Need some help reading and fine tuning therapy

[Blubarb]

i all

Very new to the world of CPAP. I am using a Resmed Airsense 11 and an Airfit N30i that I find relatively comfortable. I am also taping my mouth to prevent it opening if I roll onto my back during sleep. However, I am still getting large leaks. Any ideas on my current settings that might improve my sleep overall. 

I have included a screenshot of my OSCAR data from last night. 

Appreciate any thoughts and direction.

[Phaleronic]

Welcome to the forum Blubarb

I'm wondering if the tape is leaking after awhile during sleep? Also do you have a hose hanger rigged up, I had worse leakage before I began using one-it keeps the hose from pulling the mask around while sleeping (curtailing leakage). Also is EPR on?

[quiescence at last]

Other than the leakage, your chart looks like you had a reasonable sleep. No, i wouldn't change anything at this time, but consider trying EPR of 3 just to see if it resolves some of your flow limitations.

I look for 95% value of flow limitations of 0.10 or less, yours was 0.15, fairly good.

QAL

[Blubarb]

Firstly, thank you for the welcome and also for sharing your experience and thoughts. I will try these tweaks and report back. EPR level was set to 2. I will give 3 a go. It looks like a steep learning curve though.

[Expat31]

Hello, 

In your graphs, the settings part of the left hand window are obscured, These are important and should be be made clearly visible. 
In addition we only need the simplier presentation of just the essential graphs, in order of importance:- 

1.Events
2.Flow rate
3.Pressure
4.Leak rate
5.Flow limitations

This may liberate sufficient space for the settings to become visible in the left window.

If this does not work, you may have to reduce height of the graphs by going into preferences/appearance, and then adjust graph height from 180 to (say) 100, and adjust fonts if necessary. See below for an example that hopefully will work.

[Blubarb]

Thank you, Expat31, that is really helpful. I never picked up on that.

[Blubarb]

I have taken your recommendations, and I am also reading the OSCAR Chart Organization. One issue is that I am unable to find a way to minimize the left column so as to fit all the Device Setting info.

[Expat31]

Hi, 

Thanks for the graphs, it's a lot clearer now. You can take out the snore graph as it servers no purpose and will  gain some more space. However you have managed to get some of the details exposed. 

I don't know if you noticed the attached a screen shot last time, but to find this location, on daily page, go to top left hand corner, see FILE, then drop down menu appears, second option Preferences, then the preferences page appears, last tab marked Appearances. This is the page I previous attached in the screen shot.

In the middle of the page you have Graph height, by default it will probably be set to 180, try changing to 100.

Then in the last paragraph Fonts, you could try these size settings in my screen shot, Hopefully it should work. 

It all depends on your particular computer's resolution. You could try it,  or even modify my suggestions until you find the right settings for your computer. You can revert to original settings if you wish. (Take a screen before you make any changes).

If this doesn't work, we have clearly all your relevant graphs, so that is plenty to work on. 

I had a look at your graphs, and as others have noted, you do have a leaking problem, either mouth leaking or mask leaking. Using a pillows mask, because of its small surface can give an excellent seal, providing not too tight.

Like you, I have a pillows mask (Breveda), and mouth tape also. 

I found it really lt important to make sure a generous length of tape was used, well covering the corners. I still had leaking with taping, of about 15l/min.  This is well within the parameters of Resmed (24l/min.), but I found I needed to drop to below 10l/min, to sleep better. I use chin strap now. You may want to consider this option eventually. 

You 95% leak rate is at 25.2/min, which may well be at a threshhold level you are sensitive to and causing micro-awakenings or arousals, degrading sleep quality. 

By the way, your increases in pressure are being provoked by these leaks, you can see this clearly from the graphs. 

These pressure increases are not contributing therapy, quite the opposite.  

Obstructive apneas and hypopneas are well controlled at the moment.

The central apneas may be treatment emergent, and should reduce once your basic settings smoothed out, as with flow limitations. It early days still to tell for sure. 

Your EPR at 2 could be increased to 3, reducing flow limitations, but likely wlll increase centrals in the shot term. I would leave at 2 at the moment until leaks are solved and the picture becomes clearer.

[Blubarb]

Hi and thank you for the added information. 

I will study it closer during the day. 

This is last night and I add it to see if things still look the same - again, I will have a closer look as the day goes on downunder here.

Many thanks. I am thinking that there is a light at the end of the tunnel and not the proverbial onconing train 

I changed the EPR to 3, perhaps I should change it back to 2?

John

[Expat31]

Looks pretty good with EPR3.  Just one insignificant CA. 

Leaks much improved, with just one event pushing up pressure unnecessarily. 

You could up minimum pressure to 9 in order to smooth out pressure swings. 

Flow limitations are too high, likely causing some sleep disturbance. What is important is how you feel currently. 

As EPR is already on  maximum, a further increase in minimum pressure may also help reduce FL's, maybe more than 9 is needed, however best to make just one change at a time at the moment. 

Your events graph is taking up a lot of empty space. You could resize with your mouse, and enlargen the other graphs a little.