Sierra

It would appear that most of your apnea events are central. In this case a CPAP is not going to work. A central event is when you stop breathing while the airway is open. Increasing air pressure does not help with central events because the airway is already open.

I have not heard of an AirSense model called Respond. Perhaps it is not North American? The common models are the AutoSet, AutoSet for Her, Elite, and CPAP. All but the CPAP model capture detailed data on the SD card. The first thing to check for is to see if there is a SD card in it. It will be in a slot on the left upper side that has a flexible cover that you have to pull back to get at the card.

You can click on this hot link to find OSCAR: OSCAR

It is free to download, but requires a SD card reader and a PC or Mac to run it. If there is a card in your machine it should have all your past data on it. If there is no card and it is a model that supports detailed data collection you will have to install a 4 to 43 GB card. They normally come from the factory with a 4 GB card.

I can't make a lot of sense of the test result numbers as they seem to be event counts and not in events per hour. Normally there is an events per hour number of each type of event which is added up to give a total AHI. Ideally one wants the AHI to be under 5. But this said you do seem to have a lot of obstructive events which means you should benefit from a CPAP machine.

There should be no need to get that Fitchecker for advice on mask fit. Your machine should have a display that has a happy face if leaks are ok, and a red unhappy face if leaks are too high. OSCAR provides a much better display of your leaks though. See an example of the OSCAR report below. There is a leak rate graph that shows the minute to minute leaks during the night. The gray areas highlight when leaks go over the "leak redline". You can see a couple of those events at 5:00 and 6:20.

There is also a detailed sleep report on your machine if it is set up properly. First lets start by figuring out if your machine has a SD card and if it supports OSCAR. Here is a link to a detailed manual on the AirSense 10 that may be of some help.

https://www.respshop.com/manuals/ResMed-AirSense-10-for%20her.pdf

Welcome to the forum,

Some questions for you to clarify where you are at:

1. What CPAP are you using?
2. Does it give you a breakdown of the AHI into central, obstructive, and hypopnea events, and if so what is your typical breakdown?
3. Have you tried using OSCAR to do an analysis of your detailed data from your CPAP, assuming it supports your machine? Most of the popular ResMed and DreamStation machines have a SD card that captures detailed data for analysis.

The breakdown of AHI is very important as a CPAP is most effective in reducing obstructive apnea events because they are caused by the airway closing down, and the pressure can open it. If they are mainly clear airway or central events then more pressure can make the event frequency increase instead of decrease.

The other issue with not having the water reservoir pushed fully in is that the flexible silicone seals between the reservoir and the machine will flap back and forth on each breath in and out. It causes a clicking sound that can be quite annoying.

SPAM!

Fortunately machines like the ResMed come with power supplies suitable for 110 and 220. All you need for some countries is the adapter from North American plugs to European ones. And for short visits of a week or two, you can get away with using tap water for the humidifier. It is not necessary to carry or find distilled water. Just clean the reservoir thoroughly with vinegar when you get home to get rid of the mineral deposits.

OSCAR is not all that hard to understand. It reveals the detail behind the numbers. See this example of the important graphs that it produces. You can see when the various types of events occurred. For example at 3:10 there is a CA. central apnea event, flagged with magenta. It happened with pressure about 14.5 cm. Note that the cpap does not increase pressure in response to a CA. A little later at 4:30 or so there is an obstructive apnea event, blue, that does result in an increase in pressure. Pressure was very low, too low, and that likely caused the event. There is a rapid response with an increase in pressure, but it is too late. Pressure at that time was set at a minimum of 6 cm and 20 max, which was where the sleep clinic set it. The minimum pressure for her was way too low, and the maximum was too high. A bit later she has another couple of events around 5:40 when the machine has ramped the pressure back down again. She currently uses a min and max pressure very close together in the 14.5 cm range to avoid this from happening. She was diagnosed at about 73 for AHI, and needs a much higher pressure than you will. In any case that is what you can do with OSCAR. It is essential in my opinion if you want to adjust your own pressures. Otherwise you are just shooting in the dark. You can post your results here for input if you are not understanding what they are showing. No need for all the reports that OSCAR can do. The main one is this Daily report. It has the important stuff. With a PC use F12 to capture the screenshot. Then just drag it with File Explorer to an open message here. Start with a fresh full width window, not like this one will be with a response to another post.

The general idea is to keep the pressure as low as possible while still maintaining a low obstructive apnea index. If the pressure is too high it can actually create central apnea events especially when you are a new used of CPAP. EPR at 3 is ok to start, but once things settle out you may want to try it with it lower or off. Each person is a bit different but I have found that EPR can reduce hypopnea. In others it can increase OA events with the same pressure settings.

I would suggest you start with a pressure of 8 cm max and 5 cm min. This will give you some idea if this is enough and you can go from there. It is best to wait 1-2 weeks between significant pressure changes. I like to set the Ramp on Auto, and with the pressure settings suggested, set the Ramp Start Pressure at 7 cm. Another convenience is to set the start stop to auto so the machine starts when you start breathing and stops automatically when you take the mask off.

Do you have OSCAR. It is essential to keep track of things while adjusting the machine, and also over the longer term to measure progress. It requires a PC or Mac and a SD card reader. Check your machine to ensure there is a SD card installed or it will not capture any detailed data. Some suppliers take them out.

If you have any questions, just ask,

Since I posted here a year ago, suggesting I that I have a dent from wearing Swift FX headgear I switched to the new standard AirFit P10 mask with the improved headgear. This mask actually has worked quite well for me, but more recently the lower strap has been slipping upward at night. Feeling my head, I think the dent from the more rigid Swift FX mask has pretty much gone away. So this is kind of a good news, bad news story. The dent goes away, but the dent was useful in keeping the mask in place!

My wife and I both have CPAPs. When we travel we use tap water for the humidifier. It just means a bit extra time cleaning the humidifier reservoir with vinegar after you get home to get rid if the minerals. Does not damage the machine or the person. The humidifier acts as a distillation unit and only pure water gets breathed in.