New member, first night of Oscar data

[Gideon]

Per your statement, your mask IS too tight. Read the mask leak sections of the Mask Primer.
https://www.apneaboard.com/wiki/index.ph...ask_Primer

The purpose of the straps is to hold the mask in place, NOT to make the seal. The seal is actually supposed to be made with the PAP's pressure holding the strip of silicon around the edge of the mask against your face. If that is not happening and you are in need of a better-fitting mask. Really ols school masks were nothing but an air filled pillow where you would use the straps to physically push and conform the mask to your face because they actually fought the pressure with force to keep the seal. Modern masks are designed to seal with a skirt similar to that of a hovercraft to essentially float on your face, not conform to it.

[michael7]

Thanks for that info! That's along the lines of what I was thinking, I'll definitely try out another mask.

The last several nights I've tried it a bit looser like that guide suggested and all seems okay until I move my mouth at all, and then I get massive leaks that wake me up. I think my mouth is too wide for the mask (Resmed Airfit F20 large), so tonight I'm planning to buy the Dreamwear mask. I still need to use their chart to check my size, but I saw they had a Mediumwide size so that sounds promising and is likely what I'll end up trying.

I've thought about trying a nasal cushion as well, but between a deviated septum and (before the CPAP) a massive snoring issue, I don't know how well that would work, so I've been sticking with the full face masks for my initial tries. I am a nose breather during the day, but at night my body seems to automatically become a mouth breather. I even remember last night on the CPAP partially waking up and noticing my mouth wide open.

[michael7]

At this point I'm mostly good but still working on slight tweaks to everything so I thought I'd post a night's worth of data and see if anyone had any further suggestions. I am currently at a pressure of 8-14. I managed to sleep with an EPR of 1, I know an EPR of 2 was suggested but I had issues sleeping with it, so I'm letting myself spend a few days getting used to the EPR of 1 before trying 2 again. My mask is fitting better but still not great, I think my next step is to try a nose mask instead of a full face one. My mouth just seems to be too wide to properly fit in the masks without overtightening them.

This particular night I spent a while fiddling with my mask fit before falling asleep. I think I woke up in the middle of the night needing to itch my nose so that's why there's a disconnect in the middle of the night. I had an apnea, a clear airway, and a hypopnea throughout the night. I know the AHI is good but I still feel groggy today compared to days that I have no events, but still much better than before the CPAP.

Is my next step to try an EPR of 2 or are there other setting changes I should make? Thanks for any advice!

[michael7]

Things have been going well, I've adjusted to EPR 2 and my flow limit looks better. I still have events some nights, sometimes an apnea or hypopnea, sometimes a clear airway, but it's usually just 1-3 events all night. Here are some of my latest nights where I've had events, though I've also had some nights with no events at all. Can anyone chime in and say if they look good or if I should tweak something? My pressure is currently set to 8-13. My 95% pressure always seems to be around 10.

[michael7]

I need some help tweaking my settings. Some nights are fine, others I'll have 1-3 events, where the events might be obstructive apneas, hypopneas, and/or clear airway. I've attached images of last night, where I had two hyponeas and a clear airway. I've also attached an image of the zoom in of the clear airway event, as I've heard those can be miscategorized. I'm currently at a pressure of 8-13. My 95% pressure on Oscar is almost always around 10. I also have it set to an EPR of 2. Should I make any changes? Thanks!

[michael7]

Another night with another few events. Should I be trying to eliminate all events? Should I increase my pressure a bit or does this look good overall?

[Melman]

Your data looks great. There is no need to eliminate all events and it's probably not possible.

[michael7]

Thanks! That makes sense!

[staceyburke]

Your EPR WAS OFF. AGAIN, you need EPR set full time and set to 3...

[michael7]

I'm confused, it's not off. I actually managed to get EPR working and even managed to work my way up to 2 as had been previously recommended. I'm finding EPR at level 2 to definitely help, and my 95% flow was down to 0.04 in that image.