Sierra

It would be helpful if you posted a Daily Report screen from OSCAR. There are some things you should do first to clean up the default screen though, assuming OSCAR defaults are the same as SleepyHead. This assumes you are on a PC. Mac should be somewhat similar.

1. Under File, Preferences, Appearance, uncheck the box that says "Show Event Breakdown Chart". It is redundant.
2. Close the Navigation Bar on the right, F10 I believe on a PC.
3. Also click on the black triangle beside the date to hide the month calendar.

All these things use up valuable screen space. Make sure the Event Flags are pinned to the top. Click and drag the graph titles so the Pressure, Flow Rate and Leak Rate show.

Again on a PC the F12 key will save this screen shot as an image file. Just note in the popup where it is saving the file. Then when you navigated in Windows File Explorer and find the file, you can click and drag the file to the body of a post. Just make sure you start with a new post in the thread so you get a full width post.

If you post it here, I can give you my comments. It would be good to post a good day and a bad day.

I have diabetes and allowing BG to go high can certainly cause me to nod off, particularly after a meal. Some sleep issues are not actually due to medical conditions but due to sleep habits. I have found a lot of good tips to improve my sleep hygiene at the site with the link below. The project was started by a pharmacist and university professor who thought too many people were unnecessarily using sleeping pills.

SleepWell It is No Dream

It should only be the same as AHI if your RERA events are zero. If they are zero the RERA bar does not likely display on the Daily report screen.

Depending on the type of apnea he is suffering from, that may be as good as it gets. Central apnea (clear airway, CA) events are not really reduced effectively by a CPAP, and are more difficult to control. But under 5 is considered OK. If it is all obstructive apnea (OA) then getting down to a consistent 1 may be possible. There is a free program for a PC or Mac called OSCAR that does a very good job of displaying all the detailed data. It requires a SD card reader. All but the very basic CPAP machines from Phillips and ResMed capture the detailed data. Viewing the detailed data can be very helpful in determining is improvements can be made to the machine setup. If you need help with this, just ask.

OSCAR Download

I just tried it, and it seems to work for me. The big orange AHI bar in the top left of the daily screen changes to RDI. And the title of one colum in the Statistcis screen changes from AHI to RDI. Did a quick math check and it seems to be accurate. It just adds in the RERA events. It did require me to restart the program to make the update.

I have never found it to be a good idea to purge data. I like to keep all my data since day one.

I am not a medical professional, and could not guess what else could be going on. With CPAP some people seem to get a benefit fairly fast, while in others it takes some time. One issue is that a CPAP will always disturb sleep until one gets used to wearing it. So you have the CPAP reducing the number of apnea events, but at the same time the mask, hose, and pressure disturbing sleep. That will take some time.

It sounds like he was diagnosed with an AHI of 25, which is Moderate apnea. Do you know what it is now? The objective is to get it to less than 5, but it is not uncommon to get below 1.

OK. That one set of numbers suggests obstructive apnea is the main issue that drove the AHI up. I suspect you would learn a lot from using OSCAR. It provides much more detailed data. And as long as your SD card was in your machine, it should all be on the card. Have you checked to see that there is a card. Some providers do a nasty trick and pull the card out of the machine.

There is a setting for the ramp start pressure that you may want to look at too. You cannot set it any higher than your main set pressure, but if you leave it at default, it starts at 4 cm, which can leave you with a lack of air. I suggest 7 cm for a start pressure, then move it higher if you feel short of air, or lower if it seems like too much air.

It sounds like you may have aerophagia, or air in the stomach. I have never experienced it, but I understand it tends to affect new users of CPAP that are on a higher pressure. What pressure settings do you have? I believe the S9 Elite is a fixed pressure model. Here is a link to an article on aerophagia.

Aerophagia Causes and Resolution

The article may give you some ideas on what to try. One of the suggestions is to use expiratory pressure relief, or EPR to reduce the pressure when you exhale. Your machine is set to do that if it is set to EPR full time and at the maximum 3 cm reduction setting. The problem with EPR is that it also tends to raise the inhale pressure required to control apnea. For example if your pressure setting is 15 cm, each time you exhale it goes down to 12 cm. That makes it easier to exhale, but it also lowers your effective pressure for treating obstructive apnea to 12 cm. But at the same time it subjects you to a 15 cm pressure. It doesn't work this way with everybody, but you could possibly the same treatment with the set pressure at 12 cm and the EPR set to ramp only. In ramp only it makes it more comfortable to go to sleep, but stops the reduction at the end of the ramp. So out of this there are two possibilities for machine settings.

If your AHI is good, is it possible that the machine setting could be reduced, and if necessary could the EPR be set to ramp only. This is a little more difficult to determine with a fixed pressure machine, as about the only way you can find out is by changing the settings and trying it. In an auto machine you could stop the EPR and see if the auto function brings the pressure down by itself. In any case I don't know if you adjust your own machine or not. If not, then this would be something to discuss with your sleep clinic. Also keep in mind that with many people some adjustment time is required, and they get over it.

What is your breakdown of AHI into the CA, OA, and Hypopnea types? Central apnea can be erratic and harder to deal with. On the times when you have AHI in the 14 range, it would be helpful to know the breakdown to see how much of it is central apnea compared to obstructive. OSCAR will tell you this. All the historic data should be on your SD card, so you can go back and review specific days.