UARS CPAP setting? Help me interpret OSCAR data

[throwaway0815]

I've slept a couple nights with my CPAP now, but I feel I'm still doing worse than just sleeping on the side without the CPAP.
Here's my sleep studies for reference:

Here are the results from my earlier in-lab study:

• AHI: 10, RDI: not scored
  
• https://imgur.com/a/5jHyNvu
  
• https://imgur.com/a/ChqAO3F
  

New results from Watchpat while sleeping on the side:

• AHI: 1.1, RDI: 16.2
  
• https://imgur.com/a/mknxORS
  
• https://imgur.com/a/Ec3rtLA
  

I'm using a nasal mask (Philips Dreamwear), and the CPAP came with settings 5-15, EPR: 2. I noticed air leaking out of my mouth, so I'm using mouth tape every night.
I also noticed a feeling of not getting enough air, so I raised the min pressure to 7 and turned off EPR (I felt like it set in before I was done inhaling, again leading to feeling of insufficient air).

The AHI is low, but I still felt terrible in the morning and woke up after just 6 hours of sleep, in addition to multiple wakeups during the night. After waking up my nose felt congested.
Any ideas what's going on? Setting changes?


OSCAR data (I was going to bed at 23:45, before I was wearing the mask while watching TV):

• https://imgur.com/a/aGmYqF1
  
• https://imgur.com/a/1fLTJYv
  
• https://imgur.com/a/2gWs3W5
  

[Gideon]

Welcome to the Forum.  

5 ism, for most too low of a pressure, and EPR of 2 will not work well at a pressure of 5, which requires 6 min though 7 is excellent.
Your Flow Limits are a bit higher than I'd like so I'll ask you to leave your min pressure at 7 and set EPR = 2 full time.  If you still feel you are not getting enough air set your min pressure to 8 then try again.

[throwaway0815]

I appreciate the reply!

Will try that and post again.

[throwaway0815]

Here's another night: I raised both min pressure and EPR by 1 and I think I feel slightly better.

However, I noticed I'm still getting mouth leeks even though I'm wearing both chin strap and mouth tape right now.

Also I noticed the lower part of my nose is irritated in the morning (feels like when you have a sunburn).

Any ideas about this?


- i.imgur.com/AgspOK3.png
- i.imgur.com/tDBdRTZ.png

[Illorum]

You have way too many flow limitations. As an UARS patient you should be targeting nearly zero flow limitations. That Flow Limitation graph should only have a couple of spikes.

[Gideon]

Use F12 to take your Screen Print or follow the Organize link in my signature.
UARS is all about the flow limitations, Put the Flow Limit chart right below the Flow RAte.
Additionally learn how to spot flow limits in the flow rate.
On your machine flow limits are best treated by increasing the EPR,
UARS are all about the Flow Limits, both the flagged and the not flagged ones.

[Dormeo]

I'm noticing that in the earlier charts, you didn't have any EPR and that in the most recent charts, the EPR is only 1. So the settings haven't been what you think they've been. Could you double-check your EPR settings? After you make a change in the clinical menu, you may need to push the round dial to lock the new setting in.

Your leaks look fine. You have a couple of big mask leaks at the beginning of the night. The leaks later on might be mouth leaks, but unless they are waking you up or giving you a very dry mouth, they are nothing to worry about.

To help your sore nose, try Lansinoh, a lanolin cream that is made to help nursing mothers but works well on sore noses.

I also wanted to say that you are off to a great start, sleeping all night with mask on and machine running; finding this board; asking good questions; and using Oscar.

It can take time to start feeling benefits from PAP treatment, and they may come gradually, in subtle ways. So some patience is called for, along with the problem-solving you're doing. Adding EPR will be an excellent next step given your flow limitations. After you try EPR of 2, post again. You will probably get advice about going up to an EPR of 3, perhaps with an increase in your minimum pressure.

[throwaway0815]

Thanks Illorum, bonjour, Dormeo for your great replies!

I will try to reduce the flow limits by raising the EPR and post again tomorrow!

Use F12 to take your Screen Print or follow the Organize link in my signature.
UARS is all about the flow limitations, Put the Flow Limit chart right below the Flow Rate.

Here's the same screenshot following your recommendation: imgur.com/a/9Gd5767

Additionally learn how to spot flow limits in the flow rate.

Can you give me a pointer of how to do that?

I also wanted to say that you are off to a great start, sleeping all night with mask on and machine running; finding this board; asking good questions; and using Oscar.

I appreciate the kind words! Will post again with EPR=2.

[Gideon]

http://www.apneaboard.com/wiki/index.php...ailed_look
http://www.apneaboard.com/wiki/index.php...orum_Posts
http://www.apneaboard.com/wiki/index.php...Rate_graph

http://www.apneaboard.com/wiki/index.php...148d1f.jpg


Best, Post zoomed images of your flow rate and ask for interpretation.  First, learn how to recognize normal flow.

[throwaway0815]

Thanks, I will have to do some reading and look into the flow limitations!

In the meanwhile here's last night with EPR=2. Please ignore the part after 5:40, where I woke up and was lying awake in bed trying to fall asleep again (lots of events).

I think I'm still getting a lot of mouth leaks, which were noticeable to me at least 2-3 times.

I also added my pulse rate and SpO2 (measured with CONTEC CMS50F). I'm getting these heart rate spikes (ex: 00:15, 01:35) which sometimes feel like an adrenaline rush. And I usually wake up with heart palpitations (very strong/noticeable heartbeat). Do you know what could cause this?