnea events to be real and they caused the awake times....it is also very possible that the elevated AHI is mainly SWJ and the poor sleep caused a good chunk of the events.

But since you went from a nasal mask to a full face mask...you may just need more baseline minimum pressure when you wear a full face mask.

You might want to learn how to distinguish awake from asleep flagged events.
http://freecpapadvice.com/sleepyhead-free-software
watch all the videos....and while they mainly talk about central apneas (clear airway) false positives aren't limited to centrals as we can have awake/arousal related OAs and hyponeas as well.

About the max pressure thing....doesn't matter what it is set at if you never go there...ever.
It's the minimum pressure that does the bulk of the workload holding the airway open.
Setting the max to 20 and you never ever go over 12...doesn't do a darn thing except maybe cover you for an extremely rare exception pressure need.