OSCAR graphs

[tonyt]

Read the Mask Primer (see my signature) there are several articles there on masks and leaks.
...
If you think you can keep your big mouth shut...

I have, several times. Excellent resource.

  (none taken!)

Thanks!

[tonyt]

Last night I used "chin-up" tape which covers the corners of my mouth and the area below my bottom lip. I felt like this reduced a lot of the leakage. Graph attached.

[staceyburke]

Leaks are still high. Keep working on them. I would move up both pressures to 8 and 14.

[tonyt]

Leaks are still high. Keep working on them. I would move up both pressures to 8 and 14.

Will do, thanks.

Upper limit to 14 because the pressure graph is peaking flat sometimes? For my own curiosity, why raise lower limit to 8?

[staceyburke]

A difference between high and low seems to bring on some centrals. Centrals can just be holding your breath when turning over. Anytime you stop or pause breathing without an abstraction can be recorded as a central. Just trying to eliminate as many as possible.

[SarcasticDave94]

The large leak rate has dropped a lot, even if the leak rate is still a bit high. Overall it's a lot better than prior. I see some clustering of events, so if you do not have one, a soft cervical collar may need to be discussed/considered as prevention for the positional apnea that it seems you have.

I do agree that both low and high pressures should bump at some point. It should address some of the events and maybe calm down the activity on the FL chart. All of these should reduce events and make for a more comfortable restful sleep. And I think CA was mentioned by staceyburke; do keep an eye on these as they're consistently inconsistent and like to sneak up on you when you're not looking. If they do go up, look for a trend of 2 days of elevated stats. One day and I'd not adjust for CA, 2 or more days then yes I'd plan on an adjustment for that which is trying to diminish pressure swings.

[Gideon]

The leaks are much better managed, well done.

You have Flow Limitations that are out of control and will drive your pressure to the max value set.  Also, RERAs which are a series of flow limitations ending in arousal.
For this, we need to apply EPR so make the following changes.

Set min pressure = 7 to take full advantage of the EPR
Set EPR = 3, full time.

This is your best option to treat your flow limitations and RERAs.  We will watch your Central apneas and make adjustments based on the results.

[staceyburke]

You just got recommendations from one of the most knowledgeable people on the site. Take his advice. We are so fortunate to have him and others that have had so much experience.

[tonyt]

The leaks are much better managed, well done.

You have Flow Limitations that are out of control and will drive your pressure to the max value set.  Also, RERAs which are a series of flow limitations ending in arousal.
For this, we need to apply EPR so make the following changes.

Set min pressure = 7 to take full advantage of the EPR
Set EPR = 3, full time.

This is your best option to treat your flow limitations and RERAs.  We will watch your Central apneas and make adjustments based on the results.

Thanks Bonjour. I made your recommended changes last night. Graph attached. Note that after waking at 02:43, I didn't put my mask back on until about 10 minutes later and at this point I decided to try side sleeping. Previous nights have been almost all back sleeping. I think at some point I ended up on my back again, at least that's how I woke up. Physically, I prefer back sleeping because side sleeping has me getting up with a very tight, painful back. Back sleeping = little if no back pain upon waking. Interesting to note that on my side the flow limitations are lessened and leakage was less too. That makes me think I'd be better off on my side and trying to figure out the morning backache. Thoughts?

[Gideon]

That is what doctors call positional apnea. From an Apnea point of view side sleeping is known to produce fewer obstructive events.

Thinks about a 2-stage alarm, Alarm 1 sounds, you grab that alarm clock and throw it across the room, roll onto your back.
Alarm 2 goes 30 minutes latter and you get up. This 30 min period is to reset your back, not necessarily to sleep.

Ok, I don't recommend throwing the alarmclock across the room.

Your flow limits are out of control on your back,
Let's try a soft cervical collar, let's see if your cervical alignment is causing this. Usually when we see this the events are a little closer together. The difference between your side and back may simply be this. What is your pillow arrangement when on your back? We can try setting your min pressure to 9 and see if that helps but 1 major change at a time. I'm more confident in the collar than a pressure increase.