Sierra

One of the quirky things about SleepyHead is that it seems to want to read the data directly from the SD card. Once you have SleepyHead up and running with the Welcome screen, you should just have to click on the CPAP Importer button. It should find your data on the SD card and ask you if you want to import it. I also use a ResMed AirSense 10 AutoSet and SleepyHead is compatible with that machine.

In general I find if I get a poor sleep I tend to have more central apnea. Some of it is real, but I suspect some of it is what some call sleep-wake junk. SleepyHead will be very helpful in determining what is going on. Some of my highest AHI readings ever was when I first used a CPAP and it was not set up ideally.

The sad reality is that many machines that newly diagnosed apnea sufferers get are simply taken out of the box and handed to them. It is becoming less frequent for titration tests to be done, and having the new user set up with a specific pressure. Instead they are handed an out of the box automatic machine set at the factory for 4 cm min, and 20 cm max. For many that actually works, or sort of works. But, unless someone sets the machine up properly for them, they will never know that their settings are not ideal.

It seems like the OP is not going to return, but that is one possible explanation in this case. The machine was set 4-20, and something has changed and now it is going higher in pressure. But without seeing a SleepyHead chart one would be just guessing.

Yes, it is easy to get too much salt. I never add salt to my food, but as you mention others like manufacturers of prepared food love to add it. It is a cheap flavour enhancer. The lisinopril is a pretty common blood pressure ACEi drug that works by relaxing the blood vessels and hopefully over the longer term reduces the hardening of the arteries as often happens with age. I have taken ramipril for 20 years and more recently the newer perindopril. The chlorthalidone is a water pill and will reduce sodium. They are generally pretty save but you should get periodic checks of your sodium and potasium levels to be sure they are within range. My mother takes a similar drug and ended up in the hospital emergency with low sodium. She was avoiding all salt while taking a diuretic type drug. I took a diuretic for a while too, indapamide, which worked well for me, but I am no longer on it. There is actually one newer drug brand named Coversyl Plus which is a combination of an ace inhibitor and diuretic, in this case perindopril and indapamide. It was developed in Australia, and the combination is claimed to have additional benefits, especially for diabetics. If you are paying for your drugs, it is cheaper to buy the two drugs independently as generics though.

What is the make and model of your machine and how are the pressures set up?

There are really only two credible automatic CPAP machines on the market and readily available in the US and Canada. They are the Respironics DreamStation and the ResMed AirSense 10 AutoSet. Both are good and will basically do the same thing. The ResMed however in my opinion is the better of the two. The DreamStation might be slightly cheaper, but the difference is not much.

If you have any choice in the selection of the machine, I would suggest the ResMed AirSense 10 AutoSet, or the AutoSet For Her model. With the required pressure of 14, the For Her setting may not be the best to start with. But, the For Her model can be set to standard mode as well as For Her. It is the same price.

I will have to say I am not a big fan of the travel CPAP machines. I find the ResMed AirSense quite easy to pack up and travel with. When our son got a CPAP he bought it on line and saved enough money that the insurance company agreed to buy him both a home machine and a travel machine. For the travel machine he bought a Z1 Auto. It is more expensive than the home machine, and you can buy batteries for it to run without AC as well, but they are quite expensive. To make a long story short, he tried it for camping with a trailer and did not like it. He found it to be so noisy that he could not sleep. He ended up giving it to his parents. I didn't think it was that bad for noise, but I have never used it. My wife has. She says it is OK, but prefers her ResMed with the humidifier. So the Z1 sits in the closet somewhere as an emergency spare. I have since found out that I have substantial hearing loss and now have hearing aids. I thought it was quite before, but it may have been just my hearing loss that made it quiet!!

In any case from what I know of the Z1 I would not recommend it. The other issues to watch for is the humidifier. These portable ones either do not have them, or they use a consumable water absorption device which captures water from your breath and recycles it -- or something like that. If you are a SleepyHead user, I don't think most of them are compatible, but not sure about that. The ResMed model forces you to use a special hose connection and a very limited number of masks that will fit it. So if you have to buy the special mask it may not be the one that you like and use at home.

So those are the things to check for; humidifier, noise, special mask, SleepyHead compatibility.

What I find is that my AirSense fits perfectly in the supplied travel case, and for a short trip the whole travel case fits in my carry on bag. Or, because it is a medical device, you can take it on board a plane, and not have it count as part of your carry on, or personal item. They improved the case for the AirSense 10 over the S9, by making it all smaller, and it has velcro straps on it to conveniently slip over the carry on bag handle extenders. When we travel with our RV we take 12 volt DC to 24 volt DC converters for times when there is no AC power to the trailer. Works well.

Hope that helps some,

In the setup part of SleepyHead under File, Preferences, Import there are some setting for Combine Close Sessions, Ignore Short Sessions, and Day Split Time. You might want to check to see if OSCAR is set the same at SleepyHead.

In the US the ResMed AutoSet sells for about $70 more than the ResMed Elite CPAP. In Canada the difference is $30.

Suspect sleep labs like to do titration tests because they get paid for them...

Either program should work fine. At this point they are nearly identical. OSCAR may be improved in the future, but SleepyHead development has stopped.

What you are mainly looking for is the impact of pressure on the frequency of your central apnea events. There are two basic strategies followed to deal with central apnea., and a third if the first two fail.

1. Minimize the pressure to as low as you can. The idea is to have the pressure high enough to reduce the obstructive apnea to acceptable levels without causing excessive central apnea events. It helps with this strategy to NOT use EPR or the FLEX feature which puts a differential between inhale and exhale pressure. It also seems to work best to have the machine in fixed pressure CPAP mode so the machine does not push pressure up too high in Auto mode. I would not discount this method if you have not already tried it. Most BiPAP machines can be put into the CPAP mode, so this would be any option to try if you have not already done it.

2. If that fails then there are BiPAP machines that put a higher pressure split between inhale and exhale, which sounds like where you are now. Some machines detect that you are not attempting to breathe and will cycle the pressures to try and help you breath.

3. If neither of these approaches work, then the last resort is an ASV or Adaptive Servo Ventilation machine. These take the breathing assistance one step further and monitor each breath you take and on a breath by breath basis assist with pressure.

Hope that helps some. If you post your SleepyHead Daily report I may be able to suggest more.