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#1
New member
Hello,
Firstly a massive thank you to everyone involved in setting up and running this forum.
I am hoping to attach a copy of my sleep lab report.
From what I understand I was mostly having hypopneas.
I am a 40 year old, female with normal bodyweight. I had my tonsils removed when I was 20yo.

Unfortunately, I was suffering with severe fatigue/daytime sleepiness for many years before I finally had a sleep test.
And so for the last 10 years I have been struggling really badly with depression and ended up being diagnosed with bipolar disorder type 2/treatment resistant depression.

I started on cpap treatment 17 months ago and it made a profound difference to my tiredness and I have been able to go back to work part-time.

I live in a regional area in Australia and unfortunately the sleep specialist I went to in the nearest town is not very helpful. After my sleep study he saw me for about a minute and just said that it looked like I had sleep disordered breathing and that I could try cpap. I have not done any type of titration and he just said to have my machine set on the pressure= 6.
In Australia we purchase cpap machines from a chemist/pharmacist so I bought the one they suggested and tried a few masks and then settled on the nasal mask.

I started getting tired again a few months ago and realised my mask was leaking, I found out that I was supposed to have replaced the mask cushion- so I replaced it and then it seemed to be going ok again.
Then a few weeks ago I started to get really tired again. I was waking up with a really dry mouth and I googled to try to figure out what was going on and I am pretty sure I had started having a mouth leak. (I have never been a mouth breather before so I am not sure why all of a sudden I started doing this?). I have tried to figure out how to use OSCAR and have attached and overview and a closeup of a reading from around that time.
I have just been using some micropore tape to tape my mouth shut for about the last week and I am starting to feel less tired now.
When I found this forum I realised that there is a whole heap more information about sleep apnoea that I could know about so I have been trying to read up. I am wondering if I am having some issues with flow limitations? On the 6mm pressure I do feel sometimes like I need to use some effort to breath in and then to breath out as well?
I will try to attach some close ups of my flow rates.
Thanks again!
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#2
RE: New member
       
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#3
RE: New member
Hi, and welcome.  The short interval you have depicted in the supplied images doesn't show much except possibly the onset of REM sleep at the point where your breathing becomes ragged.  That, in turn, would depend upon when you retired and how long you had been asleep to that demarcation point.  The first REM takes place typically between 85-95 minutes, but that's after undisturbed sleep (no RERAs, no leg movements that might cause partial arousal, no apnea events...). 

The depicted AHI is very low, and I wonder if the depiction of 'no' flow limitations is correct.  Or, is it representative of the entire night?  The numbers in the data at left suggest that there was at least some flow limiting.
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#4
RE: New member
Please setup OSCAR according to this http://www.apneaboard.com/wiki/index.php...ganization

It would be helpful if you uploaded your sleep study results (with personal information blocked out).
Nothing I post is medical advice and should not be taken as such, always consult a medical professional for guidance.
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#5
RE: New member

.pdf   Sleep lab report.pdf (Size: 391.24 KB / Downloads: 9)
My sleep lab report- (sorry I was just trying to figure out how to make the file size smaller)
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#6
RE: New member
Hi, I am really sorry I have spent the last four days trying to figure out how to use OSCAR and how to set it up to take screenshots but I think it will take me a bit to get the hang of it.

The screenshots I put above are from one of the nights I think I was having a lot of mouth breathing/leaking.
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#7
RE: New member
       
These are screenshots from since I started taping my mouth shut.
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#8
RE: New member
(11-28-2019, 03:40 AM)GreenFrog Wrote: Hi, I am really sorry I have spent the last four days trying to figure out how to use OSCAR and how to set it up to take screenshots but I think it will take me a bit to get the hang of it.

The screenshots I put above are from one of the nights I think I was having a lot of mouth breathing/leaking.

Leaking looks to be a possible issue if it’s disturbing you sleep but doesn’t go into large leak territory it will improve over time as you get used to it  a chinstrap, a soft cervical collar, or learning to keep your mouth shut, your leaks aren’t huge and did not affect your therapy other than that your numbers look really good
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#9
RE: New member
(11-28-2019, 03:40 AM)GreenFrog Wrote: Hi, I am really sorry I have spent the last four days trying to figure out how to use OSCAR and how to set it up to take screenshots but I think it will take me a bit to get the hang of it.

Don't worry - you're doing fine. Oscar is a very sophisticated program, so a learning curve is to be expected. You could get more out of your screenshots if a bit more information was included, though. It looks like Oscar is running in a window, not using the full screen. If this is the case, press the F11 key before you make the screen shot - this will maximise the Oscar window and show a lot more information.

Your numbers are excellent and show your machine is successfully treating the hypopnea. While the leaks aren't going over the "red line" (24 L/min) they are pretty persistent, and this might be disrupting your sleep. Leaks can cause air to blow into your eyes or out through your mouth, or can cause the mask to lose traction on your skin and cause "face farts". All of these can cause your sleep to be not as restful as it should be.

You mentioned difficulty breathing, both inhaling and exhaling. I'd like to suggest you raise your pressure to 9. Turn on EPR and set EPR=3. This will give you a higher inhale pressure but reduce the exhale pressure. It should make breathing easier and also push down the flow limitations. The thing to be careful of is that a higher pressure + EPR can sometimes cause central apneas, in which case we would need to adjust the pressure accordingly.

You can get the clinical manual for your machine from this link: https://www.apneaboard.com/adjust-cpap-p...tup-manual Please make sure you follow the instructions exactly to ensure you get the right manual.
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#10
RE: New member
Thank you to everyone.

I will try to work on using OSCAR better.

I will try the changes suggested.

One quick question is about the flow limitation graph- it appears to go from 0 to 1.0 on the scale. Before the last few days I had not even heard about flow limitation. Looking at that graph what kinds of numbers/scale on that graph is significant?
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