[CPAP] Need help deciphering OSCAR data please

[apneabro956]

Hi folks, I need some help deciphering OSCAR data. My main issue is that I am still having apneas while I am on CPAP, for example I woke up today with my heart pounding and even though my pressure is set to 8-16, the pressure was only 8.2, shouldn't it go higher?

I looked at the data in OSCAR and it shows I am having some Central Apneas, can EPR cause that? How can I minimize central apneas. 

I also would like the optimal pressure settings. Resmed software shows I am minimal AHI but I can feel that its wrong because I am still waking up with apneas. 

I am using a nasal pillows mask. My Settings are
Pressure 8-16 (my sleep dr reccomended 5-20 but I am playing around with the settings for optimal results)
EPR 2
Humidifier is on but I am not using it.

Thank you

[PeaceLoveAndPizza]

You have significant leaks going on. Until those are resolved there is not much you can do.

In the first chart you have large leaks > 24 l/min for 85% of the time. In the second leaks are less at around 5%, but other than that things do not look too bad.

[apneabro956]

Thank you

[Deborah K.]

With a pillows mask lots of people need to tape their mouths.  I sure do.  If you want to try it, lots of folks here like Cover Roll Stretch tape or Hypafix tape.  Both work very well.  I prefer Theraband Kinesiology tape because I find it more comfortable, but it does cost more.  With your high leaks, you probably need to stick with 2-inch wide tape.  I need to cut mine to 5-1/2 inches long, well past the sides of my mouth, or I still leak.

Good luck!

[apneabro956]

Thank you for that I will look into it. 

Another question I had was how would I know what my optimal pressure settings are?

[Deborah K.]

Your pressure looks okay for now, but until you get your leaks under control it's impossible to say what you'll need for the long term.

[apneabro956]

Thanks again any opinions on epr settings whether they should be kept on or off. Or rap only versus full etc

[Dodies]

Mostly people recommend EPR on, set to 3.

As others have said, you have massive leaks, where it says LL means "large leak" and you have LL 82% of the time -- maybe you are breathing out of your mouth?

[PeaceLoveAndPizza]

To the question, how do we know what your optimal pressure settings should be. I use titration to find the applicable range, then work on narrowing it to the minimal needed to get a good nights rest. 

For example, in your case your pressure range is 8-16, but it hovers between 8-10. You could easily change it to:

Mode APAP
Min pressure 8
Max pressure 10
EPR 3 full-time
No ramp

Depending on how things go there are a few more tweaks that can be made, but we prefer changing only one thing at a time if at all possible. Other than the above changes I would leave things as they are for now. We can review after you have a few more nights OSCAR data.

Regarding EPR, leave it as I show above for now. We can always adjust from there but it seems to be working for you.