Sierra

There is an app that runs on android and iOS called Sleep HQ that you could try. I have never used it, but I think there is a somewhat limited free version that you can use.

https://home.sleephq.com/

The best thing you can do is download OSCAR and view the detailed data on the SD card. Make sure there is a card in the machine. It takes a 4 to 32 BG SDHC card. You need a SD card reader to get the data from the card to your PC or Mac.

https://www.sleepfiles.com/OSCAR/

It may be more psychological than physical. Home CPAP machines are very quiet at about 24 dB. That is like leaves rustling.

What have you contributed to this forum?

Good to hear you are still doing well despite the mask issues. It is a trial and error process. "You have to kiss a lot of toads to find a prince!"

The apnea cpap industry is behind the times. A titration test is really only required to set up a fixed pressure cpap machine. With an Auto machine you just do a basic setup and then look at the results. The system in the US seems to be very claim process driven with the more you do, the more you can claim whether it is needed or not.

Funny you should mention Epic. I got a cortisone injection this morning for trigger finger. Almost before I got home there was an Epic report waiting for me. I kind of like it but I am not so sure it improves treatment. See below. All I know for sure is that I am having a devil of a time typing because my hand is still frozen!

ln any case stick with watching results using OSCAR, and if you have any questions just post.

Masks make huge differences to comfort and the air leakage, but to overall AHI, I think not so much.

That certainly is a good result on the night of May 6th, and less good on May 7th. But, nothing is different in the setup, so that is just the quirkiness of central apnea. I am not a believer that the mask has any big impact on AHI. It certainly can on leaks and the 7th is better. With central apnea some of them can be sleep-wake noise. Is there any chance the sleep was not so good on the 7th compared to the 6th. If so, that may have been the cause - a restless sleep.. Masks always take some time to get adjusted properly. The last thing I do at night with my mask is pull it away from my face slightly so it leaks, and then I release it slowly back to my face. I think the air pressure inflates the flexible part of the cushion and gets it to seal equally all around the fit area. It may not stay in that position long and it only makes me feel good, but I think it at least gets the night started right!

I just upgraded to 1.5.3 and I don't like the Summary page much. It puts a bunch of relatively useless data at the top and the bottom part scrolls off the screen.

First, did you use OSCAR to track your results on your A10 machine. If you did then you can just add the A11 data to your old A10 results. That would be the best way to see what has happened. If you did not use OSCAR and still have the SD card from that machine you can load the A10 data in first and then update it with the A11.

With respect to your A11 was it set up exactly the same as the A10? If not what was changed. I cannot think of any reason if the setup was the same that the results would significantly change. A while back my wife switched from the S9 to the A10. I used exactly the same settings and 0.57 down to 0.53, and insignificant difference. Since that time I increased her EPR from 2 cm to 3 cm, and AHI has dropped to 0.49.

I have not seen any clear evidence that EPR increases CA events in my experience. What I have seen is that it can make a big reduction in hypopnea events. I went for a long time with EPR set for ramp only and was off during the rest of the sleep. My AHI was about 2.1 and CA events was the large portion of the total events. Then I switched to full time EPR and my AHI immediately dropped to about 0.8. The reduction was almost entirely hypopnea. And CA events did not change.

My experience is that CA events can be caused by higher pressure, and my strategy to deal with them is to keep pressure as low as possible and I have switched to a fixed CPAP pressure. Since EPR reduces pressure it really should not cause more CA. But EPR can affect everyone differently.

If the increase in your AHI is largely due to hypopnea events I do not think they are as serious as OA and CA events because it is a flow reduction not a full stoppage. However, I think I would go with the total AHI number and use the settings that give the lowest AHI.

In any case I would encourage you to use OSCAR if you are not. It would clearly show what happened. It is a free download but requires a SD card reader and PC or Mac.

OSCAR CPAP Monitoring Software

You may want to drag the Pressure chart down below the Large Leak chart so it shows, and the Pressure chart is hidden. It will become pretty boring with a fixed set pressure. I should move mine down too...