New to CPAP - Done Sleep Study & Sleep Titrations Studies

[Cali929]

Hello, so i am a 60 year old male and I've been an insomniac for as long as I can remember and a loud snorer since probably my 30's. Due to my age and feeling fatigue, having brain fog etc my Dr had me do a sleep study and it turns out I have Severe sleep apnea (AHI of 52.5). I then had to go in for a sleep titration study and I an Airfit F20 was put on me.......so uncomfortable and painful on my nose, but got through it.
After the Titration report was reviewed my PCP was told to "Initiate CPAP Therapy at 8 cm/H2O, using patient's mask of choice for the treatment of Severe OSA"

At this point I have been told by PCP that I need to start with a CPAP as that is what I have been prescribed and then if it doesn't work then will have to look into a BiPiap machine.
So at this point I am looking to get:
Resmed Airsense 11 with Heated Tube & an Airfit F40 mask dueto it being low profile and doesn't sit on my nose.

I am attaching links to my sleep study & titration study reports

1. Does CPAP sound right for an AHI of 52.5 or would I need a BiPap machine?
2. Does therapy at 8 cm/H2O also sound about right for me?
3. Any other thoughts or advice.

Thank you in advance for any responses, I appreciate it.

Sleep Study: https://imgur.com/a/sleep-study-mX7sKzV
Sleep Titration:https://imgur.com/a/cpap-titration-report-qeRqh4f

[Pugsy]

Severity of sleep apnea doesn't dictate what machine we might need nor pressure requirements.
You might or might not need a bilevel machine....gotta start with cpap though and see what happens.
Besides....the ResMed AirSense 11 AutoSet has some limited bilevel function by making use of the EPR exhale relief feature.

[Nocibur]

No REM, huh?

Did you forget?

[robysue1]

No REM, huh?

No REM on the diagnostic test.

There's a short REM cycle just before the OP woke up at the end of the test on the titration study.

Any significance attached to either of those facts?

[Cali929]

Severity of sleep apnea doesn't dictate what machine we might need nor pressure requirements.
You might or might not need a bilevel machine....gotta start with cpap though and see what happens.
Besides....the ResMed AirSense 11 AutoSet has some limited bilevel function by making use of the EPR exhale relief feature.

That's what I thought but when I visited a local CPAP store, the person I spoke to questioned the CPAP/BiPap and pressure level, So I asked in here to ease my mind.

[Cali929]

No REM, huh?

Did you forget?

I assume it was correct, especially since I got a little rem during the titration study. As I said I've always had trouble with sleeping..... sometimes i'm up all night, or only get a few hours, every night's an adventure LoL
Did I forget what?

[Nocibur]

Did I forget what?

Did you forget to do REM.

I assume it was correct

You must be a nice person.

As a misanthrope, I always assume nothing is correct.

[Nocibur]

No REM, huh?

No REM on the diagnostic test.

There's a short REM cycle just before the OP woke up at the end of the test on the titration study.

Any significance attached to either of those facts?

TTBOMK there's only one person who does not have REM sleep. It's (or was) an Israeli soldier who suffered a head wound. Interesting story.

BTW no N3 in either study.

No PLMs first, tons in second.

If there was to be REM rebound, it wouldn't have been a little blip at the end of titration, it would be a pile at the beginning.

Consider scoring error, but probably medication effect.

No desaturations listed, would be helpful to know that. Not Medicare so probably used 3% rule.

Note CPAP report:

x tolerated the CPAP treatment

I'm gonna say with a Sleep Efficiency of 50.7%, probably not.

[Nocibur]

Does CPAP sound right... would I need a BiPap machine?

I ain't Carnac the Magnificent, but IMO BiPAP was suggested because of it's use as a comfort measure because you

tolerated the CPAP treatment

[Cali929]

Did I forget what?

Did you forget to do REM.

I assume it was correct

You must be a nice person.

As a misanthrope, I always assume nothing is correct.

If the tech messed up somehow then time will tell how much rem I actually get, I guess. Now that I have been diagnosed with sleep apnea I have picked a Sleep specialist that I will be seeing for it and for ongoing CPAP treatment, hopefully he can figure out the rem issue.

"You must be a nice person." I am LoL, overall trusting but I do question things and get 2nd opinions usually.........In this case I figured my scalp, chest and shin had so many sensors attached and connected that if rem was not being monitored the tech or the labs Dr would notice/question it. Anyway, I just hope either way I start to get alot more rem sleep with CPAP.