Question about missing data in middle of night

[addeuce]

Hello! This is my first post here so please let me know if there's other information I should include.

I've been on CPAP for a few years but have recently been feeling more tired overall so I'm wondering if there are settings I can try to get more out of my CPAP therapy (maybe change the min and max pressures?). I've attached a screenshot of my OSCAR chart (following the wiki instructions) and I would appreciate if anyone has any suggestions for how to try and optimize my CPAP settings! Let me know if I should share more information.

Also, looking at the data for last night, I'm wondering if anyone knows what might be the cause of the missing data in my OSCAR chart between 3AM-4AM?

Thanks!

OSCAR chart:
   

OSCAR chart with missing data:
   

[G. Szabo]

Your pressure is too low, causing a rugged night. 

I suggest increasing it and using the following setting:
Response: Standard
EPR=1. (you want to reduce your CAs)
Min pressure: 8
Max pressure: 11
Ramp off. (you have no treatment during ramp.)

As for the missing data, apparently,  you put the instrument in a standby regime and restarted the treatment after a while because the ramp restarted.

[addeuce]

Thanks for the suggestion! I've updated my machine settings and I think I feel more well rested, however there a few new issues I'd like advice on:
1. With the higher pressure, my mask is leaking a lot. I tightened my mask straps and it seems to help. (leak rate is high overall)
2. I now wake up with my mouth very dry (got an ulcer at the bottom of my front gums) from last night.
3. I feel gassy when I wake up (probably from eating air / aerophagia).

Here's an updated OSCAR screenshot from last night with the new CPAP settings:
   

Thank you!

[G. Szabo]

Your leak rate is so high that it compromises your treatment. You must control them. You might want to find a different mask.

To reduce your aerophagia and leaks, you want to try EPR=2, but there is a price to pay: it might increase your CAs. You can also lower your max pressure to 10 cm to mitigate aerophagia.

Your events are clustered between 4 and 5 a.m., which can indicate positional apnea. You might turn onto your back or bend your neck toward your chest (chin tucking). Hence, you might want to use a thinner pillow and purchase a soft cervical collar.  try to sleep on your side.

If you tape your mouth, you can avoid dry mouth and reduce the number of OAs and Hs events. Some medications are also available for dry mouth.      

[addeuce]

I've tightened my mask a lot which seems to be helping with the leaks and dry mouth. I've also started using a soft cervical collar and adjusted my EPR=2. Looking at my updated OSCAR chart, do you think I should try increasing the max pressure further? I see the pressure topping out around 11 throughout the night. Thank you for all the suggestions so far, they have been very helpful!

   

[G. Szabo]

I agree. You should set your minimum/maximum pressure to 10/13.
Also, your EPR setting does not influence your CAs. Hence, you can increase it to EPR=3.

[addeuce]

I tried the new settings last night (min/max pressure to 10/13, EPR=3, still using a soft cervical collar) and was surprised that my AHI increased. It doesn't look like the pressure is topping out anymore and there aren't any leaks. Do you have any suggestions for other things I can try? I've attached an updated OSCAR chart below.

   

[G. Szabo]

The difference between the two nights is just noise. But you had a smoother ride at higher pressure.
Nevertheless,  your pressure should still be increased. I suggest setting the minimum to 12 cm.