Sierra

No experience but it seems you need a USB cable and the appropriate drivers in your computer. Don't think they use a SD card. There may be some basic data on the oximeter, but if you want to see what your O2 levels are throughout the night to compare to when you have apnea events it would be very useful to display the data in OSCAR.

On the main Welcome screen click on the Oximetery Wizard icon and it should tell you what meters are compatible with OSCAR.

I was diagnosed with an AHI of 37 and with CPAP it has been reduced to under 3 or so. I never had any big AhHa moment. My wife likes that I don't snore any longer. Based on your success with EPR I decided to try it again along with my fixed pressure. After trying a few different combinations I am now using the same fixed pressure of 11 cm but now with a full time EPR of 2 cm. It is working very well to reduce my reported AHI. I had gone over 600 days with the same setting of 11 cm with no EPR and averaged over that time an AHI of 2.1. With the new settings and an EPR of 2 I have averaged an AHI of 0.74 after 19 days. The hypopnea has been reduced to close to zero. While it is nice to see the lower numbers I really do not notice anything different about my sleep. No AhHa moment from the lower numbers.

My thoughts are with the OSCAR reports that you have posted that there is no further opportunity for improvement with more pressure on your CPAP. You could have the maximum pressure increased to 20 and see what the machine does. However, what I would be worried about is that the higher pressure would cause more discomfort and than it would provide benefit. My overall strategy is to keep the pressure as low as possible while still giving good AHI results. Higher pressure can also cause CA events to increase.

Some people use an oximeter to monitor their oxygen levels during the night. If it is a compatible machine the results can be imported into the OSCAR program like you can import your CPAP data. I still use SleepyHead but I assume OSCAR is similar. Here is a screenshot of what the Oximeter introduction screen looks like. You should look at the similar screen in OSCAR if you are going to buy an Oximeter to ensure it is going to be compatible with OSCAR. I have no experience with them, but it might give you some idea as to whether or not your oxygen levels are going low at night despite having good AHI results. On the advice of a doctor there are fittings you can buy for you CPAP tubing that allow you to use supplemental oxygen with your CPAP. You would need their advice as to whether or not you would benefit, and how much oxygen should be used.

If you have a PC or Mac and a SD card reader you can download some freeware called OSCAR. With OSCAR you can see in more detail what is happening. How are your AHI numbers? One option is to have the machined switched to fixed pressure CPAP mode and then use a fixed pressure that is not automatically adjusted. However you can only do that if there is a fixed pressure that works for you.

The other thing you may want to look at are the seals on the water reservoir. It all comes apart for cleaning, so you could do that and look for any damage to those seals. Basically the machine blows air from into the reservoir over the water and then out the back port. Any of those seals could leak and hiss....

I am not in the US, but I believe the US Medicare rules for replacement parts etc are extremely generous. Someone must be making big money on it. This link gives you the schedule and codes they use for replacement.

https://www.sleepapnea.org/treat/cpap-therapy/care-and-replacement-of-cpap-equipment/

My wife has a CPAP machine that is about 5 years old and it works fine. Mine is 3 years old and works fine. I am basically using a 3 year old mask with a new nasal pillow cushion. All the rest is original. You really only need to replace parts when they deteriorate. Some of the replacement frequencies allowed by Medicare are downright ridiculous. 5 years for the machine is probably reasonable though.

Hospitals should have CPAP's to use, but I know from experience if the hospital visit is planned then they ask you to bring your own machine. Keep in mind that especially when you have mild apnea a CPAP machine is nothing close to being essential for life. It is a long term risk and sleeping a few nights without it, is not really a big deal. If you snore, it may annoy someone else in the room though.

If you have an automatic machine you are unlikely to need a periodic sleep study, and one is not necessary unless you are having issues with achieving a low enough AHI. AHI should be under 5, but many people get under 2.

If you have a PC or Mac with a SD card reader you may want to download a freeware app called OSCAR that shows all the detailed data that the machine is capturing each night. It allows you to monitor the efficiency of the machine better and will let you know if you may benefit from adjustments. Here is an example of a report from my ResMed AirSense 10 machine.

I have an AirSense10 that is a bit newer, but probably just the same. I have not noticed any hissing but occasionally I hear a clicking sound with each breath. I have found that happens when the water reservoir is not firmly pushed into the main housing. You are right that there are some silicone seals between the two parts, which may be aging and not sealing as well. They can be replaced. Here is a link to a manual that shows how. See page 24. you may want to start by taking it apart and inspecting/cleaning the seals. Silicone is pretty durable. Perhaps the parts are dirty or have slipped out of place.

AirSense 10 Manual

You should be able to buy seals. This site shows one of them in a kit. Perhaps other places will sell the seals only.

https://www.cpap.com/productpage/resmed-airsense-aircurve-premium-supplies-bundle

I think that is about all you can do. I had a demo F&P SleepStyle machine for a while. It had a feature that it would detect when you wake up and automatically restart the ramp. I guess it worked. However this machine has other issues and I would not (did not) buy it. Overall I think the AirSense 10 is the best on the market.

I am not sure what you mean about hitting the ramp button? I did not know there was one and I use essentially the same machine. If you want the ramp to start over the quickest way to do it would be to hold your breath (assuming you are using smart start) and turning the machine off. Then breath and it will start again. Or if you are not using SmartStart then just turn it on again.

On the mask you may be hearing the air flow through the tubes that supply the air down each side of the mask. This would likely get worse if the weight of your head is squashing the tube on the bottom side down. Moving your head should correct it.

I wonder if the nasal style rather than the nasal pillow may be better? It seems to have clear holes for vents rather than the QuietAir vent and perhaps lets the air flow more freely. I believe the nasal pillow part can be switched for the Nasal style without replacing the whole mask.