[Treatment] Help with oscar data

[alimo11]

I've done some searching around here and found some oscar guides but it's been kind of daunting trying to learn everything. I've been using cpap for almost a year now, did some tinkering with the settings early on and many nights I'm under 1 ahi so I've never thought to look more into it... But I still get the occasional nights between a 2-4ish ahi and I'm hoping to get rid of them for good.

Can anyone offer any insight into this data for me? 

My initial thought was just a leak issue but if I'm reading this correctly that doesn't seem to be a huge problem. Can it be something with my pressure settings?

[Deborah K.]

I agree that your leaks are not the problem.  In the charts you show most of your apneas are CAs.  Were there a lot of CAs in your sleep study?  I'm guessing not, since your apneas are under one most nights.  If you lowered your EPR setting your CAs might go down a little, but then your flow limits would go up.  The flow limits are more important to avoid, so I suggest you leave EPR right where it is and ignore the CAs.

I note that your median pressure is a little over 8, so you might benefit from raising your low-pressure setting to 8.2.  It may not make any difference but it can't hurt either.

[Phaleronic]

Welcome to the forum alimo11, Deborah has good advice in her post to follow, I would just add that you don't need your max pressure set that high, please dial it down to 13-14cm.

[alimo11]

Thank you both for the advice! Raised the min and lowered the max as you've each suggested, so far so good.

As for the ca's I'm a bit confused by those showing up, you're correct that they were not an issue in my original sleep study.

[Phaleronic]

You're welcome, I'd give it a few more nights then post another daily chart, maybe two or three to see if the CAs are persistent.

[CPAPfriend]

I would say your leaks are actually pretty bad, and they're coinciding well with your central apneas / periods of increased disordered breathing AND with your increases in pressure. The reason you're still having some elevated AHIs is because of central apneas, so it's not an obstructive issue, but instead likely a pressure / leak issue. I would narrow your pressure range significantly and just avoid some of the higher pressures it reaches for to see if that does the trick. I agree that lowering EPR might help towards the same end, and you'll just have to do a little trial and error to see. There's a chance reducing EPR will sabotage your therapy too, but we can't know until we try. Keep in mind that leaks can cause CAs.