05-28-2019, 10:27 PM
OSCAR Dreamstation data
Hi,
I've been on Dreamstation BiPap AVAPS since this past December (my first machine). My diagnosis is moderate complex apnea with untreated AHI of 16 (26 at stage R sleep). After titration study my doctor prescribed IPAP 12 and EPAP 8 with a backup rate of 12 breaths per min. At those pressures I still had elevated RDI due to respiratory effort-related arousals and so she put me on AVAPS (backup rate plus tidal volume maintenance).
While I don't have a diagnosis for it, it's assumed I have some neuromuscular disease that weakens my respiratory muscles on both inspiration and expiration (MIP and MEP values below normal). I have a complex medical history in addition to the apnea. I had apnea during infancy and was on heart monitor for it but no one thought to order a sleep study until my early thirties, unfortunately.
I started off with Dreamwear nasal pillow, and in the past month switched to ResMed AirFit n30i nasal mask because it seemed more secure and my sleep neurologist told me I'd been having substantial leaks with the Dreamwear pillow. The plan was to replace my presumably worn nasal cushion and reassess in a couple months, to see whether I really need to switch to FFM. I am a part-time mouth breather for sure but the sleep tech said I did a great job keeping mouth shut during titration (first night with this alien device blowing air up my nose) and I think I keep my mouth shut most of the night at home, too. I bought a chin strap but the fabric is horrible and I'm not convinced I'm mouth breathing so I haven't used it yet.
I installed OSCAR and have been trying to interpret data, which I could use a lot of help with (though the first question is how compatible is the software with my machine?). It appears I still have substantial leaks, and I have the following questions:
1. Given my machine, pressures, and mask type, what is the expected (acceptable) leak rate? My medium leak rate is around 36. There are maxes in the 70s but these may just be when I am repositioning mask. OSCAR says large leak 0% but is this to be trusted? 95% leak rate is always 0 but % of time above leak rate threshold regularly exceeds 100%. What do these mean?
2. Assuming I have a major leak problem, are all of the other data rendered meaningless, or is there something I can use here to help figure out what's going on?
3. Assuming the data were valid, is it completely outside normal limits to have 1-4k timed breaths in one 8-9 hour night? AHI is regularly under 5, but that may be meaningless given large and long enough leaks.
4. Despite my Rx of 12, IPAP never exceeds 7 in either the version of SleepyHead I used or this OSCAR v1.0.1 (for Mac). Is that just because of leaks, or is something glitchy with the software? I can see on my machine the pressures exceed 7 all night long.
5. Why does the leak line sometimes split into two in OSCAR, and what does this mean?
Lastly, for CPAP mode, do I choose BiLevel, APAP, or ASV? Does it matter for my readouts?
Endless thanks to whoever can tackle any of these questions.
KuriApollo
I've been on Dreamstation BiPap AVAPS since this past December (my first machine). My diagnosis is moderate complex apnea with untreated AHI of 16 (26 at stage R sleep). After titration study my doctor prescribed IPAP 12 and EPAP 8 with a backup rate of 12 breaths per min. At those pressures I still had elevated RDI due to respiratory effort-related arousals and so she put me on AVAPS (backup rate plus tidal volume maintenance).
While I don't have a diagnosis for it, it's assumed I have some neuromuscular disease that weakens my respiratory muscles on both inspiration and expiration (MIP and MEP values below normal). I have a complex medical history in addition to the apnea. I had apnea during infancy and was on heart monitor for it but no one thought to order a sleep study until my early thirties, unfortunately.
I started off with Dreamwear nasal pillow, and in the past month switched to ResMed AirFit n30i nasal mask because it seemed more secure and my sleep neurologist told me I'd been having substantial leaks with the Dreamwear pillow. The plan was to replace my presumably worn nasal cushion and reassess in a couple months, to see whether I really need to switch to FFM. I am a part-time mouth breather for sure but the sleep tech said I did a great job keeping mouth shut during titration (first night with this alien device blowing air up my nose) and I think I keep my mouth shut most of the night at home, too. I bought a chin strap but the fabric is horrible and I'm not convinced I'm mouth breathing so I haven't used it yet.
I installed OSCAR and have been trying to interpret data, which I could use a lot of help with (though the first question is how compatible is the software with my machine?). It appears I still have substantial leaks, and I have the following questions:
1. Given my machine, pressures, and mask type, what is the expected (acceptable) leak rate? My medium leak rate is around 36. There are maxes in the 70s but these may just be when I am repositioning mask. OSCAR says large leak 0% but is this to be trusted? 95% leak rate is always 0 but % of time above leak rate threshold regularly exceeds 100%. What do these mean?
2. Assuming I have a major leak problem, are all of the other data rendered meaningless, or is there something I can use here to help figure out what's going on?
3. Assuming the data were valid, is it completely outside normal limits to have 1-4k timed breaths in one 8-9 hour night? AHI is regularly under 5, but that may be meaningless given large and long enough leaks.
4. Despite my Rx of 12, IPAP never exceeds 7 in either the version of SleepyHead I used or this OSCAR v1.0.1 (for Mac). Is that just because of leaks, or is something glitchy with the software? I can see on my machine the pressures exceed 7 all night long.
5. Why does the leak line sometimes split into two in OSCAR, and what does this mean?
Lastly, for CPAP mode, do I choose BiLevel, APAP, or ASV? Does it matter for my readouts?
Endless thanks to whoever can tackle any of these questions.
KuriApollo
