Help Please, with Oscar Data

[MikeE3]

Like many lately I just switched from a Dreamstation to a Resmed Airsense 10. The info available from MyAir is limited compared to Dreammapper. So it was off to Oscar to see my stats on the new CPAP.

I compared my AHI for the last month and last week using the Dreamstation to the 1st 13 days using the Airsense 10. As of now, it looks like my AHI, Hyponmea Count and OA Count have all reduced. 

   

But I'm trying to learn about and understand the other OSAR graphs and what it means with respect to making any changes to further help my therapy. I've been using a CPAP for 3 1/2 years and honestly I've not felt it has helped my sleep significantly other than my wife sleeps better because I don't snore any longer. 

Even though MyAir always has a Smilie Face for my Leaks, when I look at OSCAR I see Leaks every night. And ever night the LEAK graph is completely different, not the least bit of similarity from one graph to the next. So it would be nice to understand this area better.

Also I'm concerned I may be starting to 'mouth breath'. I've never done that in the past. Is there anything in OSCAR that might indicate mouth breathing. I use a Phillips Nasal Cushion for my mask and I'm a side sleeper. I can't detect any leaks when I put it on, but obviously have no idea what's going one while I'm asleep. 

I'll attach OSCAR Daily Stats in this post. And in the next post I'll post them for a different day. 

Andy feedback and comments are really appreciated. Last spring my Sleep Doc spent 10 minutes with me and my SD card and said everything looks OK, see you in a year.

[MikeE3]

And here's another day's Daily Stats. I should mention I'm on SSRI's and Benzodiazepine for lingering PTSD issues. I can't count that for not also having a detrimental effect on my sleep. But I'd sure like to feel confident that the CPAP is doing as good as it could be for me. I haven't slept well in years. Always wake up feeling like I didn't sleep.

[Geer1]

I would try increasing EPR to 3 and min pressure to 9. This should help with the flow limitations and may reduce some of the leaks by making it easier to exhale (so less mouth leaks from trying to breath out mouth). The pressure increase is because increasing EPR decreases exhalation pressure so increasing both keeps this the same.

[Melman]

Your data looks very good with respect to events. I suggest an increase in EPR to 3 to reduce your flow limitations which may also reduce the pressure fluctuations that may be disrupting your sleep. An increase in minimum pressure may be helpful but I would wait to see the effect of the change in EPR. Please update your profile to show your current machine.

[Gideon]

First your leaks are not that bad.  The large leaks, the greyed area, occurred just before you woke.  The short version is Peaks tend to indicate mask leaks and tables or plateaus mouth breathing.

here is some additional reading  http://www.apneaboard.com/wiki/index.php...#Leak_Rate

The other indication of mouth breathing is on a zoomed view of the flow rate.  Make sure to add the zero line, everything above the line is inhale, below exhale.  Visually check the volume under the curves,  When the volume of the exhale is less than the inhale that is an indication of mouth breathing.  Everything that goes in (inhale) has to come out and it will come out.  If it doesn't go back thru the mask and hose it had to go somewhere else, thus the deduction of mouth breathing.  Sorry, I don't have a good view of that yet.

Read the "Mouth Breathing" of the Mask Primer for some additional explanation.

[MikeE3]

Thanks everyone. I'll try one thing at a time. Tonight I'll up the EPR to 3 and watch that for a few days.

Tomorrow, I'll catch up on the suggested reading.

Meanwhile Gideon, here's a zoomed set of data with the 'center line' added to the graph.

[MikeE3]

 Please update your profile to show your current machine.

Done 

[Gideon]

I think I see some mouth breathing, what I see is expiratory mouthbreathing which has little to no impact on therapy.

[staceyburke]

Your leaks are not a real problem. It is a goal not to have any leaks but that is all but impossible. Your leaks were large leeks 2 times and not long. 

Your treatment is good but for your flow limits. Flow limits are apnea only smaller obstructive and shorter in duration. But they do stop you from getting a deep sleep and can cause you to wake up. 

To lessen flow limits we use EPR. you are set at 2. Try 3 and see if that cuts them down. If not try inching up the min with EPR of 3. And see how that effects your FL. 

OVER ALL you are doing well!

[MikeE3]

Another thank you for the help and comments.

I only changed EPR to 3 last night, only wanting to make 1 change at a time. Next would be min pressure. It's encouraging that you folks are saying I'm doing pretty good overall. When I look at the charts, because of lack of understanding, I get nervous that they are indicating problems.

Anyway, hopefully just a coincidence but last night I had my highest AHI (1.32) in the two week on the new machine. Only one other night was I over '1' and that was an AHI of 1.13. I continue for the next couple-few days with just the EPR change then raise my min to 9.0