Sierra

Unfortunately the AirSense 10 CPAP model does not capture detailed data that can be viewed in SleepyHead. The Elite model does, as well as the AutoSet.

You can get a small portable SD card reader that plugs straight into a USB port, for $10 or perhaps less. The smiley face is pretty tolerant of leaks. If 70% of your night is less than 24 Liter/min you get the happy face. Ideally you want to be close to 100% under 24 L/min. Here is my SleepyHead report from last night. The bottom graph is mask leaks. You can set a red line at 24 L/min and then observe where you are going over the redline. I like to be no more than 1-2% over the red line.

Benefits seem to vary from person to person. You should expect some discomfort and and adjustment period to get used to sleeping with the CPAP. That can offset the benefits initially, but most get used to it, and end up with a better sleep. If you are looking for some tips on how to set the machine up for the most comfort, then post back with the machine brand and model, and the mask you plan to use.

The Elite is a fixed pressure CPAP and should not be increasing pressure during the night. It should be constant after the ramp is over. Here is a link to the Clinical Manual for the machine. You should be able to go into the Clinical Menu and see how the machine is set up.

You may also want to download SleepyHead if you have a PC or Mac and an SD card reader. The SD card should be in a slot on the left side of the machine. It will have the data for each night. SleepyHead will allow you to view the data including the set pressure and mask pressure during the night. SleepyHead is free, and is no longer being developed, but it should work fine with your machine.

What kind of a machine is it? If a ResMed AirSense, if you push the round button it should show you the pressure. It sounds like you have too much pressure. The machine should adjust to the pressure even if there is no flow.

Yes, that is a quite serious case of apnea. My wife was diagnosed at an AHI of over 80. And your oxygen desaturation is not so good either. Is there anything you can do to speed up the the prescription and approval by talking to your doctor? On line suppliers of equipment can ship it out overnight, but do require a prescription.

Not wanting to alarm you, but that central apnea frequency is high too. CPAP or APAP machines do a very good job of reducing obstructive apnea, but not so good with central apnea. In fact machine pressure may even make the central apnea worse. Are you scheduled for a titration study? That is where they do another sleep study but this time adjust the pressure to see what pressure works, and if central apnea is going to be a problem. Without any significant central apnea, it is common to go straight to an automatic CPAP or APAP. But with higher central rates the titration study is more necessary.

Sleep apnea is not an immediate life threatening condition. Think about the oyster divers that go under water just by holding their breath for 5 minutes or longer at a time. An apnea event is more than 10 seconds, and typically in the 15 - 20 second range. The complications it can cause are long term, not immediate. That is just my non medical professional opinion.

I'm glad it worked out for you.

The only time I have had a bad smell from my AirSense 10 is when I let the water reservoir go dry. Wow, does that stink -- like a month old gym bag with unwashed clothes in it...

One thing you might want to try is using the pre warming feature. It is near the bottom on the main menu. It takes 15 to 20 minutes to prewarm, and then goes into a holding mode. Not sure how long it will stay there. It warms up with a lower air flow going through the hose. Not sure if it uses the hose warming or just the humidifier warming. But, at minimum it circulates air without you having to breath it in.

Welcome to the forum and congratulations on the weight loss. That can help with the apnea frequency. I use a AirSense 10 AutoSet and initially ran in Auto mode. I was diagnosed with a home study, and immediately put on the APAP with a setting of about 8 to 15 cm, and EPR at 3. Since my wife was on APAP before me and the provider of the equipment told us about SleepyHead, we had been using it on her machine, and then my machine. It told me that unlike her, I was having a high proportion of clear airway (central apnea) events. I went through many different iterations for pressure and EPR. After several months I finally concluded that my hypopnea events were driving the pressure up to 15 cm, and my suspicion was that the hypopnea events were central in nature, not obstructive. My first step to address that was to lower the maximum pressure and increase the low pressure. I got to the point where my pressure was almost fixed, so I made the change in the machine from AutoSet to CPAP. I tried a few different variations in pressure but settled on a fixed pressure of 11 cm and EPR at 3 cm, but in Ramp Only mode. I found that having EPR on increased my pressure requirement when I was sleeping. But still having EPR on when going to sleep was more comfortable. I think that is the best feature that the AirSense machine has. Now my settings are a Ramp Start pressure of 9 cm, fixed pressure of 11 cm in CPAP, and EPR of 3 in Ramp Only.

I can't explain why the doctor would have given you a Auto machine and then immediately put it in CPAP. The traditional way of diagnosing apnea with an in lab study, that is usually followed by a titration study which determines the optimum pressure. A pressure too low usually does not optimize the reduction of obstructive apnea, and a pressure too high can cause more central apnea. An AutoSet is almost the same price as a AirSense Elite which is a fixed CPAP pressure only, so you got the Auto machine in case your needs changed. Just a guess. My thoughts are that if one suffers from central apnea a fixed pressure may be better than an auto pressure mode. This is just based on my experience only. My wife still runs her machine in auto mode.

The reality is now with Auto machines, the titration study in most cases is not necessary. I never had one. If you look at the results with an initial wide pressure range for the Auto machine with software like SleepyHead you can determine what your pressure requirements are. It is kind of like having a titration test every night. However even with a machine in Auto, most users will bring their max pressure down just to prevent unnecessary excursions up, and they also bring the minimum pressure up. Having the pressure start higher helps avoid early in the sleep apnea incidents which might wake you up just after going to sleep.

As far as settings go, it sounds like you are doing well with either a fixed pressure or auto pressure range. If you download SleepyHead and view your detailed data which should be on the SD card in your machine, you will see what has been going on, and what pressure range may be idea. The software is free. It is no longer being developed but works with the AirSense machines. You need a computer to run the software and a SD card reader to get the data from your machine into the program. If you post the Daily report here of a night when it is in AutoSet mode I can give you my comments. My thoughts based on what you have said in your post would be to move your start pressure up from 4 cm to 7 cm, set EPR to 3 and for Ramp Only, and increase your minimum pressure to 8 cm. What that will do is give you 7 cm on inhale and 4 cm on exhale while you are awake in the AutoRamp mode. I find a start pressure of 4 cm is far too low and can feel somewhat suffocating, but it is a personal thing. Then when you go to sleep, the pressure will ramp up to 8 cm and the EPR will stop. After that the pressure will adjust up and down between the limits of 8 cm and 10 cm. Once you see what it is doing, some further refinement of the min and max pressures may be possible.