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[Pressure] Data Interpretation
#1
Surprised 
Data Interpretation
Hi All - I am new here and recently started using Oscar because I felt something was not right with my machine/therapy. 

I have been using a ResMed AirSense 10 for almost 2 years now - but machine was swopped about a year ago. Since last summer I noticed my therapy wasn't effective anymore till the point the last week I woke up as I was suffucating because I felt it was blowing too much air - maybe because of leak?

Anyway since then and ahead of my treatment review next week I decided to download the data and understand what's going on. Unfortunately I don't have any data when I was using the other machine and felt that was ok.

By looking at the data for the last year there seems to be an alarming pattern of alarming high breath rate which I wasn't aware at all - by looking at it it almost seems am constantly hyperventilanting in my sleep. However there are only few episode of Hypoapnea and generally my AHI score is always below 1 and rarely above that .

See below an example screenshot from few days ago -

In the chart below seems that my breath rate lowered when the pressure increased - but that didn't happen in response to any apnea event.  

Also it seems that my breath rate was lower when I was using full EPR on Level2 - not always because there moment when seems still high but on average breat rate seems worse with EPR switched off (see chart as well). 

How do I interpret these data? Can someone help to understand what's going on and why my breath rate is so high? Is it the CPAP therapy damaging me or is the machine not functioning properly?


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#2
RE: Data Interpretation
The algorithm will increase pressure in response to snores and flow limitations also, are you able to show those?
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#3
RE: Data Interpretation
here attached an overview - I don't snore a lot tbh


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#4
RE: Data Interpretation
As far as your breathing goes the area that you circled was about the same as at least 4 other areas in the same graph and the next night was lower than most of the first set of charts. So I’m not sure it is anything.

I will mention your EPR (exhale pressure relief) is doing nothing with the min pressure you have.

The absolute min pressure any pap machine goes is 4. EPR is subtracted from the min pressure to give a lower exhale pressure. Your min was 4.8 so the most your EPR can subtract is .8.

You need a min of 7 EPR 3 would give an exhale pressure of 4.
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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#5
RE: Data Interpretation
First question is why does your data show near constant leaks? Leaks of that level and regularity should be easy to pinpoint, you need to find them and fix them.

Potential causes
- leaking mask (should be super annoying with air blowing across your face constantly)
- excessive venting of mask (f20s don't vent much so shouldn't be the case unless you modified it)
- air leaking out mouth (possible but your leak doesn't stop enough for me to think it is the case, usually mouth leaks cause you to wake up and shut mouth which stops the leak)
- leaking hose (check for leaks while running, should be able to hear or feel if air is leaking)
- leaking humidifier (check for leaks while running, should be able to hear or feel if air is leaking)
- leaking seal to humidifier or from elbow that connects humidifier to hose (check for leaks while running, should be able to hear or feel if air is leaking).
- if you can't find/fix the source of leak then there must be something wrong with the machine.

Those respiration rates are not correct and they are caused by the machine being confused because your flow rate is fluctuating from positive to negative multiple times per breath. If you post zoomed in examples 3-4 min duration you will be able to see that. .
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#6
RE: Data Interpretation
Back in your original post you mentioned leaks, so I guess you suspected something like that from the start, no? So I wonder -- could your problem be that something is waking you up, or keeping you awake? The AHI figure doesn't look alarming, but I wonder if air blowing across your face, or the noise of a blower working too hard, interrupts your sleep? If you changed the machine, but kept the same mask, perhaps that suggests that the problem is in the machine, rather than the mask fit? Or did you change the mask/hose as well?

I agree with Geer1 that the high respiratory rate is probably an artefact. But you can zoom in on the flow waveform and check just by counting breaths.

BW, DS
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#7
Sad 
RE: Data Interpretation
The hose stayed the same as well as the mask - only machine changed. I have a beard (nothing too crazy just normal I would say) but I keep the fit quite tight. the humidifier seems fine - I only recently cleaned the the rubber connector elbow from the machine to humidifer but it s correctly placed and locked. 

I tried an EPR 3 last night and seen some minor improvements. I also suspect I have GERD - not too sure but have few symtpoms like breathlness at times - seeing a respiraratory physician. The feeling was that since machine has changed I start having all sort of weird  issues I didn't have before but I don't have data from old machine unfortunately. Below a chart with EPR 3 last nite and a 5 min zoom where resp rate increased.

Looking at the overall chart I see there some flow limitation when there a Pressure peak that is recorded in the higher resp rate. As you can see in these charte the leak rate is almost zero. So must be something else?

(02-02-2022, 02:40 AM)desaturator Wrote: Back in your original post you mentioned leaks, so I guess you suspected something like that from the start, no? So I wonder -- could your problem be that something is waking you up, or keeping you awake? The AHI figure doesn't look alarming, but I wonder if air blowing across your face, or the noise of a blower working too hard, interrupts your sleep? If you changed the machine, but kept the same mask, perhaps that suggests that the problem is in the machine, rather than the mask fit? Or did you change the mask/hose as well?

I agree with Geer1 that the high respiratory rate is probably an artefact. But you can zoom in on the flow waveform and check just by counting breaths.

BW, DS

How do I count breaths and check in an artefact - how much shall I zoom in?


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#8
RE: Data Interpretation
here is 4 min resp rate chart extracted from last set I posted - how do I count breath per min here?


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#9
RE: Data Interpretation
(02-02-2022, 05:03 AM)Kafka82 Wrote: how do I count breath per min here?

Well, very roughly, between 5:21 and 5:22 I count 18 breaths. So that's 18 breaths per minute Smile

Roughly the same rate seems to be in effect for the rest of the recording. There's a lot a low-level flow disturbances around the baseline, which I suspect is what the machine is counting as extra breaths. My gut feeling is that when your respiratory rate is reported as being in the same ballpark as your heart rate, what you're seeing is the effect of heartbeat on the airways. However, there are other possible explanations that have been debated on this forum.

GERD can certainly cause airway irritation, particularly in people who are prone to this. Fortunately, it's usually relatively easy to treat, if GERD is the explanation. To be honest, although I'm not any kind of expert, nothing in the OSCAR data looks odd apart from the leaks. I would advise not over-interpreting the respiratory rate, since it's clearly an artefact.

BW, DS
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#10
RE: Data Interpretation
As Stacey made mention to gain full benefit of EPR 3 your Min pressure must be at least 7. You're currently at 5. It would also be helpful to present us a standard OSCAR screenshot. If you're using a Windows based PC while viewing that daily detail data press F12. This should show Events, Flow Rate, Pressure, Leaks, Flow Limits, etc. Those 5 charts are the most helpful. As is your AHI isn't bad though.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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