Help Interperting Oscar Report

[calimom99]

            I am new to this. I just pulled up my OSCAR report and have no idea how to read this. Here is a sample of 3 nights. I find I take it off after just a couple hours because I wake up to a high pressure of air being blown. Not sure if this is a leak or something set too high.

[DaveSkvn]

Hi Calimom99,

You say " I find I take it off after just a couple hours because I wake up to a high pressure of air being blown."

I wouldn't worry too much about that. CPAP takes some getting used to and I certainly did that when I was starting & on an auto device.

I'm not medically qualified so you'll have to decide yourself how much weight to put on the following statements.

On 13 December you had a big problem with mask leaks. You'll see a red line on the chart at the value 24. Its generally accepted that if the trace is below (ideally well below) that line you are OK. If it is above the line you need to take some kind of action because the loss of air will impact the effectiveness of the therapy - you'll see a tick against LL (large leak) on the top box. On December 9 you had a bit of a leak problem. On November 11 you had no problem at all. I see you're using nasal pillows. There are at least a couple of options: (A) the mask was not tight enough, you shifted in your sleep and it was venting air from the side or (B) your mouth opened and air was being pumped into your nose and straight out your mouth - you'd probably have a sore/dry back-of-throat when you woke up from all the air flying past.

Looking at the pressure graphs (ignore 13 Dec due to the leaks), you'll see the pressure was at 9 most of the night. That is the top of your pressure range. This indicates that the machine has detected something and is trying to handle it but has hit the limit of your settings. What has it detected? Well that'll be the "flow limitations". A flow limitation of 0.8 to 1.0 is labelled an apnea. A flow limitation of 0.5 to 0.8 is labelled a hypopnea. You have pretty much constant flow limitations below 0.5 - not bad enough to be labelled hypopneas but bad enough for the machine to ramp up the pressure to try to handle them. Having the machine bump around the upper limits is unfortunately a sign that the pressure range is not appropriate and needs to be raised - with all the implications for comfort that entails.

Now things get a bit controversial. Sleep apnea is managed using the AHI. If your AHI is below 5, your will be declared treated and largely ignored. If you approach a sleep clinic with your CPAP machine saying you had a AHI of 2.3 they may not put too much effort into helping you. You'd have to wave around the graph of flow limitations and the graph of pressure ramping up immediately to its upper limit and staying there - these will not be visible or monitored. Sleep clinics only really watch "machine hours used", the "leaks" and the AHI number.

OSA has a sibling condition called UARS. Its more difficult to detect because it doesn't cause the blood oxygen level to fall. It does involve lots of flow limitations below the level that would be labelled a Hyponea (Search youtube for "Vik Veer Upper airway resistance syndrome" - March 2021). It won't show up in the AHI. It may or may not be applicable to you.

Hope this helps and that you get some relief for your sleep issues.

[Sleeprider]

With pressure at 6-9 you have very high flow limitations at at 95% level we can't see...turn off the monthly calendar by clicking the triangle in the date line. Anyway, this results in lots of RERA and many arousals, as well as pressure climbing to the maximum setting and staying there. I think most of your AHI arises from the flow limits. Read the flow limitation wiki so you understand what we're after here. https://www.apneaboard.com/wiki/index.ph...limitation Exhale pressure relief (EPR) will normally resolve this issue by providing increasing pressure support during inspiration.

I recommend minimum pressure of 7.0, maximum pressure 11.0, EPR on, Full-time, Setting 3. Please organize your chart to eliminate the calendar and that will let us see other more important information.

[jdougc]

What mask are you using, you have the pillow type selected.
You have substantial leaks if that is really a pillow mask. You may have the wrong size cushion. Don't cinch it too tight to stop the leaks, do you use moth tape?
Are you a side sleeper or do you sleep on your back?