Took a turn for the worst. Please help with OSCAR Charts

[Geer1]

Here is a bit of info to understand what is happening.

EPR creates a pressure differential that increases air flow during both inhale and exhale. The higher EPR is, the higher the flow which evacuates CO2 from your lungs (and then blood) more efficiently. CO2 is what drives respiration and if your CO2 levels drop then your body thinks it doesn't need to breath so it takes a break until your CO2 level rises again and then body realizes it has to breath again. This causes the cyclical nature you see in flow rate graph (taking a break from breathing during central apnea, recovery breaths to evacuate CO2 and then another break in breathing, rinse and repeat).

In your last example posted you can see the flagged central apneas from 7-7:20 and you can also see similar periodic breathing that is central in nature but without triggering apnea flags at other times like 1:20 and 5:50.

Did you have any central apnea during your sleep study?

[LBTRS]

Excuse my absence as I have been working on a congestion/swelling/stuffy nose issue in another thread. That problem is still a work in progress but wanted to circle back to this issue as I discovered something but don't know what could be causing it.

I am using a ResMed N30i mask with decent results but it isn't as comfortable as I would like. ResMed came out with an upgraded cushion for the N30i with is MUCH more comfortable and maintains a great seal. I really like the way it feels.

Unfortunately with the updated cushion I get much higher AHI than when I switch back to the old version. Any idea why the cushion could be causing my AHI to be so high?

[Geer1]

It could be related to how the air flow is delivered by the mask. I haven't seen too much about this on forums or studies but a sleep tech I talked to one day was telling me how the direct air flow from nasal pillow masks can cause a negative reaction in some people sensitive to air flow directed into nose. She convinced me to try a nasal mask since it is more like taking a natural breath in and can cause fewer issues. I never could get a nasal mask to seal well though.

Edit: Since you seem to have a potential form of CPAP causing rhinitis I wonder if this has even more merit then I first thought.

I am curious.

A) Do you find the congestion is any better or worse with this different mask?

B) Do you notice any correlation with congestion and central apnea (for example worse congestion = fewer centrals)?

[LBTRS]

Hi Geer1,

No correlation with the congestion and higher centrals that I can find. Last night I had a really good night congestion wise after a decent day without a lot of swelling and congestion. I decided to try the new updated N30i cushion again. I was saddened to see a high increase in centrals just by switching out the cushion. The last time I tried the updated cushion I had high centrals as well.

I seemed to think the nasal mask felt a bit better congestion wise but I also couldn't get it to seal properly and fought it all night long so it kept waking me up more than usual. I've have the best luck with the nasal cushion masks as far as comfort and sealing.

[Geer1]

It could also be good sleep vs bad sleep. I had trouble with the N30i mask/vent noise.

Flipping through your data posted again it appears like some of your better days were actually initial posts when you were still using EPR. Has your AHI been obviously better with EPR off (easy way to tell is looking at statistics tab in OSCAR)?