Oscar data

[Driver1814]

Here's some data from Oscar any insight would be great.

pressure 5/15 and night with 5/8

Thanks

[Miss Emerita]

For anyone reading this thread, here's what this follows up on:

viewtopic/t181106/Prescribed-pressure.html

Yes, judging from this chart, the max of 8 looks fine. The extra events on the other night were from central apneas, but I don't think that had anything to do with the higher maximum, since the CAs mostly occurred at lowish pressures.

I notice that you have interruptions toward the beginning of both nights, and I wonder whether you'd do better if you raised your minimum to 7. That would give you the full EPR of 3 right from the start, which might be more comfortable for you.

Next time you post, a couple of housekeeping details. Could you stay in the same thread? Also, could you squeeze these graphs into your screenshot:

Events
Flow rate
Pressure
Leaks
Snores
Flow limitations.

You can grab the gray bars separating the graphs to do the squeezing.

[Driver1814]

Talking to wife may be the stuff at the beginning????

Ya sorry about multiple threads it was a miracle I was able to figure out how to post all the screenshots on this old Mac I resurrected from the bone yard

[Julie]

Unless you talk in your sleep, those interruptions were not what you referred to but something else not going smoothly with your cpap on. There are a lot of little things that could cause an 'arousal' that you're unaware of when asleep.

[Julie]

.

[Dog Slobber]

In your previous thread you attributed lowering your pressure to lowering your AHI. Now that we have some graphs, it looks like that is not the case.

In your top most graph all of the obstructive apneas come in a single cluster right at the beginning (and end of a session) of a small session. I don't think they were real, but because they were interpreted as obstructive, your machine responded by increasing the pressure.

Don't worry about the centrals at this point, there aren't enough to be interested in, we can't do much about them with pressure anyway.

About your pressures, looking at both graphs, and I'd really like to see your Flow Limitations graph. I think you should increase you minimum pressure and set your maximum back up to 15.

On the two graphs a lot of your time is spent at 7 anyway and then a sharp pressure increase, giving your machine a bump in minimum could give it the head start it needs.

And yes, keep this thread as your only therapy thread.

I'd set it to min 7 or 8, max 15 and then see where it goes from there. Increasing your minimum to 7 or 8 won't feel all that much different because with EPR (of 3) your expiratory pressure will still be 4 (or 5).

[Driver1814]

Flow limits on this one. Only thing that gets me is with 15 max pressure, pretty much anything over 8 starts decreasing quality of sleep.

Once again sorry for the double thread should I delete the other thread?

[Dog Slobber]

Flow limits on this one. Only thing that gets me is with 15 max pressure, pretty much anything over 8 starts decreasing quality of sleep.

No it didn't, at least the data doesn't support that the increase in maximum was responsible.

You happened to have a better night's sleep when the pressure was set to a maximum of 8. But, on the night with your higher pressure on 15, the machine never approached 15 anyway.

In fact, if you look at your 8/15 night with the exception of that one burst at midnight (which you appeared to sleep through) the majority of your night was at or about 7. Your machine went to 12.5 because it needed to go to 12.5, had you constrained it, you very well might have been in choke city.

Setting your maximum pressure doesn't tell the machine to to use that pressure, it just gives the machine the ability to get there, should it need to.

On your 5/8 graph you slept better because on that night your machine didn't need to get there.

Flow limits on this one.

Flow limits aren't huge, but constant throughout the night. I think increasing the minimum will tidy them up a bit, and potentially avoid some of the volatile pressure increases.

Once again sorry for the double thread should I delete the other thread?

No problem.

You can't delete your other topic. Maybe respond in it directing everyone to this thread.

[Driver1814]

This is great thanks guys for looking over all this data. I will take your advice and raise minium up to 7 and max to 15 and give that a shot.

Appreciate all the help.

[Pugsy]

Here's the deal about any maximum pressure setting....the machine won't go anywhere near it without a good reason.
Lowering the maximum doesn't change the auto algorithm response either. All it does is restrict the maximum and keep the machine from potentially dealing with airway collapsing issues. It is entirely possible that when your machine went higher that what it was responding to...airway collapsing issues...caused the poor sleep. So it's possible it wasn't the increase in pressure but instead what caused the increase in the first place that caused some wake ups.

Now yes...increases in pressure can cause more leak chances because when we fit the mask at the pressures used at the beginning of the night then it will leak if the pressures go up a lot simply because the seal isn't adequate at the new and higher pressures. If we fit a mask at 6 cm and then the pressure goes to 12...guess what..it will likely leak. You have to fit to the 12 cm at the beginning of the night in anticipation of higher pressures.

[Driver1814]

See anything in the data that would support excessive mouth breathing??

[Pugsy]

See anything in the data that would support excessive mouth breathing??

You didn't include the leak graph but based on the 2 very teeny tiny short lived LL (large leak) flags on the events graph....no evidence of excessive mouth breathing.
I usually have more than you do.

1.4 % of the night in large leak. Max leak was not quite 27 L/min... Large leak territory is 24 L/min...so for about 6 minutes out of a little over 7 hours your excess leak was above 24 L/min and below 27 L/min. I don't even bat an eyelash over that small of a excess leak.

Excessive mouth breathing leaks...a LOT more leak and a lot higher max leak numbers...so 2 or 3 HOURS at a lot higher would be considered excessive.

[Driver1814]

Wanted to make sure, new mask order next week:)

[Driver1814]

leak graph on this one

[Pugsy]

There's a little bit of excess leak happening but it's well within the machine's ability to compensate for it.
We cannot tell by looking at the leak graph itself if it is mouth breathing leak or simply mask movement leak. To the machine a leak is a leak no matter where it comes from.

ResMed has set the 24 L/min excess leak (excess leak is all the machine reports) as the line in the sand for large leak territory but it actually can fairly decently compensate nicely up until we get above 35 L/min. It's on of those situations where the deeper you go into large leak territory the increase in the chance of the machine having a problem. I don't even blink an eye until I see 35 L/min leak and THEN I go look to see how long I was there. I don't even bat an eye at 50 L/min for like 10 minutes. It's not the end of the world to have a few minutes in really big leak.

Now if the leaks wake me up...totally different ball game but it's because they are disturbing my sleep. Anything that disturbs sleep is unwanted...no what what the size of the leak or whatever else it might be.