Night 1 OSCAR Data Interpretation

[Stuartt]

Hi All!

New to the whole CPAP/APAP scene and looking for some OSCAR interpretation!

Background: I did an at home study with Lofta and recorded an AHI of 65.3 Hourly Events (453 total, over 6 hrs 56 min).

Other Notes: 

• Obstructive Sleep Apnea (G47.33) - Severe based on pAHI=65.2 and O2 nadir of 78%
• Central Sleep Apnea (G47.31) - Mild based on pAHIc=9.9

With these results, I got the ResMed AirSense 11 APAP with an F20 AirTouch mask and the ClimateLine hose.

Last night was the first "test drive" with the device (see attached results). I don't feel too different today, yet (11AM now), but I'm usually pretty good until late afternoon when I normally start to crash.

Besides the excessive leaks, night one seems like it went fairly well? The leaks aren't surprising to me. I've got a full beard, but I'm also a mouth breather due to a deviated septum, so I've got the full face mask to help out. Add onto that, I'm also a restless sleeper, according to my wife and test results. I'm frequently on my back and side, and occasionally on my stomach... I feel like I'm a CPAP mask's worst nightmare 

All that being said, is there any recommendations anyone can give on machine settings I should change? Should I adjust my pressures a little bit, or is the 7-20 an okay range based on the results? If I get my leak rate under control, does everything else look semi-normal? I appreciate any insight or helpful comments!

[quiescence at last]

sorry we could not take a look at your chart. I did not see one attached.

Welcome to the board and to CPAP etc.
QAL

[Stuartt]

sorry we could not take a look at your chart. I did not see one attached.

Welcome to the board and to CPAP etc.

I must have uploaded it and not attached! My apologies, please see the update, and thank you!

[staceyburke]

You really cant tell a lot because of large leaks.  Those leaks stop you from getting therapy and make it so it does not show all of your events but it looks like during the time your leaks were lower you are doing much better.  Beside the large leaks you also have a lot of fow limits.  I would change the EPR from 1 and make it EPR=3.

the leaks look like they are mouth leaks and not mask leaks.  many people here use mouth tape, I don't have any experience with that you can search the site for taping the mouth, the best tape and how to do it.

[Stuartt]

You really cant tell a lot because of large leaks.  Those leaks stop you from getting therapy and make it so it does not show all of your events but it looks like during the time your leaks were lower you are doing much better.  Beside the large leaks you also have a lot of fow limits.  I would change the EPR from 1 and make it EPR=3.

the leaks look like they are mouth leaks and not mask leaks.  many people here use mouth tape, I don't have any experience with that you can search the site for taping the mouth, the best tape and how to do it.

I will look into the EPR, thank you! I Just had to look up what that meant/what it changes.

Mouth tape honestly seems like a nightmare (literally) to me hahaha. With a deviated septum, I sometimes feel like I'm suffocating just throughout the day... I'm worried that if I tape, I'll wake up in a panic in the middle of the night 

[quiescence at last]

I would say mouth leaks should not be a "thing" for you, as the full face mask give the same air pressure to both your mouth and your nostrils. Also, you rely on your mouth to be the inhale-exhale port. You don't need to tape it. That would put me in a panic.

QAL

[quiescence at last]

if you don't turn ramp to off, then raise the ramp start pressure at 7 or 8 with pressure min of 12. Ramp start and ramp time is dependent on what pressure you feel comfortable falling asleep to. Making the minimum 12 is pretty essential as under 12, you have events that quickly vault your pressure to 16 plus. See at 01:55 of posted chart, you'll see an OA occurs at about 11.5. Personally, I get a bit rattled when I get to about 14 cm pressure. so I put my pressure max at 14. If you still are comfortable at 16, then make that the max. The excursions to 20 are liable to be due to kinking the hose (throat) via chin to chest syndrome.

I had my EPR at 1 and had flow limitations as high as about 60%. Just adding EPR (changing from EPR 1 to EPR 2) caused my flow limitations to peak only about 30%.

QAL

[Stuartt]

Thanks for the replies all!

I made a few adjustments and tightened my mask down some more last night and saw much better results. I took my min pressure to 9, didn't see the last comment on thread until this morning, and changed EPR to 3, that was it for the changes.

Any advice based on the night two attached image or am I pretty well off?

[OpalRose]

Congrats on getting the leaks under control.  If you revert back to having issues with leaks, read through the
Mask Primer to get some tips on adjusting your mask.  

Flow limitations are still high. Using EPR usually helps, but since you are at EPR 3, the other avenue left to try is to raise your minimum pressure a bit more. It's ok to take it slow, but you should be at around 12cm minimum. If you can't tolerate it, use ramp at a start setting of 9cm for 30 min or less.

Agree with not using mouth tape. With your deviated septum, that could be a real problem. You have to be able to breathe freely through your nose to mouth tape.

With needing higher pressures, you may be better off using a BiLevel, which would give you more pressure support and more comfort. Something to keep in mind.

[quiescence at last]

eew! those flow limitations make me wonder just how contorted your wind path really is. Is there something else restricting flow besides relaxed muscles? Hope you find the culprit. There was so much difference between the two nights, I was wondering if you have a dog or 25-pound kitty that likes sleeping on your neck.

the last post shows the machine never retreating under about 14 once the flow limits were in the .25 and below.

when you spoke of better results, could you have meant you felt more refreshed or at-least less like there was no point in even lying down? cuz, that would be good.

have a great day.

QAL