First time using Oscar & lost on what data means

[Maxatec]

Hello, been using CPAP therapy for several years but didn't know about OSCAR or sleep data importance until now.  I am not having any real problems with the therapy or using my machine but if I can get better sleep I'm in.  I am a veteran & all the VA sleep Doctors/Techs say is that I am doing well but I think all they look at is usage & AHI, I am wanting to know what all this data means & look for improvements.  I am attaching a screenshot of my OSCAR data.  Any help on interpreting the data would be appreciated,  Thanks

[super7pilot]

First question would be. Why are you on Cpap instead of Apap? Your apneas are well controlled. But those huge leaks look like they have your mask floating over your face like a hovercraft.

So by switching to Apap. You can likely lower your pressure (more comfort and less leakage) and still control your apnea.

[Maxatec]

I had good luck in the beginning on fixed pressure, you are saying to switch to the auto setting?  thanks

[Maxatec]

Doctors put me on CPAP

[ejbpesca]

Your AirSense 10 has two choices of operation, CPAP and APAP.  You are using CPAP with a constant pressure of 13 cm.    Did you have an overnight sleep study?  It will tell a story of why 13 cm was chosen for your machine.  It appears to me that you are getting excellent therapy even with so many large leaks.

Your mask is leaking a lot but still delivering therapy. If I were to set my machine to 13 cm it would leak big time with any of the 6 masks I've tried.  Those grey areas on the top chart are large leaks. All masks leak a small amount, it is the large leaks that can be a problem and show up on graphs.   Sometimes leaks come from the mouth being open when using a nasal mask. If I had so few apneas as your report I would not worry about leaks unless the air blowing out from the mask was bothering me.

You have the option of setting your machine to APAP.  This allows for two pressure settings of minimum and maximum.  Some prefer it some prefer CPAP mode.  You may have no use for APAP.  Keep checking those OSCAR charts.  If you continue to have so few apneas, and feel better from the therapy, then great.

Your chart shows 1 obstructional apnea and one apnea called a central one that has something to do with the nervous system causing it.  I see two hypopneas.  You can read about these in the Wiki section here.  I have NEVER seen such a good report from my OSCAR charts. 

What I do with OSCAR is look over my counts, pressures, and flow limitations then make adjustments to pressures trying to get a lower AHI.  It looks like the doctor dialed in your machine at 13 because that is the pressure therapy happens.  I never had my pressures set properly, nor have access to anyone who could do it so I came here for information on settings.  The information offered here helps me a bunch but I will never get as good results as the graph you posted.

Congratulations on getting therapy.  Are you feeling better from the CPAP therapy?  More energy?  Not as sleepy feeling during the day?

[ejbpesca]

Your flow limitations graph with the spikes shows periods when air was not flowing as well as others.  Your airflow limitations were sporadic on the graph.  Mine are a steady spikes all during sleep.  I have obstructions in my nose that cause them and when I snore FL goes up.  Look on the left side of the OSCAR report for a number representing FL.  My goal is to get mine down to or below. .10.

[Maxatec]

Thank you for the imput- I adjusted my machine from CPAP to Autoset, 13/6 last night(3-1/25) & 6 was too low so readjusted to 13/9. I think 9 is still a little low but I have attached last nights data. I have to learn how to read this data.

[ejbpesca]

Doctors put me on CPAP

For some CPAP is better as opposed to APAP.  I am continually adjusting my APAP (two pressures Min. and Max. trying to find the best two pressures even after 18 years of using PAP therapy.   I started with CPAP 8 cm pressure which is way too low now.  I'm up to 11 cm and 12 or 13 would be better but I use a full face mask due to mouth breathing so I cannot use a nasal mask as you do. I may be going CPAP soon.  I have no help from an MD, DME, or technician so the help I get here has been GREAT!

[Maxatec]

I started will full face & worked myself in to a nasal.  I can't use a chin strap, too confining for me, wake up with panic attacks-lol.  I have VA benefits, they are helpful/friendly but really only monitor use/AHI so discovered all this information available but never heard of from the VA Sleep Center.  Trying to dial in the mask leaks which has been a problem from the beginning, in the beginning-they tried me in a DreamWeaver(I think that was the name of it) mask at my original pressure of 20 but it just blew by the mask.  I found Jason, lankylefty, on Utube & his videos helped a lot to understand that some masks don't work at higher pressures so found a F20 & then Airtouch F20.  Still leaked but not too bad & therapy was working.  Worked my way to not breathing through my mouth & lost some weight than was able to get down to a 13 but I want a minimal mask so luckily I found this board & OSCAR software.  Just got to learn to read the OSCAR data & not over think it.

[ejbpesca]

I had good luck in the beginning on fixed pressure, you are saying to switch to the auto setting?  thanks

You have the option to set your machine to APAP but some find CPAP to be better. Check those OSCAR reports and find what works best for you to 1. get that great therapy as shown on the chart you posted. 2. use the mode (CPAP or APAP) that is best to get good sleep and deliver proper therapy  

For me, 13 cm as you have causes my full face mask to large leak so badly air blows to my face and eyes waking me.  I got an F40 (hybrid nasal/full face) a few months ago and it has leaked less than any so I'm slowly raising my min. pressure where it should be which is making the AHI scores lower.

You did not post the whole OSCAR screen but I bet the AHI for the report you posted is extremely low. I was getting AHI 70 (that's no therapy at all) when I roll to my back and mouth breathe.  That was 8 min. 20 max. APAP.  You would think with 20 max the machine would run up and stop the AHI 70 but it didn't.  Raising my min. to 10.4 was the trick and and allowed me to take the max down to 15 cm helping to prevent pressure spikes that also woke me.

These adjustments are narrowing my min and max down to near CPAP mode which may be better for me.

Please feel free to ask questions I or others may be able to answer.  I am not an expert but after 18 years on PAP, and from advice here and other sources I have learned a lot.

I'm interested in seeing how advice here may be given to deal with those flow limitation spikes.  Some claim EPR decreases FL. It does for me so I experiment with its three levels.  Know that EPR reduces pressure on exhale.  EPR can cause problems.  It did for me until I raised my min. pressure.  For some, it makes breathing more comfortable.  I can't tell the difference with it on or off but it does reduce my FLs.

Another setting is ramp.  I don't use it.  What it does is slowly increase the pressure until it reaches therapy level.  Some like it to help them get to sleep. I don't need it and many say if you don't need it turn it off.  I don't use humidity or hose heat either.  I've tried it but found it to make no difference for me.