Sierra

Good luck with your P10. The big issue with it is the flimsy headgear with no effective means of adjustment. I found that when you use those little adjustment clips they give you, it makes it even more susceptible to movement during the night. The solution for me has been to use a chin strap (Breathewear Halo) put on second, over top of the P10 harness. The comfort of the P10 is worth the extra hassle for me.

I would still recommend using the Auto Ramp with a start pressure of 7-8 cm and with the EPR of 3 on ramp only. It makes a big comfort difference in going to sleep. It will also keep your mask more well ventilated. And remember the Auto Ramp is not really a ramp. It is a pressure HOLD until you go to sleep. That is what makes it much better than the old timed ramp. And it allows you to use EPR on ramp only, which is really the only time you should need it.

If your Dreamstation is an automatic machine, it may be reducing pressure in the middle of the night because you are not having many events. Auto machines will have two set pressures, a minimum and a maximum. It may be that your minimum pressure needs to be increased. It will help you get more air in the middle of the night, and it may improve your AHI results. If your machine is an Auto CPAP model it is an automatic machine.

Are you using a humidifier? What is it set at? Do you have a heated hose? What temperature is it set at?

If there is any chance you are located in India, I see on a Google search that ResMed AirSense 10 AutoSet machines are being sold for about 32,000 rupee. That is about $600 Canadian or $465 US and looks like a pretty good price. Not sure if that gets you a new machine or a used one though...

ResMed on OXL

I don't know what standard practice is in the US. In Canada now it typically a one night sleep study done at home. Then they prescribe an auto CPAP. With an auto machine you can set it up for a wide range, although if they are experienced they will know approximately where to set it. The new machines transmit the data wirelessly to the provider and they can do the finer adjustments wirelessly as well. No need for another return visit. The other thing that happens in Canada is that you do the one night sleep study, which typically includes a 2 week trial of a CPAP. This is all free. However, then either you or your insurance company have to buy a machine. Some buy the machine from the clinic, but if you don't have insurance then it is typically much cheaper to buy a machine on line and set it up yourself. That said the practice may vary somewhat by province. I believe Ontario pays 75% of the cost with their government healthcare.

In Canada the two night study in the clinic used to be used. I suspect to cut costs, that is seldom done anymore.

I use a 1% hydrocortisone cream on areas of redness/irritation. I put it on in the morning after I take the mask off. It is not a product that should be used continuously or while you are wearing the mask. The hope is that you get used to the mask, and the cream is only a temporary measure to help repair the irritated skin until it toughens up.

I don't have any personal experience with them, but there is a range of mask liner products. See link below. Perhaps others can give you some recommendations on what works, and what does not.

https://www.cpap.com/cpap-comfort-cleaning/skin-irritation.php

I don't recognize the name "airbase". If your machine was a ResMed AirSense 10 AutoSet that is properly set up (in my opinion) it would have the following settings. This is based on your other posts saying you can achieve an AHI of 1.0 with the maximum pressure set at 15 cm.

Minimum Pressure: 12 cm

Maximum Pressure: 15 cm

Ramp type: Auto

Ramp Start (pressure): 8 cm

EPR: 3 cm

EPR mode: Ramp only

Smart Start: On

When set like that it would behave like this:

When you put the mask on and start to breathe the machine would start automatically. The pressure would ramp up quite quickly to the Ramp Start pressure of 8 cm when you inhale, and on each breath it would cut back to 5 cm due to the EPR setting of 3 cm. Most people find this a very comfortable pressure range to go to sleep with. Although it is called a Ramp it really is a hold, because this pressure does not change until the machine detects you are asleep (or 30 minutes goes by, and the machine gives up on you). When you go to sleep the machine then ramps up quite quickly from the 8 cm to the Minimum set pressure, which in this example is 12 cm. The EPR feature is turned off at this point so the inhale and exhale pressure becomes the same. It holds there until it detects apnea, snoring, or flow limitations. Each event causes the pressure to bump up some. If you hit the maximum pressure of 15 cm it just stops there and cannot go higher. If you go some time without any events it will slowly start to ramp down to the minimum pressure. That is the way it operates in auto all night. When you disconnect the mask from the machine the Smart Start feature will automatically shut it off.

Hope that helps some,

I do not recognize the name or model of "airbase". Could it be AirSense? If so, that is the latest model of the ResMed machines from Australia. The complete name would be AirSense 10 AutoSet if it is the automatic version.

First, what country are you in? That could make a difference in what machines are available to you and what the cost might be.

My experience is with the ResMed machines, and in my humble opinion, they are the best ones. Depending on whether you are buying new or used, I would suggest two models to consider:

A Used Machine

ResMed S9 AutoSet with H5i Humidifier:

This is not the current model and you would be unlikely to find it new, but they could be on the used market. If you buy used be sure to ask the seller how many hours are on the machine. You do not want to buy one that is already worn out. The machine was sold alone, or complete with a detachable humidifier. My wife uses one and it is a very good machine again in my opinion. You should ideally get a heated Climate Line hose with it as well. It allows you to use more humidity without getting into water in the hose problems (rainout). Here is a link to read about the machine:

ResMed S9 AutoSet with H5i Humidifier

A New Machine

ResMed AirSense 10 AutoSet:

There is ResMed's latest Auto CPAP and if you are able to buy new, the one I would recommend. The humidifier is built in. And again I would recommend the heated Climate Line hose. Here is a link to more information on the machine:

ResMed AirSense 10 AutoSet

The price will depend on where you are located. If in the US I understand that they are sometimes available at a good price on Amazon, and there should be many other on line stores where you can buy it. I am from Canada, and more familiar with the market here. Here is a link to one Canadian supplier. The complete package including the machine is $845 Canadian.

ResMed AirSense 10 AutoSet

In Canada you will need a prescription from your doctor, and I suspect the same in the US.

Hope that helps some,

Edit: I had suggested the For Her version of the machine, and then I remembered that you will need at least 15 cm pressure, and the For Her version is really only suitable for less than 12 cm pressure. Also the standard machine is likely easier to find.

See the link below for some assistance in understanding the sleep study report and the severity classifications.

Sleep Apnea Report - Understanding the Results

On my sleep report it indicated that a CPAP is the preferred therapy, and dental appliances should only be considered if the AHI is <15 (mild), and there is no other co-morbidity.