Please review my OSCAR data

[stony82]

Hi

Been struggling with CPAP for about a month now.  Full disclosure - I don't have a formal diagnosis yet and am on a 9-month long NHS waiting list here in the UK to be seen.  But since I've woken up feeling tired pretty much every day of my life, I've bought a CPAP machine so I can start figuring this out now rather than hang around another 9 months.

I'm struggling to keep a mask on for the whole night so I don't have loads of data to share.  Here is last night.

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[stony82]

That didn't go well!  Trying again, this time with attachments.  Last night's data:

   

and a zoomed in view of one of the worst sections:

   

This is with pressure 6 EPR 2 and I'm using a Dreamwear under-the-nose mask.  SPO2 data comes from a Viatom CheckMe O2 Max.

In my previous post someone pointed out I had some positional apnea.  I now have a 'sleep noodle' that helps keep me off my back at night, and those flagged OAs have largely disappeared.  Progress!  But, I'm still waking up feeling like crap every morning.  

I also got advice to set IPAP to 8 and flex to 2 (I had a Dreamstation, changed to a Resmed now).  I did try those settings but struggle to get to sleep with those pressures.

Could people please help suggest:

• How may I get rid of the CAs?  Should I reduce the EPR?  Will they go away as I get used to CPAP?
  
• My O2 seems to be significantly worse when I'm wearing the mask.  Not sure what to make of that...
  
• There's very few flagged OAs and Hs, but when I zoom in I see what look to be periods of restricted or low breathing.  Would increasing the pressure help?
  

[Gideon]

You still have some positional apnea, but your CA is a bigger concern.

Let's turn EPR off, at least for now.

And please keep all your therapy posts on one thread.

[stony82]

Thanks for the advice, and ok will try with EPR off.  So far I've struggled to exhale with it turned off, even at low pressures like 6.  But hopefully I'll just get used to it?  And I can try having EPR on ramp.

I should have posted a clearer set of data - most of the OAs are from earlier in the day when I was experimenting, awake, with different masks and pressures.  So it might give a misleading image of positional apnea.  I only had a small handful when I was actually asleep, around 2am.  That said - I do think you're right and I do still have a bit of positional apnea, as the sleeping flow rate looks low & restricted in places (10 or less on inhales, usually 18-22).  I have a soft cervical collar which might help with it.  I'm trying to get used to the mask first because having the mask, back-noodle AND collar on is.. a lot.  It gets hard to sleep.

And yes, will keep everything to this thread going forwards.  Sorry, I didn't realise that was the preference here.

[stony82]

I did some testing yesterday and realised that pressure 6 just wasn't giving me enough air, even while awake.  Going to 8 felt a lot better.  However, I was only able to get the EPR down to 1 at this pressure - at 0 I felt I couldn't breathe out.  

I'm also trying a Dreamwear Full Face mask now, as I get a lot of leaks at these slightly higher pressures with the Dreamwear under-the-nose.

I think the results last night looked a lot better with these new settings:

   

CAs are down, and zoomed in the breathing looks a lot 'cleaner' than before (to these untrained eyes) - less choppy, more even.  Still room for improvement there though I think.

Another place there's room for improvement is that O2 with the mask on still isn't great.  It still improves when I take the mask off, though it's less clear-cut than at pressure 6.


So, maybe I'll try increasing pressure a half-notch or so, and/or reducing EPR to 0.  It feels at the upper end already of what I can tolerate to sleep with - but hopefully I will adjust with time.