instructions for at home titration?

[KeithF40]

I have a resmed airsense 10 in apap mode. Insurance won't pay for titration study. I know how to use sleepyhead. How do all of you go about doing an in home titration study?

[Miss Emerita]

Welcome! It's great you know how to use Sleepyhead. Please update to Oscar, because SH is no longer supported. Oscar will look very familiar to you. https://www.sleepfiles.com/OSCAR/ Let us know if you have any problems with it.

Just to get going, I would recommend setting your minimum pressure at 7, your maximum pressure at 12, and your EPR at 3. Then post an Oscar chart so we can take a look and see what kinds of adjustments would make sense. Please stack your graphs this way:

Events
Flow rate
Pressure
Leaks
Snores
Flow limitations.

Grab the gray bars that separate the graphs and push them up so you can squeeze these into one screenshot. Include the left panel with the calendar and pie chart turned off.

As for humidity, that's very much a comfort feature. You might start with 2 and see how you like that. I would suggest not using the ramp feature unless you find you're having a lot of trouble falling asleep.

I don't know whether you know about SH because you've used a PAP machine before. But if you're new to PAP, you might want to acclimate yourself with some day/evening use outside your bedroom before you try sleeping with the machine. Set things up where you can do something diverting like watching TV or reading.

Stay in this thread and keep us posted!

[KeithF40]

Sorry for delay here are my results

[cpap626]

I would bump the min up to 9 and increase the max to 15. You are maxing out the machine and that means you need it to go higher then the 12 it is set to.

[Miss Emerita]

Same idea as cpap606 but a little more aggressive: I’d suggest you raise the minimum to 10 and the maximum to 20. You’re at 10 for a lot of the night, so I don’t think that will bother you, and it’d be good to see where the pressure goes if you let it do its thing. It won’t go higher than there’s a reason to.

Either way, post a chart with revised settings. That’ll be very helpful to the titration process.

[Julie]

I would not raise the min. yet quite so much, but definitely bump the max... and you can go to 20 with no problem.

[Pugsy]

Were you maybe on your back at the beginning of the night?
Did you have any nasal congestion issues last night?

If you were on your back....I would try to stay off my back and just increase the maximum a bit.....see what happens.
If you did have some nasal congestion happen...we need to sort out those issues if we can.

While it does appear that the machine is setting a new minimum for you...I would not be in a big hurry to increase the minimum until I saw what happens when the machine can do its thing and go higher...and try to figure out how much nasal congestion or sleeping on one's back might have played a part in things.

How did you sleep? Wake often? A lot of the flagged events are showing up around known awake times when there is a break in therapy so we know you turned the machine off and then back on again.. I am wondering how much of the flagged events might be awake breathing false positives.

[KeithF40]

So I decided to average out the changes of the three posters that I read before I went to bed last night. Here are my updated results. I tend to sleep on my side more than my back and did not really feel any congestion (I do have a deviated septum so I frequently find one of my nostrils isn't very open). In terms of stoppages, I do tend to get up quite a few times at night for the bathroom. I've been turning the machine off when I get up and then back on (using smart start) when I get back into bed.

[ChicagoGranny]

You are doing well. Some of your awakenings are probably driving up the events. Click on the Events tab to get a list of each type of event and the length of that event.

If it were me, I would turn EPR down to 2 and see what the next night holds.

That's a short number of hours. Did you use the CPAP for all hours of sleep? Are you a night owl or late shift worker?

Don't forget to work on sleep hygiene, diet and exercise. Those three are hard for most people to do well with.

[KeithF40]

Here is the data from the events tab. Mask was bothering me so I took it off.

[ChicagoGranny]

Here is the data from the events tab. Mask was bothering me so I took it off.

The numbers in parentheses are the lengths of the events in seconds. Yours are very short (<20 seconds). Some of them, particularly the clear airway events, might have happened while you were awake and are not related to sleep apnea.

Which mask are you using? Go to youtube, find your exact mask and watch three or four videos on fitting and adjusting. Some of the videos are quite good. There are ways to make the mask less uncomfortable.

[KeithF40]

I will occasionally wake up with an itch and take the mask off for a second to scratch my face. I am using the n30i. I feel that it pushes a little bit just below my nose. I also don't like anything on my face so I am quite sensitive to the mask.

[Miss Emerita]

Nice! I'd be inclined to leave EPR right where it is. The number of CAs you're having is negligible, and as Chicago Granny says, they may be awake events. I see that at these settings the EPR is able to reduce your flow limitations.

There's value in staying with settings for at least a few nights to see how things go (unless something ugly happens). Sleep can be different from one night to the next, so you want to be able to see what the more general trend is looking like.

CG's advice about watching videos is excellent. If all else fails, do you have the option of trying a different mask?

[KeithF40]

I also have a p10 and thats worse