Help old hose head wth Oscar new study and new machine

After a long hiatus from cpaptalk.com, I return back to have the pro’s on here look over my shoulder for advice. After several years of poor care from my cpap doctor, I searched the internet for help. Thanks to Al Gore’s marvelous invention I found this group in 2005!
I won’t consume your time with my history at least for now. I will mention that in the early 2000’s many on this forum convinced their doctors to prescribe a new machine call an apap. I followed suit after many discussions with my doctor. She said she had never prescribed one with the exception of a substitution for an in lab sleep study. She did….I got it dialed in with the help of this group,eventually graduating to an autoBiPap…and lived happily ever with great scores and restful sleep. (Not a total lie if you knew me well you would realize this is barley an overview, hehe)
Back to surfing Al Gores internet in 2023 and I find out my Dream Station is in the recall. Good for me I just recently entered the age for Medicare . So I find a new sleep doctor and get set up for a sleep study.
The results are quite a bit different from the many sleep study’s over the years, shame on me for going without a doctor for so long. I was sleeping well and was a self-payer as a side note. I would like to link the study and my first few nights of sleep.
You can see in the messages to my Doctor I am skeptical of his advise and he of me. For that reason I’m not sure we are a good match, but I am going to give him more time to prove that I’m the problem …
You will see my first night with his script for my apap was preasure set to 8-10. The sleep study said 10 was optimal. When I saw that I was thinking why not make the settings broader say 8-20 or 8- 15 if we are using an apap lets see what it says. I complied and the AHI was 16.5, the next day I pulled my favorite senior citizen out of bed and went wtf. You will see his reply that the data indicated I had my mask on to tight…I call BS on that in the nicest of ways. If you guys see something that indicates that please school me.
I opened the ole girl up to 8-20 and tucked myself into bed. Unfortunately I did not have a data card the first 2 night and the data did not load from the previous 2 nights after I put the card in, just the summary…dang. Next day 2.8 with the same F20 mask with no adjustments. Hmm on the strap idea…I have made just a few adjustments so that I can run for a week or so and get a good base line ie. I backed off of the EPR and set the pressure to 9-18. I recently downloaded the awesome Oscar software and purchased a card reader. I do see that my mean pressure is closer to 10 but goes pressure goes higher. I know very little about flow rate and what ideal is and how to achieve that.
I know the numbers are not everything but they are a guide. Any thoughts or help would be appreciated. One last note during the sleep study I never fell asleep on my back. I’m sure I turn during the night ,normally this is the worst position possible for me. Crazy they did not get that accomplished the night of the study. To many links Ill add sleep study next.... Thank you for taking a look!

Here is the Sleep Study

Looking at your chart of 1/6 with minimum pressure of 9.0 ...

- Events are at a very low level
- Flow limitation is moderate to mild
- Leak level is very good except for brief periods about 2:00 and 3:00.

- The pressure goes high around 2:00 - 3:00 and again about 6:30. Were you perhaps sleeping on your sides and rolled to your back at those times?

---------------------------------------------------------------------------------------------------

CarolinaBlueMax wrote: ↑

Sun Jan 07, 2024 1:40 pm

When I saw that I was thinking why not make the settings broader say 8-20 or 8- 15 if we are using an apap lets see what it says.

The standard practice among experienced members is to set the max pressure at 20.0. The machine will not take the pressure any higher than is needed to maintain proper airway patency. (Some people limit the max to help prevent aerophagia.)

CarolinaBlueMax wrote: ↑

Sun Jan 07, 2024 1:40 pm

You will see his reply that the data indicated I had my mask on to tight…I call BS on that in the nicest of ways.

If you are concerned about leaks or how tightly the mask should be adjusted, find your model on youtube and watch some videos on fitting and adjusting.

I don't buy into the idea that FFMs push the lower jaw back and cause narrowing of the airway. People have observed that their pressure needs increase when switching an FFM from a nasal-only interface. This is because of human anatomy. When the mouth opens, the lower mandible moves backward slightly. This is the result of normal human anatomy and not due to FFMs pushing the jaw back.

How are you feeling? Do you feel like you sleep well at night? Do you have no more than a few nightly awakenings, and are you able to fall back to sleep in a short time? Are you energetic? Do you have excess sleepiness during the day? (Being somewhat sleepy in the afternoon is normal.)

I saw your team had a good win last night against a rival.