[Treatment] Not so newbie OSCAR help request

[pholynyk]

After looking at your data, I am confident that the charts are accurate, and I will have the Settings corrected for the next release of OSCAR.

Thanks for helping improve OSCAR

[Ratchick]

Hopefully the medium pillows did the trick!

[SDCat]

Last night I used the larger (M) pillows with the P10. I felt like there was less leaking, but OSCAR says differently. I woke at 03, and intentionally shifted to my back, and adjusted my pillow to avoid chin tuck, but maybe not as effectively as I thought - most events after 03. Actually caught myself opening my mouth.

Unfortunately, my daytime mask testing messed up the OSCAR graphs. I am still learning to navigate the graphs, and haven't found a way to 'adjust' the X-axis, or address the skew of the flow rate Y axis. I attempted a few zooms around pertinent events. Any insights greatly appreciated. 

Plan to order new mask today, perhaps try the chin strap again 

           

[Ratchick]

Firstly - you can switch off any session that you don't want to include in the data and charts - at the bottom of the Daily tab on the Main details page, there is a toolbar at the bottom that shows you each session in a day - you can turn them on and off by clicking (or by scrolling to the bottom on the left column and unticking any box you don't want to see).

Second - I personally like to show the zero line on my flow graph which is up to you, but if you want to do that, right-click over the y-axis words on the flow chart and go to dotted lines. You can also use this right-click menu to change the axis figures by specifying the exact range you want, and of course, you can drag the bottom of the chart itself to make it larger or smaller.

If you only want to see part of the day's chart, you can left-click and hold, drag over the part you want to concentrate on, and then let go, to just zoom in on that.

Re: the leaks - did they wake you more or less? From what I can see, your overall leak rates seem less, though you still had that bad leak at around 3. Was that where you woke up with your mouth open?

You're still getting pretty horrible flow limits, that's what's maxing out the pressure... if you already have EPR at 3, then you might have to push the lower pressure up a little, but I do think you're right that some of that might be positional, and for that maybe you need a collar if the pillow alone isn't working.

Where you have that big leak, can you just zoom in on a 2 or 3 minute part of the flow? It should show on that if the leak is from your nose or mouth.

[SDCat]

Thanks so much for the OSCAR tips! I'll attached new and improved graphs. 

As for last night, I decided to improvise mouth taping, just a strip diagonally across - lousy therapeutically, but perfect to call attention to air escaping. I was basically blowing raspberries all night. So, um, yeah, it's mouth leaks. Good news is my new mask is on the way. It was a good night, otherwise, flow limit .25 vs. .59, better AHI. I feel like I'm making progress! 

Another mask issue- I have the "new" P10 strap that others have complained about: it has a 'slider' adjustment, which doesn't grip quite as tightly as I would like. Some mornings I find it has loosened half an inch or more. Even the non-adjustable one could slide around on my hair too much, causing a leak. Last night, however, no slipping.

Attached are new shots of 1/3 - night before last

       


And last night...getting there!
   

[staceyburke]

I still see min 4 

Again I believe you should be at

Min 7
EPR full time 3

[SDCat]

@staceyburke - the left side settings are incorrect, apparently an OSCAR issue with reading the 'For her' algorithm per @pholynyk

My actual settings are AUTOSET FOR HER, MIN 7, MAX 10, EPR FULL TIME 3. In the older graphs, you will see the 5 min. ramp; I turned that off a couple days ago

[staceyburke]

I would go to min 8. You still have flow limits raising your pressures. 

Your charts show mouth breathing. It is something I also have trouble with and I had to go to a full face mask (ResMed f30). It has helped but it is hard for me to go the entire night with it on. It is a struggle stopping the leaks but important.

[SDCat]

Thanks for your reply. I have a new mask on the way - a F30i as I sometimes get tangled in my hose.  

I'll increase min. to 8 tonight.

[Ratchick]

If you decide to try a soft cervical collar at some point, that might help a little with the mouth leaks too - that's primarily why I use it now, even with an FFM when I don't have positional apnea, because it stops my jaw-dropping, reduces mouth leaks and chipmunk cheeks and basically removes all of my dry mouth in the morning. That said, if you can manage with just taping until your F30i comes, that will probably help too.