Sierra

That is the benefit of OSCAR. It will tell you exactly what happened during the sleep. But yes, the mask has to be on for it to help. It also has to be on to get accurate readings.

Yes, Sleepyhead can be a little, lets say harsh, with the comments. He gets really angry when you have high mask leak rates. Something like "your leak rates are horrible, see your provider immediately!". I understand the comments were removed or toned down in the OSCAR revision... One the other hand if you manage a zero events night, which I have never done, but my wife has, the pie chart turns into a happy face!

I think you are getting pretty close to an ideal setup. For now about the only suggested change I could make would be to reduce the max pressure to 10 cm. That would limit some of the pressure spiking during the night, and may make it more comfortable. In the longer term, you may want to think about trying a fixed CPAP pressure somewhere in the range of 9 cm to 9.5 cm, based on what things look like now. What is the minimum increment of pressure that you can change on a DreamStation?

I would interpret the numbers as follows:

Therapy Hours - Time the machine was running. Target would be ideally 7-8 hours a night.

AHI - Total number of central, obstructive, and hypopnea events that lasted 10 seconds or longer. An AHI of 40 is not good. The standard target is to be under 5 for AHI. It would be more revealing to know what the breakdown of events are.

Mask Fit - From that technical manual on page 4-27 it seems to be the % of time you leakage rate is high. 63% seems like too much, and the mask probably needs adjustment. Or, it could mean it was off longer than you thought during the night.

Periodic Breathing - This can be related to central apnea events. 17% seems high

90% Pressure - This means 90% of the time your pressure was at 15 cm or less. This indicates that 15 cm maximum may not be enough.

If you have a PC or Mac and SD card reader I would highly recommend downloading the OSCAR software. It would give you a much better idea what is going on. About all I can suggest based on the basic numbers you have reported is that the maximum pressure may need to be increased to say 18. The information you are missing is the breakdown of the type of events, for example obstructive vs central. I don't see from the manual how to display that, but it must be stored on the SD card. There are two other threads that are quite current an they are with a DreamStation machine. If you look at those threads you will get some idea what information is available with OSCAR.

AHI 16.7 Newly Diagnosed

UARS Suddenly CPAP not Working

If you are unable to use OSCAR, you may want to look into downloading DreamMapper. I think it is pretty basic, and not equivalent to OSCAR, but it may be better than what you have for determining your type of AHI events.

Look at it this way. You got through the first night, and that generally is the worst one. Learning to sleep with the mask and machine on can be the most difficult part.

You should download that pdf manual, as you never know when links like that disappear. I certainly have noticed a reduced need to get up in the night. Not sure how the CPAP does it, but it seems to help. I also try to avoid any drinks after dinner, and also try to limit sleep to 7-8 hours -- which means going to bed later, or getting up earlier.

Let us know what you sleep report says, or post the daily report from OSCAR, and it should be possible to refine your settings from that suggested starting point.

The power adapter should take 240 volts, but you will need a North American to UK plug adapter. Certainly the best way to get into a CPAP is with the help of a practitioner. However, in this COVID situation, I probably would do what you have done. Some thoughts on your questions:

The humidifier is a comfort feature. It certainly helps especially if the air is dry. I do turn on the preheating when I remember to do it, but it is not critical. Again, just a comfort feature. The machine should have a SD card and should record data to it automatically. It is kind of important. There is a free software available called OSCAR that you can download. It requires a PC or a Mac and a SD card reader to get the data to your computer. The software will display many machine readings and what it is doing during the night. It is very helpful in optimizing the settings of the machine. The adjustment can be managed in other ways, but using the software is the best.

My suggestions for initial settings would be 7 cm minimum pressure and 15 cm maximum. If you set the minimum pressure too low, it can feel suffocating. The ramp is optional, and you may want to leave it off until you are more familiar with the machine. Here is a link to a technical manual for the machine. It is kind of difficult to use because the manual covers a few different machines. If you have any questions after looking at the manual, just ask.

Once you have the machine set up, I would try it before going to bed, and while you are watching TV or something. It does take some time to get used to. I would recommend against the alcohol as while it tends to help you get to sleep, you can wake up in the middle of the night and not be able to get back to sleep again.

Some have posted that if you wash the headgear it shrinks and tightens up. I never found that to be the case however. I replaced my P10 mask headgear with the headgear from the Swift FX mask. It is much better. See this link.

P10 Headgear Upgrade

I didn't want to tell you what my daily readings are like as my apnea issues are not unlike yours, and my AHI is very variable. That unfortunately is the nature of complex apnea. My obstructive apnea is generally very good, but central apnea is a problem, and so is hypopnea. I believe a good portion of my hypopnea is not obstructive in nature, but central in nature. I have had many theories on what makes it go up and down. Part of it seems seasonal. In winter I keep our room cooler, and now that spring has arrived, the readings have gone downhill... In general my AHI has been significantly poorer since mid April. Here is a screen shot of my overview. My 280 day average AHI is about 2.5. My wife on the other hand who seldom has CA events averages about 0.8 for AHI. I was diagnosed with a home test and AHI of 37. My wife was diagnosed at an AHI of 83. It shows that where you start with apnea is not a good indicator as to what you can achieve with a CPAP.

For these reasons it is quite risky to make pressure change decisions on the basis of just one or two nights. When you get things into closer control, it would pay to wait at least a week or two between adjustments to see which setting is the best.

I have not worn a pulse oximeter and basically depend on my AHI values to indicate how well I am breathing.

I have never seen the pAHI designation before. On a quick google search it seems to be a bit of a specific brand name thing with the p standing for PAT. Not sure what the PAT designation is other than it seems to be part of the name of the machine... In any case I found this document which you might find helpful, if this was the specific machine that was used to do your test.

Sleep Test Meaning

I don't see anything too unusual here. Your AHI is in the lower end of moderate apnea. No CSR was detected. If there is a weakness in this study method it would be that it does not breakdown the CA, OA, and H events. CA events are the ones you have to watch and be careful about, as they are not automatically treated with a CPAP, and may even be aggravated by pressure.

I think the good news in this report is that CA events are quite low. Most of your issues are obstructive and hypopnea. They may be solved with an increased minimum pressure. My thoughts would be to try 9 cm for a minimum and see what that does.

You do have a few green highlighted areas of what Phillips calls Periodic Breathing. They can be related to the central apnea events and a certain type of them are called Cheyne-Stokes respiration (CSR). In that other thread here about UARS I posted some examples of it. The second event you had included a hypopnea event. It would be worth looking at that more closely by repeatedly left clicking on it, or using the up down arrow to zoom in. The Minute Ventilation may be of some help in seeing what is going on there.