Sierra

I have never really liked using a snorkel mask. It always seems like it is restricting my air flow more than I like. When I first started using a APAP I was quite apprehensive. My machine was probably not set up as well as it should, and certainly not the way I would set it up today.

The main mistake that many new users make, and many professionals that set up machine is to start with a pressure that is too low. Out of the box the machine is set up to deliver a minimum of 4 cm of pressure, and a maximum of 20 cm. Many just get handed the machine and told to go for it. The reality is that 4 cm of pressure is too low, and for the majority of people it will feel like the mask is restricting the air flow (like the snorkel mask feeling).

What one really needs to do is get comfortable with the mask while sitting up and watching TV or something. After you feel reasonably comfortable then increase the minimum pressure 1 cm at a time and breathe in deeply. At some point it will start to feel like there is no restriction at all when you breathe in. That is a good minimum start pressure to use if it is reasonable -- probably in the 6-8 cm range. The second most important thing is to turn the Expiratory Pressure Relief (EPR) on and set it at 3 cm. This will reduce the pressure on exhale by up to 3 cm. It cannot reduce it below the 4 cm minimum of the machine. So for example if your minimum start pressure is 7 cm, it will reduce to 4 cm on each exhale and then increase to 7 cm on each inhale. Most find that very comfortable with it easy to inhale and exhale. The third step is to set the EPR to be on only during the Ramp because that reduction to 4 cm during sleep can promote apnea, which in turn will initiate a pressure increase by the machine. The automatic set pressure can be kept lowest if the EPR is automatically shut off when you are sleeping. Last the Ramp type should be set to Automatic. This way the 7 cm and 4 cm pressure cycling will be held at those pressures until the machine decides you are asleep. Then it will increase the pressure to the minimum automatic set pressure point (if it is higher than 7 cm). Reduction of the pressure on exhale will stop.

When set up this way, I find the mask very comfortable for going to sleep. It feels like you are wearing no mask at all, from an airflow and pressure point of view. Before I set it up that way, it was not so comfortable and I got frustrated when trying to go to sleep. Another trick is to use the user menu to start the humidifier prewarming about 15 minutes before you go to bed. This warms up the water so you will get the set humidity right from the start. Not essential but more comfortable.

An important point is not to put the mask on and jump into bed the first night. Spend some time with the mask during the day while watching TV or reading and just make friends with the mask. Adjust it until it is comfortable fitting and not leaking.

Hope that helps some. If you want a checklist in order of the items in the setup menu let me know, and I will give you my suggestions.

The standard objective is to be under 5 for AHI. With central apnea as an issue I have a bit of trouble always doing that. My wife on the other had who has almost no central apnea, is usually under 1.0 for AHI.

Sounds like a case of the "Pink Tax"! If you check around the various websites both in Canada and the US, the standard version and the For Her version sell for the same price. Obviously the price from the factory to dealers is the same for both.

There is no reason to have a regular SlimLine hose other than as a spare. I have one and have never used it. When we RV off the grid I save power by turning off the humidifier and heated hose.

I have no experience with MAD devices, but there are one or two sleep specialist dentists that check in here. Hopefully they can give you some help. If you want to go back to a CPAP device I might be able to help you there.

Your hypopnea events of 31 combined with a total monitoring time of 374 minutes or 6.23 hours indicates a hypopnea index of 5, the same as they reported. This means they used total monitoring time as the basis, not actual sleep time. Your actual sleep time is likely to be less than 6.23 hours. Say for example it was 4 hours then the real AHI would be about 11. That is about in the middle of the mild apnea range of 5-15.

If you are not getting good sleep you may well benefit from a CPAP. The total snoring time of 324 minutes is certainly a bit of a red flag. A CPAP is very effective in reducing snoring.

If you have to pay for a lab test, and can get a prescription based on your at home test, then you may find it less expensive to just buy a Auto CPAP and try it. The ResMed AirSense 10 Autoset costs about $900 in the US, but if you shop around you may find it for less.

I have a recollection of a poster a few weeks ago asking about having zero CA and OA events. I think they even posted a Statistics sheet from SleepyHead, but when they posted as Daily screenshot the Unclassified events were there and quite significant. My conclusion is that the ST function sort of fixes the apnea, but not quite... One would need to see a zoom in of the flow graph during some of them to be sure what is going on.

Thinking about your post a bit longer, there is one other possibility. I see that he is using a ST machine. That sometimes means that a backup forced breathing method is used. This timed backup can interfere with the detection and classification of the apnea events. In the ResMed machines they still report those apneas but they are designated as Unclassified. There may be some possibility the number you are seeing is not including the Unclassified apneas.

First, I realized I didn't fully answer your question about the For Her masks. They will fit standard machines (or most any brand) and the main difference is the color, and in some case the headgear is smaller. Unless you have a smaller head size I would not order one. The exception might be the P10 mask. The straps on those masks tend to loosen and there is no good adjustment method. If you don't mind the color, then the For Her version of the P10 mask may be a good idea. If I was buying one again to use just as it comes, I would order the For Her version. But, I guess it kind of depends on your head size...

As for the For Her special algorithm here is the ResMed story on why and how they developed it. A quote:

"Women tend to have less severe OSA than males, with a lower apnea-hypopnea index (AHI) and shorter apneas or hypopneas. Episodes of upper airway resistance and flow limitation that do not meet the criteria for apneas are more common in women."

I think the reader's digest version is that it is optimized for someone with lower AHI, potential upper airway resistance, and needing less pressure. The bottom line is that it is only an option, and if it does not work for you, you can just switch it back to the standard algorithm. You would think they would just offer a unisex machine with the option on them all. But, they don't, so it just a marketing thing.

The AutoSet For Her machine is identical to the standard AutoSet machine, except that the For Her version has an extra For Her mode built into the software. And the color is different. The standard machine is basic black, and the For Her is a beige color. The same masks fit both machines. In fact most other manufacturer masks fit the machines too. The mask to machine hose connection is standardized.

There are only two AutoSet machines. One is the AirSense 10 AutoSet, and the other is the AirSense 10 AutoSet for Her. Both capture detailed data. Both adjust pressure automatically.