3 weeks in and would appreciate some advice - OSCAR report attached

Hi everyone, this is my first post here! https://imgur.com/a/QKC1zuA

This is my 3rd week using my APAP and I have the Airsense 11 Autoset. I have a diagnosis of severe SA in REM sleep at 35.5 AHI. These past few weeks I have been using various masks as I am doing a mask trial with the supplier I bought my machine from. Last night I used the ResMed AirFit P30i, with a chin strap, as I have a deviated septum and breath through my mouth at night. I was using mouth tape before, but I didn't like it so I have switched the chin strap.

I am struggling a lot with the masks, as it seems like no matter which one I use, I am waking up with air blowing into my eyes (I am mainly a side sleeper and I am wondering if this has anything to do with it). I think my main complaint is that I feel like I keep waking up 5+ times throughout the night, which leads me to feel like I am not getting a restful sleep. Although I do think I am feeling a lot less tired, I haven't had much success with having a consistent AHI, most nights its been around 3.

Please note on my OSCAR report; I had to wake up to drop my partner off somewhere, and then went back to sleep, so that's why there is that large gap in-between ~5-7 ish.

I guess I am just looking to see if there's anything obvious from my report that could help me. I know that this takes a lot of time in terms of adjustment, I am hoping I am on the right track.

Hardware:
Resmed Airsense 11 Autoset
ResMed AirFit P30i

User settings:
Ramp Time: Off
Tube: Slim Line, with a tube cover
Humidity Level: 4
Pressure Relief: On

Clinician settings:
Max Pressure: 14.00
Min Pressure: 6.0
EPR: On
EPR Type: Full Time
EPR Level 3

Other things that might be important:
I wear a nightguard to help with teeth grinding/TMJ.
25F.
BMI 29.0.
251 feet above sea level.

Thanks in advance for your help please let me know if you need any extra information from me!

On the present chart Your breathing becomes nice and stable once the pressure goes above 7.5 or so
Once you breathing is stable, you machind figures, "oh great, we can drop the pressure now" and you get flow limitations again.

A number of ways of handling that:
Put the machine on a higher minimum pressure - at your median at least.
Check which algorithm you're usings: Autosense for Her won't let the pressure go back down so quickly - it will automatically keep the minimum higher for the night once it realizes the drop causes more events.
It's also possible that you don't need EPR - or don't need it so high.
Some people find they get better treatment with standard response vs. soft response.

Don't try all these things at once.
If it were me, I'd try the higher minimum first.

ozij wrote: ↑

Tue Jun 27, 2023 7:43 pm

On the present chart Your breathing becomes nice and stable once the pressure goes above 7.5 or so
Once you breathing is stable, you machind figures, "oh great, we can drop the pressure now" and you get flow limitations again.

A number of ways of handling that:
Put the machine on a higher minimum pressure - at your median at least.
Check which algorithm you're usings: Autosense for Her won't let the pressure go back down so quickly - it will automatically keep the minimum higher for the night once it realizes the drop causes more events.
It's also possible that you don't need EPR - or don't need it so high.
Some people find they get better treatment with standard response vs. soft response.

Don't try all these things at once.
If it were me, I'd try the higher minimum first.

Hi @ozij, thank you for that information! I have set my min. pressure to 7 for tonight, so hopefully that helps makes a difference

By any chance, do you know how I can change my AirSense 11 to AutoSet for Her mode? I can't seem to find any information outside of the AirSense 10 AutoSet for Her. Thanks!

Looking at the manual https://media.resmed.com/sites/3/202106 ... ER-ENG.pdf I notice that only apneas keep the pressure from dropping in Autoset for Her.
It looks like it's simply one of the modes on the machine - but probable wont' make a difference of your other nights have so little obstructive apneas.

Thank you @ozij. I figured out how to change it to AutoSet for her this morning. Last night I increased my min. pressure to 7.0 and EPR to 2. Here is my OSCAR chart from last night. https://imgur.com/a/Me2vPbQ