Sierra

Assuming the A11 is the same or similar to the A10 just go press the round Set button to go to My Options, then rotate the knob to go down to "Run Warmup" and press the round button again to select it. You can feel a low air flow coming out of the mask if it is turned on. It is located below Run Mask Fit and above Airplane Mode on my A10.

I don't think a tube cover will do much. If you are in a cold and humid climate it may help a bit with condensation (rainout) in the tube, but the heated tube is the best and running in Auto is the best solution. I believe the hose is about $40 at on line CPAP places. I had to replace mine as it failed after about 3 years use.

My experience is that a low pressure going to sleep is almost a suffocating feeling. I test the pressure by taking deep fast breaths. If the pressure is too low I feel like I am not getting enough air, and that certainly does increase the anxiety level. When you have the pressure set at 7 cm, and are using the EPR set at 3 cm. You are getting 7 cm on inhale, and the minimum 4 cm on exhale. That should be very comfortable. If you put the ramp on Auto it will hold these settings until it decides you are asleep. I use a fixed pressure of 11 cm after I am asleep (end of ramp), and actually use 9 cm of pressure during the ramp. That is as much pressure as I feel I need to get rid of that suffocating feeling.

Getting a heated tube and putting humidity on Auto should help a lot. Also if you use the Prewarming feature that should help too. It does not need the heated tube to work, as it is just heating up the water in the reservoir so you get more moisture right away. As I said it takes about 15 minutes, and it will hold it preheated for 30 minutes or so. When I remember I turn it on when I am getting ready to go to bed. Another of my standard routines is to chew two Tums right before putting the tape over my mouth and going to bed. It helps with the heartburn in the going to sleep phase.

I think I answered this in another post. The headgear on both look the same, and I have used the P10 and find the headgear to be too flimsy to stay on my head.

I am not so sure it is a good idea to use tape under a full face mask. It is better to use it with a nasal or nasal pillow type mask. I do it with 1" 3M micropore tape, and 4" Mefix tape overtop of that. I am a determined mouth breather. Most people get away with just the 1" 3M micropore.

I have my machine set up in Auto Humidity control which is available when you use a heated hose. The temperature is set at 27 C or 81 F, and I have no issues with dryness. You can prewarm your machine with the User menu. It takes about 15 minutes before you start the machine.

Your ramp start pressure seems to be very low at 4 cm. I would suggest setting the Ramp start pressure at 7 cm, and also set the minimum pressure for the machine at 7 cm. If that does not help, you may also want to consider changing your machine to fixed pressure mode (CPAP). You then have to set the pressure by trial and error, but it looks based on your OSCAR chart you could get away with 8 to 9 cm, and perhaps would end up with a lower AHI.

Hope that helps some. Any questions, just ask.

This post seems to have been delayed. No idea why. Sometimes multiple graphics can do it.

Yes, by headgear I mean the part that goes over your head and holds the mask in place. For most masks it can be bought separately, but there is no uniform standard to let you switch headgear independent of the mask frame and cushions. That is why I had to modify the P10 to use the Swift headgear.

Getting a good mask does tend to be a trial and error process.

Your post was probably delayed due to the graphics. I just saw it today.

On your sleep test are those numbers events per hour? If so an AHI of 33 is moderate apnea and should be treated. I am a bit surprised that the pressure you are using is as high as it is (95% at about 18 cm). My AHI at diagnosis was 37 and I use 11 cm of pressure.

I find your results from the MAD device very interesting and are worth exploring. They are expensive but it would be worthwhile getting one made by a dentist.

You are using EPR at 3 cm and full time. People respond differently to EPR. I went a long time with EPR at 3 cm but on ramp only. When I switched to full time at 2 cm my hypopnea events went down significantly and my AHI improved from about 2 to less than 1. It is hard to predict the value of EPR and the best way is to try with it on and without it to see what works best for you. For some having EPR off can reduce the frequency of obstructive events and as a result reduce required pressure. Trial and error seems to be the only way to figure out what works best for each individual.

I have had issues with central apnea which you do not seem to have. The other big improvement I got and especially with respect to CA events was to switch from auto mode to fixed pressure CPAP. In auto it seems that the machine can sometimes start to chase its tail and raise pressure too much. I also think it can raise pressure too much based on hypopnea events which may be central (open airway flow reduction) in nature rather than obstructive. The machine is smart enough to not raise pressure in response to central events, but it seems to not be able to distinguish between central hypopnea and obstructive hypopnea. In any case I was running pressures in auto up to 15 cm, and now I am using a fixed 11 cm of pressure with full time EPR at 2 cm. It may be worth a try to see if it works for you. It is a trial and error process and based on your one night you may want to try 15 cm to start. And at least in the beginning make 1 cm changes in each direction to zero in on the optimum fixed pressure for you. Once you get close then you can fine tune with smaller steps. See my history below to get some idea how I did. Not very scientific, just patient trial and error!

On coffee I drink lots of it, but never after 12:00 noon, or any other caffeinated drinks in the PM or evening. There is some good sleep info at this link. It was set up by a professor of pharmacy in Nova Scotia I believe. His objective was to try and get seniors off sleeping pills.

Sleepwell It is No Dream

I am not familiar with many of those types of events. I would consult your sleep doctor to see if a CPAP may help you. Normal practice in most jurisdictions is to prescribe a CPAP trial if AHI is over 5. It may help, or it may not. Keep in mind that a CPAP will only work to reduce obstructive apnea events and hypopnea.

Are you using OSCAR to track your sleep data? If not it would be worthwhile to see in more detail what is happening. The software is free, but you need a Mac or PC and a SD card reader to use it. It provides a lot of detail which you can help to determine if your CA events are real or not.

In general when one is sleeping poorly and waking up you can get false flags of events. It is best to evaluate your results on a full night of good sleep.

There is no reason for a nasal mask to cause more events than a full face. You do have to change the setting in your setup to match the type of mask you are using though. Since your CA score was not that high during your home sleep test, and seems to be higher now, it is likely you are suffering from treatment emergent central apnea. The higher the pressure the more likely CA events are to occur. In most cases this effect goes away after 6-8 weeks of CPAP use. But, in general it is best to minimize the treatment pressure to what works for you. If one mask or another results in more pressure for some reason then the frequency of CA events can also change. OSCAR lets you see when and at what pressure events occur, so you can determine possible causes.

For a long time I had EPR set to run only during the ramp period and turn off after the ramp. But when I did a more extended test with EPR set to 2cm and full time, I got a reduction in hypopnea, and overall AHI reduced from about 2 to less than 1. But everyone is different. The best is to try it on and off for an extended period of time to see what works. In some, having the EPR on can result in more frequent OA events, and that in turn would cause the machine to use more pressure.

Believe it or not, I have learned to cough or sneeze through my nose! In doing mouth taping for over 3 years I have never been forced to take the tape off other than when I forget to take my bedtime meds. I got a horrible cough/cold in January 2020 before they were testing for or diagnosing COVID (but I think it was COVID) and made my way through it with the P10 and mouth taping. I coughed so much I pulled muscles in my rib cage area.

Here is a YouTube video from a dentist on How to Mouth tape for a Better Sleep. I actually use two layers of tape as I am a determined mouth breather. The first layer is 1" 3M Micropore, and the second layer is a more flexible 4" wide Mölnlycke Mefix over top.

I was not even aware of that N30 mask. It looks to me that the headgear is identical to the P10 and the vent system the same as well. The only difference is the under the nose cradle fit to the nose. It might be worth a try if you dislike the prongs the P10 uses. The problem I see is that it may not stay on your face with the poor headgear design similar to the P10. It also my not seal as well with higher pressures. But, I have no experience and that is just my impression after looking at the pictures of it.

A better test would be to turn your pressure down to 4 cm, but it is still not a real test. You should get a home test done to see where you stand. They are less expensive and reasonably accurate. Congratulations on the weight loss. That should help.

No, a BiPAP is not better for ease of sleep. It just uses higher pressure for those that need a lot of pressure or pressure support. If you detail your issues and how you have your machine set up, I may be able to make some suggestions on how to improve comfort on the A10. I use the machine.