Help Improving Oscar Settings

[Mettywap]

Hello! Would anyone mind providing some input on how to improve my setting?

I’ve been using a ResMed AirSense 10 with a full face Evora mask for about 2 weeks, but I'm still experiencing significant sleep fragmentation (has been happening for over a year). I was diagnosed with mild sleep apnea OSA during REM sleep, and I generally sleep on my side.

I typically sleep 2-3 hours before waking up multiple times for the remainder of the night, with vivid dreams. I estimate between 3-5 hours of poor sleep a night. When waking it usually takes around a half hour to an hour to go back to sleep. This has led to extreme daytime fatigue, making it difficult for me to function and keep my eyes open. Despite my exhaustion, I try to walk 10,000 steps daily on a treadmill, but it doesn’t seem to improve my sleep. I follow a whole foods diet, I’m in good shape, and I don’t drink alcohol or smoke.

Previously, I tried a nasal mask with tape, but that resulted in massive leaks. In terms of medication, I take Mirtazapine, melatonin, and usually 3mg of Benadryl. Despite these efforts, I'm still struggling with exhaustion. Any input would be greatly appreciated! (I realize I did have a little bit of leaking this night).

[Pugsy]

Do those leaks wake you up????

Please review this thread for graph formatting pointers and save some attachment storage space by removing the unneeded images containing graphs that aren't helpful.

http://www.cpaptalk.com/viewtopic/t1585 ... eview.html

[Mettywap]

I generally wake up anywhere from 5-9 times per night, which has been a pattern for me over the last year (before cpap). Even on days my leak rate is under 1% I still awake multiple times and am never fully rested.

And thanks for the link! I deleted the last panel with less relevant information.

[robysue1]

I generally wake up anywhere from 5-9 times per night, which has been a pattern for me over the last year (before cpap).

How is your sleep hygiene? Often times when there is an insomnia problem that predates using CPAP, the sleep hygiene is not particularly good and bad sleep hygiene can lead to continued wakes during the night even once the OSA is taken care of by the CPAP therapy.

Even on days my leak rate is under 1% I still awake multiple times and am never fully rested.

Can you clarify what you mean?

Leak rates are reported in Liters per minute (L/min), not as a percentage. And Resmed defines a large leak as any leak that is over 24 L/min.

Oscar lists the percentage of the night in Large Leak territory. The Resmed machine's on-board "leak icon" in the Sleep Report shows up as a green smiley face as long as you spend less than 25% of the night in Large Leak territory. The MyAir website gives a Mask Seal "number" on the splash page that is between 0 (awful) and 20 (good), but I've never been able to find any documentation for how that number is computed. If you click on the "Mask Seal" link for more data, you see a bar graph with the 95% leak rate numbers posted. (If your 95% leak rate is 8.0 L/min, that means that your leak rate was LESS THAN or equal to 8.0 L/min for 95% of the whole night.)

The data you posted indicates you have a lot of low-level leaks (leaks with rates between 5 L/min and 20 L/min) all night long. So it's reasonable to ask: Are the pesky low-level leaks waking you up at night? If they are, then you need to work on leaks even if the percentage of time you spend in Large Leak territory is minimal.

[Mettywap]

Thank you for your reply!

I diligently follow best sleep hygiene practices. Having the same bedtime everyday, no screens before bed, no coffee alcohol ever, 10k steps daily.

I don't believe the leaks are keeping me up but I have found a mask that has minimized leaks. Do you have any suggestion on possible settings that could improve my sleep results? As the CA's are more than the OA's I've read possibly using a fixed setting or narrowing the pressure so it's less of a difference?



Here are last nights results