Help w/ Oscar Data (recent mask switch)

[cpapillon]

Hi, I've been using Auto CPAP for 12 yrs and I recently switched to a full face mask (the F&P Evora) from a nasal pillows mask (the full face being considerably more comfortable for me) and my AHI has increased above the thearapeutic level of 5 most nights. 

In my research I learned that I probably needed to increase pressure, and while I've done that, it doesn't seem to be helping much. Before the switch my pressure settings were Min: 6 and Max: 14. Right now I'm all the way up at 11.5 and 20.

I can't seem to figure out what's going on and I'm hoping someone more experienced with the OSCAR data can have a look and let me know their thoughts. Thanks so much!

[staceyburke]

You are having some positional apnea.  You can see positional apnea where either H or Oa events are clustered together.  Getting rid of as many as you can will lower your AHI.  Positional apnea can NOT be controlled by pressure changes.  You have to find out what position you are getting into and cutting off your own airway.  Have you changed your sleep position?  Sleeping on your back?  Using more (or new) pillows?  These things can cause positional apnea by chin dropping to your sternum and cutting your airway.  Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar.  I have a link to collars in my signature at the bottom of the page.  It shows people who are not wearing a collar and the SAME person wearing a collar.  There is a huge difference between the two.  However, yours are NOT that often – but enough to push your AHI up.

I would go back to your old pressures and concentrate with finding why your sleep position changed.

[quiescence at last]

I'll point out that this chart shows the "Large Leak" criteria was not broken, so there is no time when the machine thought leakage was out of hand. That does not mean there is no leakage problem, nor whether leaks disturbed your sleep.

Also, if you can change from CPAP mode to APAP with Flex is set to any value, you'll then see a flow limitations graph. If you have that, it will help to identify specific timeframes where the flow limited conditions occur and how badly.

Can you share a chart of some recent night's before you changed to the full face mask?

Thanks and good luck,

QAL

[cpapillon]

Also, if you can change from CPAP mode to APAP with Flex is set to any value, you'll then see a flow limitations graph.

Thanks so much to both for commenting. I've attached a couple of my previous nights with my nasal pillows mask (chose particularly good nights AHI wise) to see if that can offer any insight. As far as changing from CPAP mode to APAP with Flex, is that something in the OSCAR software? Or is this something I would do with my machine? I'm not totally clear on that. Thanks again everyone!

[quiescence at last]

oh boy, sorry it has been so long since I have checked in. Yes, the settings to switch to APAP is on your machine. I am not familiar enough to guide you through that process, though. I hope to find out.

for your info, if I had a value of .97 on a flow limitation graph it would mean that mean I resisted 97% of air flow. But, in the statistics board, I am not sure if that means the same thing, or just that sometime during the night your flow was cut off enough to get this reading, maybe once like Jul 29 at 5:55 where that really loud snore was registered.

QAL

[Phaleronic]

Hi cpapillon,

You are having quite a few hypopneas, obstructive apneas and flow limits, your 95 percent pressure is 16cm so you need to raise your minimum pressure to at least 12cm, change from a-flex to c-flex (not all DS2s have c-flex option so if it doesn't leave it on a-flex), turn ramp off completely and set c-flex to 2. You may need more pressure but for now this will help get the FLs, Hs, and OAs under control, here's how to get into the clinical menu:


https://www.apneaboard.com/dreamstation-...structions

[quiescence at last]

You will not have a flow limitations chart unless the machine is set on APAP, and you are already on CPAP. So, if you are interested in seeing when the flow limitations are occurring, you'll need to change from CPAP to APAP.

Change as you like, and good will and wishes to you.

QAL