Help with Dreamstation settings

Help required with settings on new machine

I was diagnosed with severe apnea end of December and provided with a Dreamstation Auto CPAP plus Resmed F30 full face mask. Tend to find as a side sleeper that the mask often leaks around the top of the cushion around the nose area when pressure increases, no matter what I do with the fit. Have asked if I can switch to an F&P Simplus

My AHI was 35 prior to commencing with the CPAP treatment and now down to 5.5 but i'm looking to improve on this as get it down to 1 if possible and not sure how to fully interpret the data in Oscar yet, still learning. Do feel the min pressure is pretty low and wonder if still getting higher AHI due to this or not.

Could i have some advice or feedback please on the screenshot below and what I could potentially do to improve the AHI, plus any general observations on the stats/figures provided?

Many thanks,

Mike

On raising minimum pressure, yes to 7.5 for now, and higher in a few days or so, like 1cmH20. Flex is really worthless on a APAP. As far as your leaks... they are unacceptable to me period. Even though you have an APAP.... and the machine rams up, the minimum pressure could be doing it eventually and to have leaks is defeating the purpose of a higher minimum to prevent events and ramping up to max pressure. I would work on reducing your leak rate upon the pressure you achieve to achieve better therapy. CA's and OA's are next to nill, your hypopneas are alot but are hard to keep away. I manage to keep might few, but I have a bilevel machine. You partial obstructions, hypopneas, come in during the ramp up and is not helping, so to me it's not quite enough pressure.

Here is a screenshot of my ResMed machine on a night when leaks were hitting the redline limit of 24 L/min. ResMed displays mask pressure (the blue trace), and as you can see, the mask pressure is unaffected. See the area where the green cursor line is. Also note that there are no events when the leak rate is high. The pressure does fluctuate a little up and down with each breath and that is the reason for the ragged look of the trace. However it is that way whether or not there is a larger leak or not. While DreamStation does not show the mask pressure, I suspect it is highly likely to be just the same as a ResMed machine. They are both doing the same thing.

While it may be worthwhile to reduce leaks for other reasons, such as comfort, I would suggest it is a rabbit hole non-solution to the issue of higher AHI. There are other reasons for the high AHI. They probably can be solved with a higher minimum pressure unless the hypopnea are central in nature. You will notice that my hypopnea is not that good either, and I believe at least some are central in nature. It is very unusual for me to get under 1 for AHI.

I guess you missed the end of the night where you leaks escalated and have 4 Hypopneas, which btw are partial obstructions and Five OA's I see, at 3:00 am and following each other, is where your leaks were the greatest, so yes regardless of the mask pressure, you have events coming into play. I would suggest you read the graphs more carefully and you will see.

the Night before is 0.68

I sure do after wasting 5 months on a APAP. But the bilevel Vauto on Set has settings your airsense doesn't. I'm not getting my hopes up with under 1 AHI.