New to CPAP - Question about my OSCAR Data

[Oikos22girls]

I started APAP therapy on June 12 after being diagnosed with Mild OSA (7.7 AHI, including some mixed, central, and hypopnea). I didn't think I was much of a mouth breather, so wanted to try the P10 nasal pillow mask. Also, I mostly sleep on my left side. I started with XS nasal pillows (from my instruction session) and have moved to trying the S and M nasal pillows on the P10 mask. My provider has my machine set to 6 Min - 18 Max pressure, and as the pressure increases, I have a harder time keeping a seal on my nasal pillows, especially the XS and S sizes, and even a bit with the M size. I am trying to determine if I am having mouth leaks, or if most of my leaks are because of an increase of pressure in response to events or position which causes my nasal pillows to lose their seal. I am also trying to decide if I need to use a chin strap. In other words, I am trying to figure out how to decrease my leaks and my events. Oh, and also get some better sleep!

Last night I rigged up a chin strap and started the night with that and the size S nasal pillows. I was restless because the chin strap needed adjusted, and I kept having nasal pillow leaks. Halfway through the night I got up, adjusted the chin strap I had rigged up, and changed to the size M nasal pillows. If some experienced eyes can take a look at my data from last night and provide feedback, that would be greatly appreciated. I have also attached data from the night before (no chin strap), if that would give you any more insight.

I have learned a lot from reading on this board and want to thank those who are so kind to provide their experience and feedback.

       

[SarcasticDave94]

Welcome to Apnea Board,

To help with your therapy, I did want to ask about the sleep study data and if you've requested your copy? My reason for asking is the Central Apnea component. If you do have this report, you may attach the info regarding this in redacted of personal info. The main thing I'm interested in involves for now the event count and type in the base sleep study before CPAP was introduced. Depending on this info may indicate the approach and machine type that'll be best for you.

[Oikos22girls]

I have attached my redacted sleep study results.

       

[SarcasticDave94]

Great this helps. For your reference, the 4 CA plus 12 mixed combined is about equal to the 15 Obstructive Apnea. It may be an uphill battle for what I was thinking regarding the Central Apnea component. This thought being a different CA specific machine. It means right now we're in neutral about this, and see if we can avoid some CA with your current CPAP.

Central Apnea or as the machine called them clear airway, they're still the same item. They're clear in the sense that your airway isn't restricted like with the Obstructive events. Your breathing is doing long pauses on occasion, some due to the CPAP flushing out extra CO2, reducing the signals to breathe the next time. Some were there before CPAP too. That's the 16 total CA plus mixed mentioned.

OK what you may want to try for one night is to reduce EPR to 2 due to CA. Here's a part of the avoid CA plan. You may also need to turn off the Ramp to see if it affects CA, but let's stick with one item being edited to be certain what affected your therapy and how it did so.

We'll probably want to get this therapy as best as we're able, if it remains and/or obtains decent comfort. This is for you to decide, and there's no wrong response. You decide comfort and rest scores because it's your therapy.

If it becomes bad due to inability to avoid CA consistently, and if therapy is feeling uncomfortable, next step might be requesting doc to consult and consider VAuto bilevel or onto ASV, depending on how good or bad things go from here.

Unfortunately we're all guinea pigs when it comes to CPAP and masks. Consider the edit down one of EPR to 2, follow with an OSCAR chart and telling us if things are going well, bad, terrible, etc. It should be evident pretty quick if this is headed the right way or not. Great job on OSCAR attaching.

[Oikos22girls]

I have attached my data from last night. I reduced my EPR to 2 last night, as suggested. We had a power outage for an hour or so and there were more events and leaks after replacing my nasal pillow mask after the power came back on. I felt like I had a good seal on my mask last night. In looking at the leak rate, does it look like I was having mouth leaks? I know I exhaled through my mouth at least a few times, so I don't know if that is registered as a leak. 

   

[SarcasticDave94]

I think it does pick up on this mouth leak from exhale. While not ideal, it's also not terrible in light of the recent CPAP therapy start.

How did the session compare to the last before EPR edit? Both overall Obstructive events and Central CA were close to equal about 2.3x. Again not ideal, but the Obstructive didn't multiply with reduction in EPR. At least for one night anyway.

Care to try as is one more night? Unless it felt terrible then we'll have to go back to EPR 3. It appears the CA might just be stubborn enough where you may not be able to avoid most.

[Oikos22girls]

I didn’t have any issue with the lower EPR, so I will try again tonight. Thank you for the feedback.