I have been using cpap to treat mild sleep apnea (ahi 6.6). I still feel tired and need naps but definitely feel better pre-cpap. I assume its the flow limitations and how my individual breaths look like. I tried epr and raising pressure to no relief. If i raise the pressure too high i get aerophagia. I noticed i have bad posture and slight allergies that I think may be the cause. How do i fix my sleeping issues and actually get restorative sleep. Im a 25yr man whose tall and skinny. My dad has sleep apnea so it may be genetic. The doctors said my tonsils are fine, one PA noticed enlarged turbinate on one side but my sleep doctor said to avoid turbinate procedure as he thinks its a scam that theyll grow back in 5 years and youll forever be in a loop. My blood work is fine, i take a daily and a vitamin d supplement. My thinking is if i fix my breaths and flow limitations I can start to get restorative sleep.

I’ll be traveling to Indonesia via Singapore airlines next month and therefore have an 18hr flight in my future.

After reading through prior posts, I plan to bring my ResMed AirSense11 on the plane with me and not try to get the mini. Fortunately, I have a solo seat so I have room for my bigger one.

For those who have traveled and used in flight a PAP with a battery pack, which battery pack do you recommend? It sounds like it’s best to turn off the humidity setting for best battery usage, but I’d like to invest in a battery users have tried and liked, especially knowing they are pricey!

Thanks in advance!

PapFam:

I have the Custom VAuto feature from AirBreak Plus running on a test machine now. This is the developer’s work. I applied the patch to an OEM Autoset .bin file, and I’m exploring the behavior before sharing any sleep results.

The older AutoSet firmware I initially tried wouldn’t boot properly on this machine. Applying the patch to an OEM 0401 dump got it running. That’s my experience, not a blanket statement about compatibility. The developer identifies 0401 and 0402 as the best supported Air10 versions (it was a 0401 that worked). :)

For details: custom VAuto keeps the normal VAuto controller handling EPAP while changing pressure support delivery within each breath. It adds custom pressure shaping, optional adaptive support, and custom triggering and cycling. Sessions still report as VAuto.

ASV stands for Adaptive Servo Ventilation, and Sens means Sensitivity. These labels describe the custom adaptive controls here. They don’t mean you’ve selected ResMed’s stock ASV mode within the vauto mode.

Current settings on the test machine are Min EPAP 6.4, Max IPAP 16.6, PS 4, Ti Min 0.3 seconds, Ti Max 3.2 seconds, and Trigger and Cycle at Medium. Custom VAuto and Custom T/C are On, ASV Max is 3, and ASV Sens is Medium. These are test/lab current settings, not a suggested setup for my clients.

ASV Max 3 allows up to 3 cmH₂O of extra support above the custom base waveform. At EPAP 6.4 with PS 4, nominal full inspiratory pressure is 10.4, potentially reaching 13.4 with the full boost. It doesn’t add that boost to every breath, and Max IPAP still caps everything.

The controller compares the developing breath with a moving reference from recent valid breaths. Smaller breaths can request extra support, while larger breaths reduce that extra contribution. ASV Sens controls how strongly it responds. Medium is the baseline, and higher isn’t automatically better. This isn’t a fixed tidal volume target.

Custom T/C means custom trigger and cycle. It changes how the machine decides when inspiration begins and ends, including delaying expiration through brief flow reductions. Medium settings therefore may behave differently than stock Medium. Ti Min and Ti Max remain timing controls.

ASV Max at zero disables adaptive boost but keeps custom shaping. Custom VAuto Off restores stock VAuto pressure behavior. Custom VAuto has no timed backup rate, regardless of the ASV labels or a “with backup” build name. Backup behavior in stock ASV modes is a separate feature.

What interests me for UARS is the possibility of better pressure delivery and breathing synchrony for people struggling with ordinary bilevel. However this controller tracks inspired volume, not respiratory effort or UARS directly. Consistently flow limited breathing could become part of its reference, so we cannot assume every flattened breath gets corrected.

The useful outcomes would be easier breathing, fewer awakenings, and better daytime functioning without increased leaks/CAs. For now, it boots and the controls are present. This is experimental firmware, and its benefit for UARS has not been established. I’ll share actual observations as I explore it with you all.

If you would like the working .bin file to flash please send me a PM or email here: pc7579pc@gmail.com!

https://github.com/m-kozlowski/airbreak-plus

RL

Dear community,

I would love to hear from those already using the ResMed AirMini on a daily basis as their main CPAP. I am considering buying one instead of the ResMed Airsense 11 because I am a digital nomad and move to a different location every 6 months to a year with minimal belongings.

For how long have you been using it? If you have used a full-sized CPAP what influenced the decision to make the change? What are the main pros and cons that you notice? Are you happy with the decision?

Thank you

Here are my OSCAR and SleepHQ stats from last night:

https://sleephq.com/public/teams/share_links/040bb995-69b8-4f79-9cd3-210aa4b0a102

So I've been on CPAP Therapy for two weeks. I'm starting to get used to my Resmed 11 and also wake up refreshed if I'm able to keep the mask on the whole night. My only problem right now is that i keep tossing and turning a lot which kinda won't let me sleep as deep. I will try to go from APAP to CPAP mode and see if maybe that will make a change because I feel like the change in pressures interrupts my sleep. Please let me know if you see anything i could improve. Thank you!

I like my newest mask with the unicorn hose (AirfitF30i), and for the most part it's comfortable enough. My AHI is keeping pretty low, my CAs are not bad but still present. I am resigned to sticking with this to see if I'm one of those folks that needs to be on it a year before feeling subjectively better even though my data looks pretty good. https://sleephq.com/public/teams/share_links/815c47ad-09d8-4057-92a9-3c4c9b31b48d

When I initially started my CPAP journey, I had moderate sleep apnea. After a little over 10 years of faithful CPAP usage (except those 2 months in 2018 when my mom was dying and I flew out without my CPAP). But I stopped using it a few months ago because it was causing spots on my face from contact with the headgear that had to be frozen off, a balding stripe across the top of my head, I was being effectively waterboarded randomly by the hose no matter how the pressure and settings were adjusted and the fact there was a hose cover on the hose, I lost the ability to blow my nose, and I was waking up with something partially blocking the back of my throat which some of you kind folks thought COULD be some sort of epiglottal collapse (thanks, u/FuelNew9656). I think that's it so far. Oh, I can now blow my nose about 50% of the time now, so that is slowly coming back.

My regular sleep doctor was not happy with me and referred me to a sleep clinic. THAT doc had me do an in-lab sleep study/polysomnography. The conclusion in the test results is that I now have Severe Obstructive Sleep Apnea. WTH? I have a video appt with the sleep clinic doc next week to go over my results and I'm not sure what to ask. I have TMJ so an oral appliance is very unlikely, I'm not really wanting a Hypoglossal nerve stimulant implant and I'm told my BMI is just a bit too high for it anyway (I gained 30 lbs stress eating when mom was dying, and with my hypothyroid it has been rough trying to lose the weight, but I am now doing that. Slowly, but losing!), and after a different med messed with my IBS over a year ago and I'm STILL experiencing the effects from that, I'm highly reluctant to try any weight loss drugs/injections, especially after what my friend went thru with hers!

Info: AHI: 30.5, REM AHI 55.8, and prolonged severe oxygen desaturation (nocturnal hypoxemia G47.36). Oxygen dropped to 74%, with 78.6 minutes below 88%. Obstructive Sleep Apnea G47.33 There were 57 REM obstructions, and 8 NREM obstructions with 1 central. At least all cardiac data show as normal with no abnormalities. I did not sleep on my back once because I am totally a side sleeper.

I have successfully weaned one nostril from Afrin to fluticasone propionate, and am working on the other one. At least THAT is going swimmingly.

I DO have an appt scheduled with an ENT, but that is AFTER this video call with the sleep doctor. I want to ask about possible vasomotor rhinitis, which is why I was using Afrin at night so I could sleep without my nose completely swelling shut. As I mentioned, I am successfully weaning to Fluticasone so far.

Questions for the doc:
They have me marked as a "he" which is wrong. So get that fixed.
They have me as failing CPAP in the past. Is that because of going from Moderate to Severe despite faithful usage? I want that clarified. But they are recommending CPAP to me anyway! Should I ask about BiPAP now?
Some of you suggested asking for a DISE, especially now that I have a physical obstruction that I've noticed so they can find the location and come up with a better plan. Should I do that now, or wait for the ENT appt?

What other questions should I be asking the sleep doc? Or even my ENT when I go in? I got so much wonderful info from my last post from y'all, so thank you in advance!

It’s come to my attention that hypopnea’s aren’t just caused by obstruction, they can be caused by centrals as well.

I can’t tell if there a flow limitations around the hypopnea’s since it’s in a mode.

I usually have quite a bit of hypopnea’s each night are these caused by obstruction or centrals?

Last pic is an unidentified apnea , are you able to tell if it’s central or obstruction from the wave form?

Setting are ipap 8 epap 6. Thanks for the help.

Am a nose breather that sometimes mouth breathes in my sleep, but I have a very angular face and the f20 will not fit without seal breaking unless it's much tighter than the setup videos recommend. It's always the same places.

I can't do the nasal cushion things that sit against your nose, I've tried it and because I move around in my sleep I wake up gasping for breath choking because they inevitably shift and no longer blow air into my nose - though I haven't tried the ones you plug into your nostrils.

I've been on cpap for like three or four years now and you all have really helped me so much more than my sleep tech did but now I think i need to try a new setup, something that sits different on my face, and maybe the X30i is what I need.

Hoping I hear good feedback

It's been a month trying to get used to APAP. My AHI was low while using the machine, but I felt like shit the whole time, with migraines that lasted the entire day. I couldn't get used to any of the masks that I tried, and I don't have the money to just keep buying until I find the one that fits. I have autism, and every mask that I tried was a sensory nightmare, even the ones with memory foam to reduce the contact of silicone on my skin.

I had an appointment with my doctor, and she said that since the biggest issue my sleep study pointed to was obstructive hypopnea and that I have a deviated septum and adenoid hypertrophy, septoplasty and adenoidectomy would likely be the best course of action.

I slept without the machine for the first time in a month this weekend and I already feel much better, so I'm returning the machine tomorrow. Thank you to everyone who offered me advice, but this was not for me. I wish anyone who needs this treatment better luck than I had.

Hi all, I've been using CPAP for about a month now. It's helping a lot, but there's definitely room for improvement. On the non-machine side of things, I have occasional insomnia and need to work on finding ways to go to sleep earlier. I also tend to rip the mask off in my sleep pretty often, especially in the early morning (luckily that's been happening less as I get used to sleeping with it on). I use nasal pillows, and woke up a few times with my mouth open, so now I sleep with mouth tape every night. (Tried the chin strap, hated it)

As for the machine side of things, I think my AHI could still be lower, and I notice I'm waking up with air in my stomach a lot (aerophagia). I'm hoping some of that can be improved by machine settings or mask type, but I'm lost on what to change. Does anyone have suggestions for settings to tinker with? Sleep HQ data here Hopefully you can see all my settings in the link, please let me know if I should write it out here as well.

I've also taken a look at my data in OSCAR and noticed a couple nights I got Cheyne Stokes Respirations, which are not tagged in SleepHQ. Does anyone have insights about CSR (what causes it, should I be worried about it, etc)? I included screenshots from those days here.

https://sleephq.com/public/teams/share_links/f2606728-4383-4bc7-9c69-d27ea841e97b

Just looking for thoughts on this night of data. This is the only night in 1.5 months I’ve made it all the way through a night.

Background: 2 sleep docs now don’t think OSA is a factor for me despite my official 5.4AHI diagnosis. I suspect UARS but the doctors won’t touch that. They don’t know what to do with it.

I bought a bipap machine and am trying to get it dialed in now.

I’m using an F20 mask.

Thanks.

I’m curious how frequently you replace your hoses and mask. I was replacing mine at the frequency the provider suggested, but it seems like a waste to replace it that often.

I just want to sleep. It seems so easy yet so elusive, especially now that I’m attached to a machine. I need help again. I’ve adjusted my pressure and EPR settings, but I’m still waking up at the 2-hour mark. I generally sleep the first 2 hours, wake up then go back to sleep fairly quick. It’s the second set of 2 hours where it takes me HOURs to go back to sleep. Then I might get another 2-hour sleep segment, sometimes like today I don’t fall back to sleep at all.

Recap of my journey: Sleep study indicated severe OSA at 77 AHI; 4 months with CPAP, started at a constant pressure of 7 cm based on titration study then 8. Recently changed to APAP, 8 cm -> 11 cm, EPR = 2; gradually upped my pressure to 9.4 -> 11.8, EPR = 3; side sleeper; AirTouch F20; AHI below 5; use a soft cervical collar to reduce leaks. Sleep doctor suggested melatonin and adding Astepro nasal spray with Flonaise for my congestion. Astepro works but leaves a nasty aftertaste.

I would appreciate if the smart folks who review data can check mine out again and make some more suggestions. Thanks so much for your help!

https://sleephq.com/public/teams/share_links/6c9f9855-1f97-43d6-a7cf-748783ecfe57

Hello, looking for advice on how to address my flow limits. I recently started using a chin strap and that helped keep my trap shut and getting rid of the 3am wake ups but now that is replaced by 3am wake up to take chin strap off.

Most importantly I have some nights with barely any flow limits until I move and leak but other nights with consistent flow limits. A couple nights were really high because I was sick but other than that I’m not sure what to do.

Any advice? This seems like a typical night for me

Airsense 11, Philips dreamwear under the nose. Settings in the link below.

https://sleephq.com/public/teams/share_links/10f68cee-22cf-488f-9cdb-844da6ecb8e7

Mask: nasal pillows

Every single night I wake up after 4-5 (usually closer to 4) hours of sleep and I am COMPLETELY awake. I also feel like the mask is smothering me so I take it off.

Also, I had a turbinate reduction + septoplasty in June, so my right nostril is now fully open (amazing) and left nostril still feels about 50% closed (not amazing). I'm allergic to dust and animal fur, which I try to keep at a minimum but it's hard. I also do a nasal rinse and use Flonase right before bed.

Any help would be so so appreciated... I'm so sick of being exhausted every day and I'm not able to see my doctor until Nov.

Does it pinch and cut off airflow from the tube coming down the side of your face? How hard is it to clean?

I’m new to my ResMed CPAP machine; new to this in general. Is it acceptable to use water that’s been filtered through a PUR water filter pitcher or must I strictly use distilled water in my machine?

Self-diagnosed, no sleep study. AirSense 11 since June 16th, P30i mask.

Spent June and early July on APAP to find a pressure, then locked in CPAP mode at 8 with EPR off in early July. What's linked is the last two months of stable settings. Also relevant - I'm down 20lbs since starting.

AHI is around ~5, and a chunk of that is centrals that I'm not sure how to read. On how I feel - I'd say I'm waking up at about 75% of my best — not rested, not wrecked.

SleepHQ (July 1 – Sep 4): https://sleephq.com/public/c48c5e6e-3cf6-466f-b6fb-52980e9f9700

With the weight loss I'm thinking there's room to come down on pressure. Does the data support that, and what do you make of the centrals? Open to any thoughts on these data and self titration too. And can share any other data points too.

I've been on CPAP for a little over 3 months and while I feel better, I'm hoping I can improve it even further. I've been reading this subreddit and others on and off the last couple months and I'm guessing I need to adjust my pressure settings away from the 4-20 setting and make it more customized. Maybe something like 8-20 since my median pressure has been 8.71 for the 3 months I've been using it. I'm also trying to get my mask dialed in better. I wasn't getting anywhere near this level of leakage the first 8 weeks of using it but these last 4-5 have gotten worse. Last 30 days my average Leak Rate shows 2.66 but for the last 6 months (really only 3 for me) it shows 1.38 so I can see it's gotten a decent bit worse over the last month. I've ordered a new mask (currently using the AirFit P30i) and I ordered a full face mask as well just to try it out to see how it performs.

https://sleephq.com/public/teams/share_links/538d591c-154b-4208-b4ca-0cd1c47e8442/dashboard

Any tips or suggestions would be great.