Trying to learn what OSCAR data means and I need help understanding my flow limits

[emmylouwho]

I have an ResMed AirCurve 10 ASV.  I gave up on therapy and now I am back and trying to understand this disease and use OSCAR.  I've been back on therapy for a month now and with the exception of a couple of nights, the most I could use the machine was around 4 hours.  My full mask would eventually drive me crazy itching around my mouth and nose.  I was told I couldn't use anything but a full face mask when I had my study 3 years ago.  I've spent all this time being jealous of nasal pillow users.  I posted last week asking if I could use nasal pillows and I got a resounding yes in reply.  I've had two nights with the ResMed P10.  I've had to take it off due to my nose getting sore but I assume this will get better with time.  It has felt so much better than the full mask.  It feels like I am cheating!

My flow limits look high on these screenshots and I don't really know what it's supposed to be normally or what to glean from the graph?  So I included a shot from last week with my full mask and last night with my nasal pillows.  Also, the full mask shot I had an EPAP of 8.  Last night after reading on the forum that standard for most people is 5, I changed it and gave it a try.  

I can share more if necessary.  I appreciate any and all help in making sense of this while I learn more!  Thank you!

[Sleeprider]

Really fantastic results. We tend to ignore flow limits on ASV because the machine delivered breaths will tend to look flow limited, and we can go into this in more detail if needed. As you can see the flow limits follow the pressure support and this is pretty normal for ASV. The big question is whether your sleep is less disrupted. With the nasal pillows, the mask is so much quieter and doesn't bounce around on your face with pressure support, so I suspect you are on the right path. Your comment says it all, "t has felt so much better than the full mask. It feels like I am cheating!"

[emmylouwho]

Sleeprider, thank you thank you thank you! I feel so relieved. I may have cried a little. I feel like this is doable now.
So is my EPAP just fine set at 5 instead of 8?

[Sleeprider]

I don't see anything in your results that suggest a need for higher EPAP pressure. Normally, if a higher pressure would be indicated, the machine would indicate events like UA or H. We use EPAP to resolve obstruction, and once that is satisfied, the pressure support is used to level your breathing rate and volume. That is happening without any problem, and it's my impression this therapy is both comfortable and effective.

[Sleepless in Dewberry]

An easy way to stop the sore nose is to put silicone tape were the cushion is rubbing on your nostrils.
I use it most nights,  I got the idea from other users on here.

[emmylouwho]

Thanks for the tip. I’m struggling with the P10 after a good first couple of days. I feel like I’m not getting enough air and when I go up to the medium size it feels like the right pillow is closing. I’m wondering it’s just not the right mask or if it needs more time. Since my data looks good, I think I’m not sleeping because of mask issues. I tried mouth taping which stopped my mouth from opening during the night.

[Sleeprider]

The P10 work best when you use the largest size that fits and won’t leak. You might want to try Flonase for a couple days and see if that keeps your nose open. Mask does not need to be tight. Spread the straps.

[emmylouwho]

Ok then I’ll have to just keep the mediums on and not go back to small during the night. I have the headgear pretty much as loose as it’ll go.
I did start using my nasal sprays again since I have pretty bad allergies so that’s covered.
Is it unusual to develop aerophagia when switching to nasal pillows? It’s not intense but it does make me burp some and have slight stomach discomfort.

[emmylouwho]

I figured out the pillows and was able to use the medium all night! I fiddled with the angle and that was the problem not the size. Between proper angle, nasal spray and hose insulator with humidity, my nose has never been so clear in the mornings which was a small victory!
I kept the mask on 9 1/2 hours but got horrible sleep. I’m waking after 3-4 hours and never really going back to sleep well. I was doing the same with a FFM. I think it’s just going to take time for my body to adjust to anything on my face because we think my OSCAR data is fine.

[Lucid]

Having your nose feel clear in the morning is a major step!

Did you ever experience this problem of waking up and not being able to go back to sleep before CPAP?  Is the issue discomfort on your face, the way the air feels in your nose, sounds, not being able to relax because you're wondering if it's working, difficulty getting into a comfortable position with the mask, thinking about the next day, or what?  

I do think it takes time, like months, to get really used to using the machine every night.  But if there's some specific aspect that's bothering you, there might be a way to resolve it.

For example, many people use hose hangers to get the tubing out of their way.