Breathing pattern with oscar data?

[BDGold99]

Hi, thanks in advance to those who offer input i appreciate it. 
-Nasal cushion
-EPR 0
-(starting AHI)15 obstructive apnea
Im wondering whether my breathing looks good during the night, and im unsure which direction to move in. Ive seen on other peoples oscar data that the thickness of the breathing pattern looks wider than mine making me think im not taking deep inhales(but tidal volume looks ok right?), but maybe im wrong. I can see my flow limit looks ok also(I think), at 0.04. Im unsure whether to increase pressure to remove these hypopneas, the issue with that is, im using strong mouth tape and multiple times through the night air is still escaping waking me up. Increasing pressure would make this worse, so im not sure what to do.
           

[Deborah K.]

The reason you show just a line of pressure is because your machine is set at 9.6 minimum and maximum. My guess is that this is how your doctor set it. I suggest that you instead set a range of pressure to see what your body actually needs. Try 7 minimum and 15 maximum. Then we can evaluate if changes are needed.

As to your mouth tape, you are likely using tape that is too small or not very good tape. I need to use 2-inch wide tape that is cut to about 5-1/2 inches long to avoid mouth leaks. Maybe you do too. Lots of folks here like Cover Roll Stretch tape, and it's pretty inexpensive. I prefer Theraband Kinesiology tape as I find it more comfortable, but it does cost more.

Good luck with improving your therapy, comfort, and taping.

[BDGold99]

The reason you show just a line of pressure is because your machine is set at 9.6 minimum and maximum.  My guess is that this is how your doctor set it.  I suggest that you instead set a range of pressure to see what your body actually needs.  Try 7 minimum and 15 maximum.  Then we can evaluate if changes are needed.

As to your mouth tape, you are likely using tape that is too small or not very good tape.  I need to use 2-inch wide tape that is cut to about 5-1/2 inches long to avoid mouth leaks.  Maybe you do too.  Lots of folks here like Cover Roll Stretch tape, and it's pretty inexpensive.  I prefer Theraband Kinesiology tape as I find it more comfortable, but it does cost more.  

Good luck with improving your therapy, comfort, and taping.  

Hi thanks for your comment. 
I set the pressures that way myself as I’ve found that leaks become worse if I raise it, and apneas increase if I lower it. Another reason is the fact that when using a range, the changes can decrease sleep quality, and I’m easily disturbed. Although tonight I will try the range as you mentioned.

I’m also using really good strong tape, hypafix cover roll stretch tape, at roughly the same dimensions you mentioned, so there’s no room for improvement there. I’m also rolling my lips in.

[UnicornRider]

It looks like you have titrated your obstructive apnea very well.

From your charts it looks as if your EPR is set to EPR 3 cmH2O, Reducing EPR to 2 or 1 may reduce the number of CA events at the risk of having Flow Limits increase and possibly Hypopnea & OA events increase in number.

At the bottom of Left Hand Panel, under Session Information un-select the first session( possibly the first two sessions) it appears you never really fell asleep, it will re-calculate the AHI score for only the session where you slept starting at ~0040 session.

Several of your events look clustered, typical of Positional Apnea, "Chin Tuck", Although some people do not think CA events are causes by positional apnea, I have seen enough evidence to say yes it is possible. Do you use a Soft Cervical Collar? Do you use a low height pillow?

"Im wondering whether my breathing looks good during the night, and im unsure which direction to move in. Ive seen on other peoples oscar data that the thickness of the breathing pattern looks wider than mine making me think im not taking deep inhales(but tidal volume looks ok right?), but maybe im wrong."

Looks can be deceiving!
You can re-scale the Y-Axis to Dynamic Scaling (Auto Fit) by double clicking your left mouse button on the Numeric scale just to the left of the Y-Axis.
You can right mouse click the same area it will open a window, scroll down to Y-Axis, there you can rescale the Override values. I run my Override Values for Flow Limits at -40 to +40 for most of my zoomed in viewing, looking for disrupted breathing. Try rescaling the same view of the good Flow Rate wave forms you captured on your 25 June OSCAR Report starting at ~0135.

Practice re-scaling your graphs, it is a skill that may be needed when presenting graphs for review by forum members. Or at home while looking at Flow Limitations.

Your tidal volume looks ok, dependent upon your Height, Weight, Build and possible health issues.

"I can see my flow limit looks ok also(I think), at 0.04."
Your Desirable 95% Flow Limits Should be 0.00, your Desirable 99.5% Flow Limits generally are less than 0.20.
With a different machine you would be able to add Pressure Support, to suppress the Flow Limits. With EPR at 3cmH2O, you have no further options in that direction.

"Im unsure whether to increase pressure to remove these hypopneas,"

If you can stand the increase without compromising your sleep with leaks, You could try small increases every few days to see the effects.

It is also possible that corrections for Positional Apnea, can reduce some of the Flow Limitations and Hypopnea.  

https://www.apneaboard.com/wiki/index.ph...onal_Apnea

When presenting multiple OSCAR views for review, it helps if you show the lower half of the Left Hand Panel on the second view by using the slider to bring that information in view before taking the screen shot. Your Device Settings add valuable information.

CPAPFriend is a fellow forum member who has posted several very good YT videos, I suggest to many they review his videos for navigating OSCAR.

      https://www.youtube.com/watch?v=32JwMc6dphQ

      https://www.youtube.com/watch?v=ujaoKvBnP00

 He has several good YT videos, I also think this should interest you, but do not limit your views to my offerings.

      https://www.youtube.com/watch?v=LwOjeESNGIY


    Any question, concerns or doubts  post back! Meanwhile enjoy your journey and post more OSCAR Reports.

[BDGold99]

Hi, thanks for your comment and all the information you supplied, I appreciate your time and effort.

I use a low pillow, try to fall asleep on my side: I tend to toss and turn during the night with frequent arousals even on cpap. Ive just bought a cervical collar but not used it yet. I’ve set the graph at 40 as you suggested, and it looks like many other peoples data now, which is good and what I was curious about. 

I think the reason it looks like EPR is 3 that night is because I changed the setting on the machine in the morning to try it out, and was left on 3 during screenshots. I used EPR 1 that night.

I’m now going to raise pressure for a few nights, should I leave EPR on 1, or do you recommend increasing it, or do you recommend using an APAP range as Deborah suggested? Thanks again.

[Deborah K.]

You could also try a narrower range, such as 8-12. That would probably be easier and might help your comfort and therapy.