(OSCAR Help) Is leak rate my biggest issue?

[knifebunny]

Hi,

I have been using CPAP for about two years and for a large part of it I worked night shift so my sleeping habits were always changing.  Since working a standard 9-5 for the last 6 months, my sleep has improved but im still struggling.

I've been looking at my data and I see there is an amount of mask leaks that are going on here, but these don't always line up with events

I can sometimes feel like I have uninterrupted sleep, but constantly I wake up low energy and exhausted, and feel like an afternoon nap almost every day.


Does anyone mind looking over this data with some insight on what I can look to improve?

[SarcasticDave94]

With the ResMed, the leaks reported are going to be unintentional or large leaks. If I recall correctly, the jaggedness shape indicates mouth breathing. Your leaks are intermittent so mainly these will add to sleep disturbance. However during that leak period, your therapy pressure is missing as its blown out. Possibly they occur when you shift body position in your sleep.

Something you didn't ask but I'll give, your pressures are default at 4-20. Maybe you'll want to get a better setup. And EPR 1 can't do anything at the minimum pressure of 4.

[PeaceLoveAndPizza]

You are doing really well, hopefully you are having some good quality sleep. A few comments…

Your leaks are not an issue, but keep an eye on them. You have a couple of mouth leaks, but if not affecting your therapy or sleep, nothing to worry about.

Second what Dave said about pressure. Suggest you move it from 4-20 to 7-20. Keep EPR AT 1 for now, but consider raising it to 2 or 3 for comfort or to help control flow limitations.

Make these changes and reports back in a few days.

[knifebunny]

Hi team,

Thank you very very much for your inputs.

I have made several adjustments based on the recommendations and I have allowed some time to adjust to see some improvements

The main changes I have made are to adjust the minimum pressure to 7, and I had to change the EPR to 3 for the most comfort under this setting.  Adding to this, I also replaced my headgear as I felt like the fit wasnt as snug as before, and I have started mouth taping with some medical tape, as occasionally I would wake up with dry mouth and I though there may have been air escaping, or snoring happening.  

I noticed some improvements, but I am still feeling really gassed during the day.

One thing I struggle with the most is that I seem to wake up earlier than I would prefer, sometimes only getting 6 and a half or maybe 7 hours, sometimes even less and in those occasions I find it really hard to get to sleep.

Can you look over my data for the last two nights and share any thoughts?

[SarcasticDave94]

Your leaks have improved in both those charts, lower leaks is a good thing. I'm not certain if this will help or not, but you may want to edit your ramp settings. Holding yourself to 4 for 20 minutes will often times hinder things a bit. That's 20 minutes less therapy. You only have the single session so the time isn't terrible. I would either decrease ramp time or bring up the pressure within ramp a bit. Whatever is most comfortable and least disrupting.

I have to correct myself from the earlier post on leaks. The jagged shaped leak areas would be more like mask leaking, while a rounded wide area, somewhat like a rainbow shape, indicates mouth leaks. Regardless as I said they're much improved.

[knifebunny]

Thank you Dave

I will lower my ramp time I think, I sometimes listen to a bit of youtube while I drift off for 5-10 minutes so I think that is what I will set it to

Lastly, is there anything around near the end of my sessions that look like they might cause sleep disturbances?   I generally feel like my therapy is good and that I get good sleep - but I generally do not sleep long enough, and I sometimes feel startled when waking, and then have trouble returning to sleep

[SarcasticDave94]

Myself, I'm not seeing anything within those charts at the session end that shows any issue. Maybe the better chart reader crew spots something.