First 2 nights

[OpalRose]

Narcil,

Even though the leak rate is low, even small leaks can be disruptive... so work on keeping that mask on.  If you look at the FL graph and compare it to the leak graph, sometimes you can see the correlation between the two.  Sort of like the chicken and egg thing!

I agree with you on trying EPR 3 along with an increase in minimum pressure to 8cm.

Go ahead and try the increase in EPR first, but I feel you will need to be set at a minimum of 8 with EPR 3 so as not to invoke an increase in Obstructives.

8 minimum minus EPR 3 gives you a minimum EPAP of 5.  It's the EPAP that sprints the airway open and keeps Obstructives at bay.

Overall, you're doing pretty good!  

The main thing is to focus on the mask issue.  If you're aware of removing it, put it back on right away.

[Narcil]

Here's 2 more nights, EPR 3 and the second night raising the min pressure. Think it looks a little better with 8cm minimum ? no more REs.

Sometimes the machine keeps ramping up when i'm trying to sleep, somehow it detects a flow limitation and 11cm was too much trying to sleep so i just reset it then i fell asleep..

the leaks are when my mask touches the head pillow and moves the mask off my face, still want to try the n30i.

[attachment=63132][attachment=63133]

[OpalRose]

Look at far you've come since you posted your first chart! You're doing well... except for your mask. And the mask can make or break a good nights sleep. There seems to be just too much movement with your mask.

Yes, the FL is still higher than we like to see, but it is half of when you started. The mask movement (spikes on the leak graph) correlates with the FL rising.... which cause you to wake up.

I would keep the minimum pressure at 8cm and watch this for a few days. Try to work with your mask for a better fit. If sleeping on your side, move to the edge of the pillow, so that your mask sort of hangs off the side.

[OpalRose]

Narcil,
Keep us updated. Post another graph when you're ready.

[Narcil]

Narcil,
Keep us updated.  Post another graph when you're ready.  

Sure thing  Here's the last 3 days.. Personally i think it looks amazing almost too good to be true...

Are Clear Airway events in Oscar the same thing as Central Apneas?

There's no reason to switch back to CPAP mode is there? Can you do EPR in CPAP mode?

 

[OpalRose]

There is no reason to go back to Cpap mode unless you felt more comfortable with it. And yes, you can use EPR in either mode.

Clear airway and central apnea are just interchangeable terms. Yours are very low in number and not to worry over.

If you're sleeping well, then I'm assuming the FL doesn't bother you??? We can't get it down any further unless we raise the minimum pressure, and I'm not too sure that would work either. Otherwise... looking good!

[Narcil]

Only time to FLs are really bothering me is when i'm trying to sleep and it keeps ramping up the pressure. I watch TV on my back for 10-15 mins to fall asleep and if it ramps up too high i just have to reset it. Which is why i brought up CPAP mode but my median pressure being around 10 i'd probably have to set it too high to be comfortable anyways so i just need to get used to it i think.

But yeah sleeping well otherwise. i only remember waking up once last night and i'm not even sure it was because of the mask. I'd still like to try a nose cradle type mask (like the n30i or p30i) since i have no problems with mouth leaks surprisingly. the n20 is okay but leaves a huge imprint on my face for 3h, and my nose is still a bit red when i go to sleep 16h later.... 
but the masks are 150-200€ here so i really need to go through the hospital and i don't want to turn this one in since it's working reasonably well. i doubt i could buy them without a script anyways. 

One more thing, Oscar says i have the humidifier installed and on level 4, but i never received a humidifier and have the cover on, should i post it in the software support forum? is it a known issue? it might be due to the machine being very recent (revision #39480), i got a warning when i first opened oscar that this revision wasn't officially supported yet. i did say yes to the popup to send the infos to the developer.

[Narcil]

Here's last night. I feel less tired for sure.

Still quite a bit of FL but not sure if i should even worry about it. since the machine never reaches 15 only thing to do would be switch back to cpap mode with higher pressure? or a bilevel?

[OpalRose]

You've probably gone as far as you can unless you can make a move to BiLevel which gives you extra pressure support.

If you're experimental, and want to see if a higher minimum would lower PS more and help with the snores, then try a minimum set at 9cm. Look at the statistics on the sidebar. You are already utilizing a median pressure of 10 and are over 11 for 95% of the time or less.

If it's uncomfortable or doesn't make much difference, then stay where you are. There's also nothing wrong with using a static pressure (Cpap mode), but I would keep it at between 9-10cm.

The decision is up to you and how you feel. I know in my own therapy, moving to a higher pressure doesn't always give the results hoped for. I've stopped chasing numbers long ago, and put comfort first.

[Narcil]

I tried 8.6 and 9 for a couple nights, honestly can't really tell a difference. think i'll keep it at 9 longer then switch back to 8 see if it makes any difference.. no point trying 10 right?

Are those unflagged OAs, CAs or REs?

i'll talk to the doc about a bilevel but that's in july..