This chart doesn't look good to me - What do you get from it?

[jimvs]

Been struggling to get up to speed with APAP. Have been since end of June. Started at 5/15, then 5/10, now 5/8 because of issue with full face mask (ordered nasal pillows--they're on their way). But at 8mm, it seems like it's doing nothing, yet I can barely keep the mask from leaking! Feedback? Suggestions? BTW, this was the longest I've been able to keep the mask on. Usually I don't even make it 2hrs.

[Sleeprider]

Really typical for positional apnea and no EPR. Set minimum pressure 8.0, EPR on Full-Time and read the positional apnea wiki. https://www.apneaboard.com/wiki/index.ph...onal_Apnea

[jimvs]

Thanks for the reply @sleeprider. I looked at that WiKi article. The second chart, which is scaled to show individual breaths, depicts about a minute of reduced flow followed by a recovery spike. I zoomed in on my charts and it looks very different (see attached). Maybe 8mm is too low(?) Not going to try to go any higher until my nose pillows arrive.

   

[Sleeprider]

The flow rate at the start of your zoomed segment is representative of severe Class 2 flow limitation. We see flow reaches a peak and slows ahead of expiration. Several of the peaks show a double peak which represents soft-tissue obstruction that momentarily releases. The increasing flow limitation and increasing respiratory effort leading to arousal is the definition of RERA. My working theory is that this close up shows you are already in positional obstruction and the respiratory stress from the flow limits and apnea causes a series of arousals to break the obstruction, but you don't get out of the obstructing position until about 07:15. It would be helpful to track flow limitation instead of pressure or mask pressure. If you move to Autoset pressure in the range of 8.0 to 11.0, your pressure will automatically titrate when flow limitation appears, and the use of EPR will minimize flow limitation to the extent possible. Your CPAP settings clearly are not able to respond with fixed pressure to these positional obstructions. Autoset pressure will help, by increasing pressure as needed, but you will have to also assess your sleeping position, number of pillows and consider a soft cervical collar if those measures do not help.

[jimvs]

Me again. I reordered the graphs in OSCAR to show Flow Limit (as reported) along with Insp & Exp time (since I understand at least the former is used by the ResMed to 'predict' flow limitation). I don't know if this jibes with positional apnea or not (perhaps it does...!) I'm seriously considering videoing myself while sleeping to see if there's a definite correlation between my changing sleep geometry and what this contraption thinks is going on!