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[CPAP] Help with graph interpretation please
#1
Help with graph interpretation please
I am new to this forum, but I was diagnosed 5 years ago with mild sleep apnoea - which occurs mostly when I am sleeping in a prone position.

I would like to be able to read my graphs from Oscar - when AHI is higher, what am I doing that I can change? There does not seem to be a correlation between higher AHI and feeling heady and awful the next day.

For a start I have included a recent Oscar screenshot. I would like someone to show me how to interpret the graphs. It is lot of variables to sift through what is important to improve the treatment.

How do I see if I have a mask leak? - the Large Leak graph has never recorded anything, but I can hear it when the mask leaks when I am awake. Of course I can't hear it when I am asleep.I don't know how to interpret the pressure graph.

Thanking you,

Ron aka Fredd000

   
   
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#2
RE: Help with graph interpretation please
Welcome to the forum

Leaks, all masks leak! This is a good thing. What you don't want is to is have a "large Leak" which means a leak large enough to decrease your machines ability to identify events which are interpreted to drive pressure changes. On fixed pressure it is just about identifying apneic events.
So ignore leaks if they are not large and not disturbing your sleep. Your leaks are in the acceptable category. Generally jagged peaks in the leak chart tend to indicate mask leaks, plateaus tend to indicate mouth breathing. You can also see what is happening in a 2-minute view of the flow rate chart.

Your CA events are slightly elevated. To correct this try lowering or turning off your Flex. This parameter tends to increase the flushing of CO2 from your system to where it drops below your apneic threshold. Turning it down tends to somewhat correct this situation. It doesn't always work but does need to be tried.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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#3
RE: Help with graph interpretation please
(08-11-2020, 11:14 PM)+1. I would suggest shutting off flex completely for 1 week and evaluate how you feel. bonjour Wrote: Welcome to the forum

Leaks, all masks leak!  This is a good thing.  What you don't want is to is have a "large Leak" which means a leak large enough to decrease your machines ability to identify events which are interpreted to drive pressure changes.  On fixed pressure it is just about identifying apneic events.
So ignore leaks if they are not large and not disturbing your sleep.  Your leaks are in the acceptable category.  Generally jagged peaks in the leak chart tend to indicate mask leaks, plateaus tend to indicate mouth breathing.  You can also see what is happening in a 2-minute view of the flow rate chart.

Your CA events are slightly elevated.  To correct this try lowering or turning off your Flex.  This parameter tends to increase the flushingof CO2 from your system to where it drops below your apneic threshold.  Turning it down tends to somewhat correct this situation.  It doesn't always work but does need to be tried.
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#4
RE: Help with graph interpretation please
   
Thankyou for the quick and to the point reply.

I switched off the C-flex plus, and I feel the same, so I figure I don't need it. Also I switched off the ramping.

I don't know if it is connected at all, but I have been experiencing some cyclical periods (some RERA and PB- 22 min long and 18 min). Is this something to be concerned about? Or should I just worry about the apnoic events?.

Please  see last night's data.

I have just added a hose support, and also bought a new mask - they both seem very comfortable.

What does worry me is that I still wake up with a dry mouth and still wake up feeling lousy.

What I want is to wake up feeling alive.

Thanks,

Fredd000
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#5
RE: Help with graph interpretation please
The periodic breathing is likely what's left over from your Central Apneas. The detailed breaths indicate a lot of flow limitation. I'd like you to increase your pressure to 8 and see if we reduce your hypopneas. See the clusters of obstructive apneas. This is likely you tucking your chin which is causing a physical obstruction that no amount of pressure will relieve. For now I want you to be aware of it and watch for it. If this occurs with any degree of frequency you will need a Soft cervical collar, read the wiki article linked in my signature and the link to positional apnea in that wiki article.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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#6
RE: Help with graph interpretation please
       
Thankyou for the interpretation. I appreciate it.

Increasing the pressure has made a difference - AHIs are down. However, the amount of gas which I swallow is up, and I wake up with a painful gassy belly. This all happened before, but it is much more pronounced now.

The other thing that has changed is that I have a lot of large leaks, where previously I had almost none.

What is frustrating is that I feel a bit better, but not much better.

I have ordered some soft cervical collars.

I have read up on all I can get hold of about apnoea, including what is in your signature, and made notes.

I am including the latest data.
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#7
RE: Help with graph interpretation please
let's add flex = 1, and see if your aerophagia goes down and hopefully the CA stays manageable.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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#8
RE: Help with graph interpretation please
I have increased the Cflex + from 0 to 1. There are no clear results just yet, but I want to clarify the pressure reading please.The CA is unclear if its up or down, but the large leak is much less.

The pressure graph previously showed a straight line of 8, which is expected for a fixed pressure. With a Cflex+ of one, the pressure varies from about 6.4 to 6.6 (ie around 6.5). This does not make sense to me. Is my machine working properly, or is there a problem with Oscar displaying the pressure? Above the graph, there is a label that the graph is EPAP and the set pressure is 8.  Or should I have the fixed pressure higher at 11.5??

Thanks again.

I can send the graph to make it clearer if you like.
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#9
RE: Help with graph interpretation please
Following on from the last email, here is last night's snap of the important data.

My problem is the Pressure axis labelling. The graph must be the Cflex pressure.

In the end, it doesn't matter as long as I know that I do/don't change the pressure when I change the Cflex setting - but I do like to understand what is going on.

thanking you
   
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#10
RE: Help with graph interpretation please
One easy way to see if you have to much mask lead - First make sure the correct type of mask is listed on your machine. (the type of masks has different amount of leaks).  Next put your cursor on the left side of the chart "leak rate" and  right click in that area.  Next you should see options - choose dotted line.  Then choose "leak rate upper theshold".  That will put in a dotted line.  That line is the point where the Machine (cpap or bipap) can no longer give adequate pressure when an event happens.   Some leaks will happen with any mask but above the line needs to be stopped.  It could be mouth breathing or not, that is the first thing to figure out.  Next would be to adjustment of the mask or finding another mask that keeps a seal on your face.  This is something that all of us work at all the time.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
Cervical Collar     Dealing w DME     Chart Organizing
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