OSCAR data suggestions

[thistle]

Last night was my 4th with a CPAP and first with an SD card to gather the full data.  It was the first night I woke up feeling significantly more refreshed and not sleeping nearly as long as I have been.  My diagnosed AHI was 12.4.  I also switched to a pillow that isn't as tall and stiff last night and maybe that helped.

I have an AS11 with N20 mask.  My partner thinks she may have heard air coming out of my mouth once or twice during the night.  I start sleeping on my back and when I switch to my side I have a tough time getting the mask/pillow interface just right to not get an air leak 

1. Is there anything in my data that stands out that I should be looking for?

2. What suggestions do you have based on my data, if any?

3. I had a fair bit of condensation/water collection in my cushion this morning.  Anything I should change for that with the humidity level or just leave it on auto?

   

   

[OpalRose]

You are using your Apap at a wide open range of 4-20, which isn't optimal for most.

If you look at the statistics on the left side bar, your median pressure is close to 8cm.
This is where your minimum pressure should be set.  So let's narrow the pressure range a bit by setting the minimum to 8cm, maximum to 15cm.  
Leave EPR set to 3 full time.  

Your overall leak rate is fine, but the graph shows you have some movement of the mask and possibly some mouth breathing.  The spiky areas on the graph usually signifies movement.  

When you are sleeping on your side, you almost have to learn a "new" way to sleep.  Try to sleep with your head near the end of the pillow so that your mask hangs off the side.  

Try the different humidity settings to see what works best for you.  
It's best if the hose it routed upward then back down to you.  Many of us use some type of hose hanger to accomplish this.  

Also, if you're experiencing condensation, try covering your hose with a fleece cover.
If you're using a heated hose, try a higher hose setting.

[thistle]

Awesome. Thanks. I'll try that tonight.

What's the benefit of lowering the max from 20 to 15?

What is the indicator of mouth breathing? Is it the sustained periods of leak rate staying above 0?

Would I be better off trying a full face mask? At what point do I need to look at that?

[OpalRose]

Flow Limitations will cause the pressure to rise, so by lowering the maximum pressure, we try to control that. Sometimes this rise in pressure can cause awakenings or arousals.

I couldn't tell from your leak rate graph, but spikes in the graph indicate movement and flat tops in the leak graph point to mouth breathing.
Also, if you wake with a dry mouth, you are more than likely mouth breathing.

Your leak rate is ok, except if you are awakened by it. Then that becomes disruptive to sleep.

[thistle]

Last night felt like a good improvement.  I woke up feeling better still.  I'm only on day 5 with a CPAP but am very encouraged so far.

AHI is down to 1.05 and only 2 OA and 1 CA.  The rest were Hypopneas.  I woke up with a fair bit of water in the mask again so I raised the tube temp from 80 to 82 and will try that tonight.  If that doesn't work or is too warm I'll move the Humidifier down to 3 from 4.  

I've attached my daily shot, an example of an OA, and an example of a CA.  

Any input is welcome.  Thanks!

   

   

   

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And here's a shot of an ongoing leak.  Would this indicate I need to try a full face mask?

   

[Sleeprider]

There is a lot of disrupted and large-volume flow at the beginning of your session due to the ramp pressure being too low to supply the air you are demanding. You should select a minimum pressure that you tolerate or turn off ramp. Try a pressure of 6.0 which will give you a as start pressure of 6/4 (inhale/exhale).

[Dog Slobber]

What's the benefit of lowering the max from 20 to 15?

There often isn't one, and looking at your data there wasn't one.

With *some* people there can be a need to limit the the maximum pressure:

• Aerophagia
  
• Intolerance to higher pressure (especially when new)
  
• Pressure induced central
  
• etc
  

But there was nothing on your charts nor commentary that suggestd you needed a limit.

Some people advocate, not using a max limit. The thought process being, on the rare occasion where it might need to go above the max limit, let it. And if it never needs to go above the max, then it doesn't matter.

An analogy:
If you had a bathroom scale that had a maximum of 250 lbs, and you only weighed 180, is there any value in swapping out your bathroom scale to one with a maximum of 200?

[OpalRose]

To answer your question about changing to a full face mask due to leaks.

It's early yet and the leaks are not at a point where your Cpap can't detect apnea's.
You are mouth breathing a bit, and that might be that you feel as if you're not getting enough air, or your mouth is just dropping open from habit.

Do you feel you are awakened by the leaks? If it doesn't cause you a disruption to sleep, then unless it increases, don't worry over it.

I would try to stick with current settings for awhile, but you should try to wean off using ramp.

[thistle]

Thanks for all the input! I'll implement all of that and give it a try for a few days and see where we are.

[thistle]

I can't thank you guys enough.  I'm learning a ton between the feedback on my thread and the reading I'm doing on others' threads.  My sleep has already significantly improved.  Oscar has so much more data than I imagined I would be able to get about my sleep.  But I guess the more you learn the more questions you have...

1. I really struggled with my mask last night.  It's an N20 and I just couldn't get it to fit well.  I put the whole thing on and off a few times.  I adjusted it tighter and looser.  I just kept getting leaks that were usually blowing in my eye.  It hasn't been like this before.  I wipe it down with a baby wipe each day.  I assume 5 or 6 days isn't long enough for the cushion to significantly change shape.  Any tips?

2. I kind of knew this before but the data confirms it.  When I'm falling asleep I go through this phase where I wake myself back up because I notice I'm not breathing.  Last night it happened the first time I fell asleep and also after my break in the middle of the night to use the bathroom, adjust the humidity settings, lowered the ramp time to 5 minutes, reset my mask, etc.  Can anything be done to help this or should I just ignore them?  This happened before I started using CPAP too so it's nothing new.

3. I raised the tube temp from 80 to 82 yesterday and still woke up with a ton of moisture in my mask.  Middle of the night I dropped humidity to 3 from 4 and I woke up without water in the mask.  I guess that's the ticket.

4. I ordered a hanger as suggested on here and should get here tomorrow.  I don't know if it helps with the moisture or just comfort or what but I'm willing to give it a go.  

   

   

   

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And here's the data from my OA and large leaks.