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Hello! I started using a CPAP after my snoring became too much for my spouse to bear. Had an at home study done, got the machine, instantly felt better! My snoring had previously been so bad I slept in the guest room, but have re-joined my spouse. She has mentioned I am still snoring, just much quieter, but occasionally I will snore quite loudly.
I found the forum through a google search, got an sd card and installed OSCAR to try and solve the problem. The ENT I had the sleep study done has closed, and it's been very tough trying to get an appointment, so I thought I'd try this! I only got the sd card yesterday, so I only have detailed data from last night, I have attached a screenshot to this post. What changes should I make, if any? Do I need to wait a few more nights and gather more data first?
Your setting for the min is the lowest the cpap can go. The EPR (exhale pressure relief) is set to 3 (where I think it should be) but is doing nothing at all. What the EPR is to do is lower the min on exhale - BUT 4 is as low as the cpap can go. So try turning the min to 7. That would make the settings do this.
One of the reasons we use EPR is to lessen your Flow Limits. FL are apnea also just like the O and H events - all are apnea and epr will help with the flow limits. FL stop you from getting into a deep sleep, can wake you up and raises the pressure of the cpap machine. Take a look at your pressure chart and compare it to your flow limits. When you have flow limits you can see the higher pressure...
Here's the screenshot from last night. I felt awake and full of energy as soon as my alarm went off, and I wasn't woken in the middle of the night by my bladder. It took some getting used to the new pressure at the start, but I realized that having min at 4 was not enough air right when I put my mask on. My wife mentioned that I snored loudly briefly before she fell asleep, but she wasn't disturbed. Looking over the charts I can see some improvements, but where should I go from here? What, if any, adjustments should I make?
You're never really reaching your minimum of 7 at any point during the night, and you appear to have some leak issues when you reach the higher ranges. I would set the range from 11-14 and see how it goes.
Look, I'm an engineer, not a doctor! Please don't take my opinion as a substitute for medical advice.
Sure I'll make those adjustments tonight. Do you think I'm having a mask fitment issues causing the higher leaks at high pressures? Or is it just the nature of the machine operating at that pressure? I've been reading the Optimizing Therapy wiki article and I think I'm starting to understand what some of the graphs mean.
It's both. If your mask fit is OK but not excellent, it may be that the trouble is only apparent when pressure goes up. If your mask fit is really good, it will seal properly at all pressures available to the machine. I recommend that you limit to 14 because you had a very small amount of time at those pressures, and it's worse to be leaking at high pressure because the higher the leak and pressure, the harder it is for the machine to deliver the extra air volume at that pressure to keep up your mask pressure for proper therapy.
There is a mask fitting tips and tricks section of the wiki here as well, it is worth a read if you haven't seen it yet.
Look, I'm an engineer, not a doctor! Please don't take my opinion as a substitute for medical advice.
Here's last night, leaks were a big problem! I read through the detailed mask fitting guide, going to follow it step by step before bed to see how tonight goes. last night I re-routed the hose, thinking maybe it might have been a leak factor. Am I correct in thinking that this data isn't worth much due to the leaks?
Followed all the tips from the mask fitment articles in the wiki, and yesterday afternoon, I changed the min and max to 20, and spent 10-15 min playing with mask fit at full pressure. Once I got the mask sealing against that much, I loosened everything slightly, and returned pressure settings to 11-14 for the night. Attached is last night's data, I think I'm getting closer on mask adjustment and sealing. I'm primarily a back sleeper, sometimes side, and I think the large leaks are on my side. I'm using a buckwheat pillow, so there is minimal pressure on the mask when on my side.
I'm going to adjust a little tighter on the mask and see what happens. No marks on my face, and from what I remember before I shut off the machine and got out of bed, mask was comfortable on my face and I didn't feel any leaks. I was asleep before my wife came to bed, she said I was very lightly snoring, but did not disturb her falling asleep.
Where should I go from here?
Best numbers yet! I continued to improve mask seal and I think this is the lowest AHI number I've ever gotten. Now that I'm hitting my max pressure, do I need to adjust it? I'm still concerned with leak rate and I will continue to make adjustments to my mask but what should i be shooting for? I know that leakage is designed as part of the system, but do I need to strive for zero leaks or just under the threshold?
