Sierra

That information is helpful, but it would be much better to include the whole Daily Detail screen which shows the events bar, and the graphs including pressure, mask pressure, flow, snore, flow limitations, and leak rate. To show as much as you can on one screen, use the F10 (PC) key to hide the right menu bar. Click on the triangle beside the date to hide the month calendar. Use File, Preferences, Appearance, to uncheck the "Show events breakdown pie chart" box. F12 saves the screen. Post it here with a new Write a Reply so you get full width to display it.

What is unusual about your data shown beside the very high AHI number is that so much of it is Unclassified. I suspect that is because you have an extremely high leak rate on your mask - 77% over the leak redline (25 L/min). Ideally this number should be close to zero. In any case the machine has a hard time classifying events when the leak rate is high, so that is the likely reason for the high unclassified. Total time in apnea of 1.25 hours is really high too. As Sleeptech has said, having the 95% pressure number at your maximum for pressure of 15 cm indicates the machine is maxed out on pressure. I would suggest increasing max pressure to 20 cm since you are in auto mode, if you are comfortable doing that yourself. Otherwise you should request a pressure increase from your sleep clinic. Here is a video on how to get into the setup menu to change the pressure if you decide to do it yourself. It should be right at the top of the menu list under Therapy.

More pressure however, is likely to increase mask leakage, and it is way too high already. I see from an earlier post you are using the F&P Simplus Full Face mask. Perhaps Sleeptech or others can give you some tips on how to fit the mask properly. I have no experience with that mask.

In any case, if you can post the full screenshot of the Daily Report detail, I could provide better comments.

I don't believe the ENT is correct in saying a CPAP would not be appropriate. An apnea event not only causes oxygen desaturation, it also initiates arousals and awakenings which disturb your sleep. Unless your AHI is mainly central apnea events, a CPAP is likely to make a very significant reduction in that AHI of 19 to less than 5 and without centrals to about 1.

What is the breakdown of your AHI of 7-8? Is it mainly obstructive, or clear airway? What pressure are you using?

I have tried the full face masks and have gone back to the nasal pillow type. I actually have a Swift FX on order now which I hope will be a little better than the AirFit P10. If you open your mouth in the night, it can usually be solved with tape on the mouth. Or, worst case, chin strap and mouth tape.

On the F10 mask is there a reason you are using the full face type?

Hi Joe,

It would be quite a lengthy response to cover all the aspects of SleepyHead. The best way to do it would be for you to post a screenshot here, and I could make the comments specific to you and your machine. Let me know if you need help posting the screenshot.

Here is a screenshot on my results a week or so after starting with the AirSense 10 AutoSet.

What can you see on this chart? First I was using EPR full time, and that was causing pressure to run too high. And despite the pressure I was having both high numbers of central events and obstructive events. Pressure was set at a minimum of 10.4 and the max at 15 cm. The machine was running pressure all the way up to max at times. You can see where the apnea and pressure woke me up about midnight. The event breakdown showed that the majority of the AHI was due to Clear Airway events. About the only good news in this chart was that my leak rate of the mask was low.

Here is another more recently:

On this one EPR was set for Ramp Only. The pressure was nearly fixed with a minimum of 12 cm and max of 12.2 cm. I slept right through for 8.5 hours. Total AHI was low at less than 1, but Clear Airway events were still significant. I had one fairly large leak. This is a better than average chart for me though. I am now averaging about 1.7 for AHI.

This is just scratching the surface of what you can do with SleepyHead. By clicking on the events of interest you can zoom in and see what is going on in more detail.

Hope that helps a bit. It would be best if you posted a screenshot from a night that you are concerned about, and I could go into more detail.

If you buy an oximeter I would be sure to get one that is compatible with SleepyHead. See this info:

That said is your machine capable of saving data and viewing it in SleepyHead? That may tell you a lot more than an Oximeter will.

You are welcome. If you download SleepyHead and view the results there, you may have an opportunity to further refine your settings. You might gain further comfort by increasing your minimum pressure to 7-8 cm, and the start pressure to the same pressure. It would be kind of shooting in the dark though without seeing the where your pressure is going and where the apnea events (if any) are occurring. If you want help with SleepyHead and how to post results here, just ask.

If you have set the Essentials to Plus, you can scroll down on the User Menu and view the more detailed Sleep Report. Set it for various time periods and post back what your Pressure is. It represents what the 95 percentile pressure is. That will give some idea without using SleepyHead, where your pressures are running to, and whether or not there may be some room/benefit in increasing the minimum pressure.

Have you tried the fitting instructions and printed out the fitting template? If you print it make sure you get the right scale. I see some of their sales stuff claims it fits 93% of patients.

Have you looked at the Respironics Amara View and the DreamWear Full Face? They are quite similar and come in a large size.

In your first post you reported that you were having sleep onset apnea. I would hope that with the settings I gave you the initial ramp start pressure would be high enough to prevent the apnea. It it doesn't post back and there are some other options you could try.

• Use it in CPAP fixed pressure mode and start at that fixed pressure with no ramp up or hold in pressure. The machine will be active right from the start in detecting any apnea events, so you will quickly see if you continue to have sleep onset apneas, and what pressure is required to stop them.
• You could use EPR and not use EPR during the ramp or hold.
• You could use the Standard AutoSet algorithm to see if that works best for hypopnea reduction while sleeping, or if the For Her mode works best. I would expect if you get the For Her model it will default to the For Her mode.

I answered most of this a bit further back in the thread. Here is a copy.

A setting of 10 is moderate. The machine is capable of going from 4 cm to 20 cm. I am now using a pressure of 11 cm. If you are going to run the machine in the For Her Auto Mode, and your recommended fixed pressure is 10 cm, I would set the minimum pressure to 8 cm, and the maximum to 11 cm as a starting point. Then after some experience with that setting and using SleepyHead to monitor the results, you can either refine those pressures, or go to a fixed pressure based on actual experience with the machine. Here is a cut and paste copy of what I gave another user of the ResMed for initial setup for comfort.

• Ramp Time: Auto (This will hold the machine at the start pressure until you go to sleep)
• Start Pressure: 7 cm or more (I would not set it at less than 7 cm unless your minimum pressure has to be less than 7 cm. You can't set Start Pressure higher than your minimum pressure. I adjust this pressure even higher to give me a feeling that there is no mask on my face at all. This pressure should be high enough that breathing is very free and easy)
• EPR: On
• EPR Type: Ramp Only (The purpose of Ramp Only is to give more comfort while going to sleep and a more effective therapy pressure after you go to sleep)
• EPR Level: 3
• Climate Control: Auto (providing you have the heated hose)
• Tube Temperature: 27 C

A little further down on the setup menu under Options you will find this item:

• Essentials: Plus (Setting it to Plus will give you more options on your User Menu, and a more detailed Sleep Report.)

If the issue of apnea events right as you go to sleep is not solved by this, there are other options. But I would start with this.

Here is a link to a video on how to set the AirSense 10. I would also download SleepyHead so you can monitor the results you are getting from day 1. The settings may have to be adjusted a little based on your actual experience with the machine. Another poster put some examples of SleepyHead reports a little further back in this thread.

You for sure want to get a hard copy or pdf copy of your sleep report. You will want it for future reference as to where you started this CPAP journey, and if you ever want to buy even a mask, you need it in the US.