NEWB Advice Needed

Probably not the best/recommended approach to Apnea, however I am on a self-pressure settings experiment in an effort to justify higher expenses (sleep study, equipment etc). I am a VERY loud mouth snorer for many years and often believed I may have an issue but only recently when waking with shortness of breath decided to address it. I was able to get a free used (great condition with ~1k hours on it) Airsense 10 (non auto) with F20 mask and have been using the last three nights (manual humidity @ 3 and auto heat). Decided to start therapy at 8.4 pressure level and increase by .6/night and review results. I have had the following three readings so far (pressure/events): 8.4/11.4, 9.0/10.2, 9.6/12.4 I was able to get my leak level down to 2 last night which is excellent. Planning on bumping to 10.2 pressure tonight.

I'm imagining hitting a pressure level where there is a larger drop in events and then tweaking around that +/- to find optimal. My question is whether I'm on the right path here or wasting my time? I know there is considerable more diagnostics involved with full sleep study, but believe the approach is similar.

Have you been diagnosed, or are you just assuming? Could you (or your insce) afford an auto machine - better idea with more options to tweak and understand results. Have you tried to not sleep on your back at all (assuming you do it) and used something to keep from flipping over once asleep? Did you feel any better the next day? Have you seen an ENT to look into the snoring (in itself not an absolute for apnea)?

And whatever other info you can come up with would help us to help you.

Exactly which non Auto model did you get?
Are you using EPR exhale relief? If so, at what setting?

2 models of non auto ResMed AirSense 10 machines
The Elite or the CPAP....should show plainly on the face of the machine the words ResMed AirSense 10 CPAP or Elite.

The Elite is full data and can tell you what event categories make up the AHI (and is compatible with OSCAR software to see those details) but the CPAP model doesn't offer anything that tells you what that AHI is composed of.

This is critical because the AHI is composed of 3 event categories and 2 of them will respond to more pressure by reducing but there's one category that more pressure doesn't help and might in fact make more centrals pop up.

So kinda important to know what you are fighting.

If you have the Elite...get OSCAR
OSCAR https://www.sleepfiles.com/OSCAR/
http://www.apneaboard.com/wiki/index.ph ... stallation
http://www.apneaboard.com/wiki/index.ph ... rpretation

And post a detailed nightly report from a recent night ...see this for how and what to post
viewtopic/t158560/How-to-post-images-for-review.htmlIf

If the machine is the CPAP model....going to be hard to figure out what to do because we don't know for sure exactly what is going on.

Thanks for the feedback. To try to help with info, no I have not been officially diagnosed or seen an ENT (i have been to ent for other issues tho). I have snored all my adult life and it's BAD. Can snore sitting up, right side, left side, back, and as far as I know on my stomach! I cited tiredness, and gasping for air waking up (that's what really tuned me in). Also have more trouble concentrating lately, irritability, etc. 2 of my 3 siblings have Apnea and CPAP machines so runs in the family. My sister gave me the Airsense she had (he got the 10 Auto for Her version).

I have an Airsense 10 CPAP (got for free with assortment of mask, and both types nose). I understand this is limited on what data it can provide for diagnostics (little other than basic). I do have EPR enabled but don't recall there being any level adjustment for that other than on/off.

I guess I'm not expecting any golden nugget suggestions as I don't believe there's enough information I can provide to help more at this point on data. Rather, if you were in same equipment position as I, would you be doing same testing methodology or different? Ultimately, if I can get some improvement by my experimentation I'd just present these results to my PCP to see if I can get a script for an Auto machine, and go next step for either full or at home study.

The AirSense 10 CPAP model doesn't give needed details.

Any chance you could sweet talk your sister into letting you use her machine for a night or two so you can get better data?
It has the details we need to better help you sort out things.

Your changes in pressure haven't been all that huge and the changes in AHI could be just normal nightly variances but with such small changes I don't know that we could have really expected much of a change...and of course we have zero idea what your AHI might be without cpap.
For all we know it could have been 3 times that much.

You might try turning EPR off tonight if you can...that' might offer some clues as to which way to go.
If you can't do without EPR there is a setting in the setup menu where you can use EPR only during ramp and then you can make use of the ramp feature and once you are asleep and no ramp we can see if your AHI changes.

Interesting about EPR, thank you. Researched that a bit more as I didn't understand potential negative impact and will definitely turn it off next try.

EPR creates a bilevel pressure situation and there is a very small number of people out there that bilevel pressures can trigger central apneas in numbers that are troublesome.

Now I don't know that your AHI is primarily made of central apneas or not because the machine you are using can't tell us event categories.
But it is about the only thing we can offer to try beyond just increasing the pressure to maybe accomplish something when we can't see the actual category breakdown.
It's something to try.

You may not be part of that very small group of people who have a problem with bilevel pressures...heck for all we know maybe your AHI is all obstructive and the reason it didn't change much with the changes you made was that you need 15 cm or something pressure to prevent the apnea events.

I have a cardiologist follow-up appt next Monday and plan to discuss with him. I've come to the conclusion I do want to get a full study done and presenting whatever data I can gather with this machine in this week. Turning off EPR tonight and keeping same pressure to see what diff that makes. Plan to increase by 1 each night and probably stop at 15-16 if nothing improves before that.
I may go back and try 6 and 7 as well since I started at 8. Maybe I'm going in the wrong direction, but I doubt it. Will get it figured out one way or another. Thanks for keeping the thoughts coming.

Made some progress overnight. Turned off EPR, left at 10 pressure and got a 7.1 EPH (down from 19 at same pressure)! Mask seal was 0. Thanks for that tip! I told my sister about that yesterday and she also tried it. She normally averages 3 EPH these days and said she had a 0.9 EPH last night. Trying level 11 pressure tonight.