bonjour

I highly recommend that you become a vocal consumer. You want to get an Auto-CPAP IMHO the ResMed Airsense 10 Autoset (or the Autoset for her) These are the most flexible of the CPAP machines and if needed or desired you can even look at what is happening for the entire night right down to the breath by breath basis. It will make it easy to change your settings, or see that you need to change them just with sharing your nightly charts here. Also note that you will have this machine for 5+ years.

I don't see any 10 minute segments of continuous CSR indicated in your chart, even though you had 35 total minutes. At least that is my guess. Just not considered medically significant, similar to having an AHI of 4.999 (it's under 5)

Wash the headgear for the P10 it will shrink.

I'm certain that the connector for the AirSense 10 is proprietary. This is to prevent the use of generic set-ups. Here is a link to another forum. If you search you will find how to make one.

http://www.apneaboard.com/forums/Thread-Equipment-12-volt-adapters

My story: Like many here I did NOT have sleep apnea, I didn't stop breathing in my sleep, I didn't snore. Sound familiar. JUST to tell her "I TOLD YOU SO" I took a sleep study. I had 90 events per hour, an AHI of 90!! Go figure.

I didn't have a problem, I was driving off freeways at exits because I was driving to stay on the road. It was the rumble strips on the side of the city road that woke me up, rumble strips you ask, most know them as driveways, I was driving across driveways, and scared to admit it. my 2nd sleep study was the titration study, and I woke at 5:30am actually feeling awake and refreshed, I was stunned! My DME told me 6-8 weeks to get a CPAP device and I said no way. I said find one elsewhere and I'll travel as far as it takes to get it. End result was about 1.5 weeks to get an appointment and the device, and I've never looked back. My Rx was CPAP (brick) at 19 cmH2O (could only get 18) and I took to it like a duck to water. I was lucky, I was immediately feeling better. That was in 2003. I'm currently on the Sleepyhead Development team and a frequent contributor to an Apnea WIKI. My typical AHI is now around .5 with a ResMed Aircurve VAuto averaging a fairly steady pressure of around 15 with a PS of 4.

dmypub look at 3 min segments (2-5 min segments will show details of the pattern and make it distinguishable) of several of the CSR/periodic breathing and print them for your doctor. On multiple days too, If you have Sleepyhead on a laptop take it in with you so your doctor can personally evaluate several of these segments. Print any 10 min segments of CSR too.

It's the evenness of the increase in breathing with the decrease of breathing with a Central Apnea in the middle that defines this pattern.

Another similar pattern that is somewhat similar starts with an OA followed by a large recovery breath and each successive breath is smaller then you have another OA event and repeat.

Cheyne-Stokes Respiration (CSR): CSR is a breathing pattern characterized by cycles of crescendo-decrescendo changes in tidal volume followed by central sleep apneas. A complete cycle of apnea, hypopnea, hyperpnea, and hypopnea leading to the next apnea usually takes about 45 seconds but may be longer. At least ten consecutive minutes of these cycles should be recorded before CSR can be diagnosed.

Based on the above look for a CSR series that is 10 min plus and print that for your doctor as that appears to be a diagnostic standard. BTW CSR is fairly common in individuals with CHF. 25-40% of CHF patients have CSR

To have these CSR events once in a blue moon I would just dismiss them, but regularly and I would have them professionally checked out.

Success in another forum similar chart

http://www.apneaboard.com/wiki/index.php?title=Optimizing_therapy#Positional_Apnea

search Sleep Apnea Solutions Ultimate Chin Strap

I don't know this forums link policy so the above search parameters

I'll add that I do feel that chin straps are good to use because they pull back on the jaw and have the potential to cause "positional" apneas and/or TMJ. They are one of the traditional solutions for mouth breathing.

Try the tongue trick. It took me months but it is what I use every day.

Place the tongue on the roof of the mouth. Practice during the daytime. The idea is to train the tongue that this is a good place to be, not overnight, but it works for some.

Many consider taping to be dangerous and I have found it is both controversial and effective. The concept is to seal the lips to prevent air from escaping. It is not to keep the mouth closed. The tape I recommend is any tape intended for application to human skin. Why? because those tapes are the least likely to cause skin irritation. I am personally an advocate of taping.

Other solutions Mouth Breathing is when you open your mouth and the air pressure from your PAP is venting out your mouth typically showing on your charts as a large leak which can substantially negate the effectiveness of your therapy. It is generally not good. The solution varies depending on the person

With SleepyHead look at your Leak Rate graph where it is shaded (large leak/ LL), flat tops on this graph suggest mouth breathing. In SleepyHead right click on the left header of the Leak Rate graph and click on Dotted Lines then select "Leak Rate Upper Threshold" to get a line across the graph for ResMed. Manually set the value for Philips Respironics. Severity depends on how much over this threshold and for how long it is in the Large Leak territory.

How to manage Mouth Breathing, not in any particular order.

Tongue Trick. Place the tongue on the roof of the mouth, Practice during the daytime. The idea is to train the tongue that this is a good place to be, not overnight, but it works for some.

Cervical Collar. A "soft" Cervical Collar. This helps support and align the neck and keeps the jaw/mouth from dropping. This is becoming a very popular option. Rarely used prior to mid 2016. Users are posting a high success rate with this device. When OA tends to occur in clusters at different times of night. It's an indication that an obstruction may have occurred when the chin tucks towards the chest. It's common, and the solution is either an ergonomic pillow or soft cervical collar that prevents the neck and head from being out of alignment and cutting off the airway, but they can be comfortable, prevent leaks and prevent an airway from closing up due to tucking your chin to chest and other issues.

Fit: You are looking for a comfortable fit 2-inches larger than the circumference of your neck and just tall enough to support the jaw when your head falls out of alignment (measure your neck from collarbone to jaw and subtract 1". It's a very small investment that has worked very well for some people. More pressure may solve the obstruction, or it might go away with positional therapy.

Chin Strap. A chin strap is to manage mouth leaks from a variety of causes. Most result from the jaw dropping or opening either partially or wider. The chin strap is to gently keep the jaw closed. If you have to crank it shut to make it work this is not the correct solution. Note that your jaw is strong enough to open if it wants to. There is one chinstrap that is notably different than others, the Ultimate Chinstrap, Search for it if you desire.

Ergonomic Pillow or CPAP Pillow, The purpose being to maintain a proper head and neck alignment while allowing for the mask maintaing the seal in multiple positions.

Mouth Guard The concept here is a closed mouth guard to keep the air from leaking out.

Taping. Definitely the most controversial. The purpose of taping is to seal the lips and prevent mouth leaks / mouth breathing. It is not to stop the mouth from opening. I make sure that I can easily open my mouth, when taped, if I need to.

FFM – Full Face Mask or Hybrid Mask. This is a very traditional solution and it is generally effective.

Dry mouth is a symptom mouth breathing that is uncomfortable. It can and does occur with some users of a Full Face Mask.

Many users use a product called Biotene to get relief from this symptom.