Help with analyzing OSCAR data please?

[Finallysleeping]

Hello! I started CPAP therapy two weeks ago. I'm able to fall asleep with my CPAP easily but I keep removing my mask unconsciously after about an hour of sleep. Can anyone please help analyze my data? I'm wondering if there are any adjustments I should make, 2) if anything stands out, and 3) if there's anything unusual around the 23:01:30 mark that causes me to remove my mask unconsciously? I can't seem to sleep past 1-2 hours with the mask on without removing it

I fell asleep for an hour starting at ~22:30:00. Please disregard the data prior to this because I was awake. 

CPAP: Airsense 11
Mask: F20 Airtouch
EPR: 3
Ramp: Off
Humidity: 3
Prescribed pressure: 8 to 12 but I reduced the min to 7 slightly 

One thing I noticed within that hour are multiple CAs. Not sure if there is something causing that. 

Thank you all for your help! 

             

[G. Szabo]

Inspiratory peaks show some flow restrictions which lead to a recovery breathing immediately followed by a CA. There are also some leaks within the same period.
To address this issue, you should set your minimum pressure to 8-9 cm. This will also improve your flow limit figure.
But the number of your CAs is not concerning.

[Finallysleeping]

Thank you for your help. I'm using an Airsense 11. Do you think a Bilevel would be more appropriate to treat the flow limited breathing? Or do you think I can correct the issue with my Airsense 11?

[G. Szabo]

I would suggest to stay with your current instrument.

[Phaleronic]

Hello Finallysleeping,

You please need to turn EPR down to 1 for now, leave your minimum pressure @ 7cm. your flow chart is showing us that you need more pressure during inhalation and EPR @ 3 is not letting this happen. Your 99.5 percent pressure is 10cm, lowering EPR is letting the machine correct your apnea and hypopnea events while mitigating CA events, I'd like you to turn it off completely and raise your minimum pressure closer to 10cm, but we can get there slowly and it will be more comfortable. You may not need bilevel if we can get you dialed in on your AS11.

[G. Szabo]

... your flow chart is showing us that you need more pressure during inhalation and EPR @ 3 is not letting this happen.  

I do not understand this statement. 
EPR reduces the pressure for expiration, c.f. EPR=expiratory pressure relief. Hence,  it does not affect the inspiratory pressure. If "you need more pressure during inhalation," then you need to increase the pressure. Either the APAP instrument does it with some uncomfortable pressure adjustments, or we increase the minimum pressure, as I suggested, to provide a smoother ride for the member. 
The EPR= 3 setting provide more comfort and also improves treatment effitiency.

[G. Szabo]

... your flow chart is showing us that you need more pressure during inhalation and EPR @ 3 is not letting this happen.  

I do not understand this statement. 
EPR reduces the pressure for expiration, c.f. EPR=expiratory pressure relief. Hence,  it does not affect the inspiratory pressure. If "you need more pressure during inhalation," then you must increase the pressure. Either the APAP instrument does it with some uncomfortable pressure adjustments, or we increase the minimum pressure, as I suggested, to provide a smoother ride for the member. 
The EPR= 3 setting provides more comfort and also improves treatment effitiency.