Sierra

And here is another good article from another location at this website.

Complex Sleep Apnea

With the Essentials set to Plus, I would have thought the summary level detail from your 4 nights so far would have showed up, based on the thought that this summary data is stored in the machine. Perhaps it stores it on the card. Don't know. You have to keep scrolling down past the basic sleep report data to see the more detailed data. The first line should be the interval period which you can set.

Based on the limited data you have, it would seem you have issues with central apnea. Your pressure of 5 cm is only 1 cm above the minimum the machine can produce - 4 cm. That means you have very limited opportunity to reduce pressure. If you can't get AHI under 5 with a CPAP, you may have to explore the dental appliance route, which uses no pressure. But on the other hand a dental appliance is really only effective in reducing obstructive apnea, so it may not work either.

I suffer from central apnea as well as obstructive apnea. What I have observed is that hypopnea can be either an indication of partial obstruction, or it can be a central apnea (reduced breathing effort) that has not fully developed to a full central apnea breathing stoppage. What I am getting to is that your hypopnea events may be related to central apnea, not obstructive apnea. About the only way to determine that is to zoom in on the flow rate graph and see what it looks like. Most often you can determine what type is it likely to be by the visual appearance in SleepyHead.

This all should give you a good case to get a better machine. I would try to get the AutoSet if you can, and if not that then the Elite. The AutoSet can be set to use a fixed CPAP pressure mode, as well as operate in Auto mode.

With the machine set at 5 cm and EPR of 2, it will be delivering a steady 5 cm on inhale. In theory the EPR set at 2, will reduce the exhale pressure by 2 cm from that. However, the machine will not go to less than 4 cm, so it will only reduce pressure on exhale to 4 cm. Bottom line, is that you have very limited opportunity to reduce pressure. You could turn the EPR off, and that may help a little bit, and is worth a try. And pressure could also be reduced to 4 cm for a try. However, that may start to feel uncomfortably low.

Hope that helps some. Here is an article about central sleep apnea to read, if you have not already. Central sleep apnea may have underlying causes which are treatable without CPAP.

Central Sleep Apnea

I am familiar with that mask, as my wife has used that one. The machine I am not so familiar with. Both my wife and I use a ResMed. Does that machine also have a heated hose as well as a heated humidifier? On the ResMed when you have the heated hose, you can set the air temperature and put the humidity control on automatic to get pretty comfortable results. For what it is worth, my wife has now changed from the Mirage FX to the F&P Brevida and finds it more comfortable with fewer leaks. However, mask preference is very personal. I prefer the ResMed AirFit P10 nasal pillow over the Brevida.

In any case my thoughts would be to try SleepyHead again. If you can post some daily reports here, I would be happy to give my thoughts on what may be any opportunities for improvement. With an AHI of 0.5, it may be possible to reduce pressures some to improve sleeping comfort, and reduce the potential for sinus issues. On a PC all you have to do is maximize the Daily report screen, press the F12 key, and it saves an image file in the SleepyHead Screenshots directory. With File explorer, just left click and drag that image file to the body of your post.

From your other post, I believe you are using a fixed pressure AirSense 10 CPAP. Not sure how you got to the point of using a CPAP but the normal way is that you get the sleep lab report which is the diagnosis of apnea. An AHI of 8.5 would be considered in the 5-15 mild category. The choice for treatment at that level is a CPAP or a dental appliance. The traditional next step if the CPAP route is chosen is to do a second overnight study (unless the first night was a split study). This second phase is a titration study where they increase the pressure of the CPAP over the night to see how much pressure is needed to stop the obstructive apnea. That becomes your treatment pressure and if you get a fixed pressure machine then it is set at that optimum pressure determined by the titration. Due to the extra cost of that second titration study the more recent practice promoted by insurance companies is to skip the titration study and just prescribe an automatic CPAP. It then adjusts the pressures.

So, I guess the question would be if you had a titration study? and what was the pressure selected? The second question would be the breakdown of your AHI of 8.5 at diagnosis. Do you know how much was central apnea and how much was obstructive? And does your machine report now report AHI and the portion of that is CA? The reason I ask all this is that there is a condition called treatment emergent central apnea. In other words the CPAP pressure can make the central apnea worse. In most this emergent apnea resolves itself over time.

With those numbers I can sure see why you would want to use SleepyHead. It would identify all the events and when they are happening and the type (OA, CA, hypopnea). One thing you could try if you are not currently getting a detailed sleep report from the machine is to enable the enhanced sleep report if your machine can do it. Here is a link to a technical manual for the AirSense series. What you want to do is change the Essentials setting, which is under Options, from On to Plus. That should give you the most detailed reporting that you can see on page 19 of this manual. The manual explains how to get into the clinical settings, but it basically is hold the Home and Round setting button in at the same time for 5 seconds or so. This will bring up a clinical menu that works basically like the user menu. Scroll down to Essentials, push the round set button and then select Plus. Then Home key out to the User Menu. If this works on your machine, you can then set the reporting period in the Sleep Report section and it will give you the more detailed numbers for the selected time interval.

Since you have only had your machine for 4 days, is there any option to return it and exchange it for an AutoSet? That might work much better for you.

Most people are more susceptible to obstructive apnea when they sleep on their back compared to their side. Also some report that they can get their head and neck in a position that seems to promote OA as well, and use a soft cervical collar to help keep their head/neck aligned. The other issue is the type of apnea. SleepyHead flags all the individual events as well as the graphical trend.

These are the kind of things that SleepyHead is quite useful for. I believe your machine is compatible with it. The reports are a little less informative when using a fixed pressure. Here is an example of one of my nights when using a fixed pressure. You can see toward morning I had a cluster of events, but they were all central apnea (CA).

If it turns out the machine does not support detailed data collection and you want it, then you may want to consider a company like Second Wind CPAP. They buy and sell used machines as well as new. Perhaps you could trade in your existing machine for the AirSense 10 AutoSet, which does support detailed data and SleepyHead.

I have been doing some digging and I have come to the conclusion that the two basic CPAP machines from ResMed; AirStart 10 CPAP, and AirSense 10 CPAP, only store basic data, not detailed data, although they both have SD cards. The AirSense 10 CPAP Elite may save detailed data, and the Auto machines (AutoSet) for do save detailed data. Probably best to phone ResMed and get the story direct from them. All the information I can find on line is a bit evasive.

Some links for SleepyHead. The software is free, but you need a PC or Mac with an SD card reader to use it. I find it very useful in tracking the detailed data these machines capture.

SleepyHead Download

SleepyHead Basic Manual

For what it is worth, it seems SleepyHead creates a folder for every day's data and there are a number of files in each folder. Here is a screen shot of what my latest folder looks like for the overnight starting on Nov 9/18.

Looking at the folders and files on your SD card may help narrow down the problem a bit to determine if the machine is actually creating the files.

Is it the AutoSet model? However, I think they all collect data, except perhaps for the basic basic CPAP model.

I have a vague recollection of someone posting a rumor that there was going to be some way to disable data collection after a certain manufacture date. I know there is some setup that can be done to the machine beyond what can be done with the Clinical Provider Menu. I see a comm port right below the SD card slot, and I suspect there must be a way to connect the machine directly to a computer or setup machine to do certain changes. For example each machine seems to be set up to use a specific wireless provider, and if you buy a machine in the US the wireless may not work in Canada.

It is a bit of a dirty trick to not supply the ResMed SD card as every machine to my knowledge comes with a 4 GB ResMed branded SDHC card, so someone is taking the card out and not giving it to you. It would be an even dirtier trick to disable the data collection. If you can't figure out what is wrong, perhaps time to go back to the supplier to complain. If it is a production date problem, then perhaps they would have an older production date machine of the same model they could exchange yours for.

When you put the SD card in the machine, do you get the gray colored message saying it is preparing the card? Any kind of error message? If you have any other SD card around to try, especially a smaller one, it may be worth a try.

That is about all I can think of, but will post again if I come up with anything else.