Ocha's Therapy Thread

[Ocha]

Greetings from Finland! New CPAP user here. 

I got Airsense 11 machine and now I'm in the process of buying a suitable oximeter. I have Resmed Airfit N20 mask. 

I recorded my first nights and imported the data into OSCAR. AHI is around 0,4 and no major mask leaks. My doctor set the pressure to 4-16 but I changed into 6-16 and it feels betters as my EPR is 3. My mean pressure is around 9 and max is around 12. 


Couple of newbie questions: 

1) After dealing with a blocked nose I still haven't been able to get a full nights sleep. I usually wake up at least once (normally I don't) and struggle to sleep my usual 8 hours. My max so far is around 6 hours and sometimes I wake up after 3 hours. 

2) I checked my flow limit rate and there is plenty of events. 
   

3) I also think my breathing pattern (flow rate shape) is not normal. Is this something to worry about? 
   

Do you think flow limit events and my breathing shape is the reason I can't sleep enough or should I not worry and it just takes time to get used to the therapy and mask?

[Old Steve]

If you post an OSCAR chart or two either I or someone else may be able to help you.  That being said, if you are going to run your EPR at 3 you really need to set your minimum pressure at 7cm to take full advantage of the EPR. 

Welcome to the forum.

[Deborah K.]

Since your median pressure is around 9, I suggest you make that your starting pressure.

[Ocha]

Hello Old Steve & Deborah! Thank you for the replies!

Finland's healthcare system basically works so that I get the Resmed device + supplies for free If I use the device regurlarly and my nurse and doctor monitor the progress. I've heard rumours they really don't like if the patients fiddle with the settings too much. So at the moment I'm a bit hesitant to make too many changes before I get a green light from my healthcare provider. I have no idea how active they are monitoring the progress and how much adjusting they have time to do per patient but most likely not much and that's why I want to be as proactive as possible to optimize my sleep and health.

I haven't gathered quality data yet because of the problems with my sleep. Last night I got around 6 hours but some reason OSCAR shows only data from 12:00:04 to 12:16:04. I have no idea why. I forgot to lock my SD card the first time I imported data. Is it possible it got corrupted somehow?

I will post more charts soon if the SD crard is not corrupted or anything.

[Ocha]

Here are a few screenshots from yesterday during my late evening nap and sleep from 03:30 to 09:30. 

Do you need more detailed views? Is it possible to upload OSCAR data files for your review or is it common practise to upload screenshots? 

I seem to mostly have RERA and UF1&UF2 events. Also I have no idea how's my breathing wave pattern is looking like. Look's a bit weird, it's not a round shaped wave.


   

   

   

[Old Steve]

Please show the whole night not just an enlarged section.  Screen shots are what is needed but include of all of the screen, including the info from the left side.  Looking at your chart from November 21 it appears that you could use more minimum pressure.  You flow limits are still a bit high and EPR is used to help control them.  As you are already on 3 EPR all you can do is to raise your minimum pressure.  Flow limits are like mini Apneas so you want them as low as possible.  I agree with Deborah since your median pressure is still running at 9cm that your minimum pressure should be at or around 9cm also.   Try that then post some more charts.   Good luck.

[Ocha]

Thanks for the reply Steve!

Here you go, more screenshots one with the details and one with the Daily view. I also added one zoomed in screenshot from the Flow Rate chart just to show the shape of the flow. 

I will increase the pressure to 9 tonight and let's see how the Flow Limit chart looks like after that. 

   

   

   

[Old Steve]

I forgot to mention to remove of the calendar from your chart, that way we can see all your information.

[Ocha]

Right! Done!

Two screenshots from last night. I increased the min pressure to 9. 
The first screenshot is from my nap+ sleep and the other one zoomed into last night's sleep. 

I must say I find the min pressure better when falling a sleep. I get shuteye way faster when I switched off ramp and increased min pressure to 9 even though I find the nasal mask's pressure a bit irritating. But I get good a flow and don't feel like suffocating while waiting for the ramp to kick in.

Still not getting my full 8 hours of sleep. I tend to wake up after 5 or 6 hours and one or two times during my sleep. I have to take a nap after work. But I must say I still feel way better, not groggy and hungover like before cpap therapy and I don't crash like I used to. I might get a little sleepy during eveing after 5 or 6 hours of cpap sleep but it's nothing like before so I'm really motivated to keep going with the therapy. My main concern at the moment is to get full night's sleep and after that optimize what I can. And btw, I'm having really vivid dreams now which is cool.

After increasing min pressure to 9 the AHI went up a little though I guess it's negligible and the flow limitations still persist.

Do you think it's possible to get rid off flow limitations all together and get AHI to zero with fiddling with cpap settings or maybe getting a more suitable mask? 

   

   

[Old Steve]

As to getting flow limits and AHI to zero...anything is possible.  I will get a zero every now and then, but the most important thing is how you feel not so much the numbers.  

I would suggest that you try 10cm minimum to see if will lower the Flow limitations as you are using as much EPR as is possible.   You are also having some apneas that more pressure should help too.  If 10cm isn't enough, you may have to go a little higher.  Your leaks are not terrible, but they are not where I would want them to be.  Small leaks can cause arousals disrupting your sleep.  Post some more OSCAR charts in a few days. Good luck.