New member - First night using Oscar

[Sleepy_Sam]

New member here, and I wanted to say hello to the community and thank you in advance for being patient with me. I have used a CPAP for about 15 years a Respironics System 60 which has been recalled. I ran a pretty high pressure of 15 using my old machine. Last night was the first time I used a Resmed AirSense 10 with a pressure of 15 and an EPR of 2. My mask has been a Quattro FX full-face mask for over a decade and I used it with my Resmed last night using the correct settings for mask type and tubing. I had a fairly normal night's sleep which for me is generally waking up tired. I would like to lower my pressure now that I can get Oscar data from the AirSense 10 APAP. Arriving at 15 cm with the old system was with me changing the settings over time based on what I felt like. My prescribed pressure was 12cm 15 years ago when I was evaluated in a "real" sleep lab. Any help would be appreciated with interpreting the data.

Thanks,
Sam
https://www.dropbox.com/s/cb55wflvu9kfq ... e.JPG?dl=0
https://imgur.com/2N9XSxD

[jlsmithseven]

Except for the leaks, that actually looks like a very decent night. At least to my eyes without zooming. The RERA someone might be able to help you with. I do know that your prescribed pressure 15 years ago might have changed since then, so you might actually need 15 now.

[Okie bipap]

Over all, it looks good. You had a few large leaks, but if they didn't disturb your sleep, don't worry about them. It looks a lot better than my first night looked.

[Pugsy]

The thing that concerns me about your leaks is that the baseline isn't at 0.0...it's up around 15 L/min. That's not normal.
When is the last time you checked your hose for holes? Only time I have had a high baseline like that I found a hole in my hose.

You should have at least some time where the leak line is down around 0.0 and you never do.
There's a consistent baseline leak somewhere.

[Sleepy_Sam]

The thing that concerns me about your leaks is that the baseline isn't at 0.0...it's up around 15 L/min. That's not normal.
When is the last time you checked your hose for holes? Only time I have had a high baseline like that I found a hole in my hose.

You should have at least some time where the leak line is down around 0.0 and you never do.
There's a consistent baseline leak somewhere.

I haven't checked the hose for leaks, I'll give it a look tonight. Thanks!

[Sleepy_Sam]

Thanks for the replies. I'd like to titrate down if I can because of some gas and boating issues that I have always just kind of "lived with". Any recommendations on a schedule to follow?

[Jlfinkels]

I find it interesting that your leak median appears consistent at ~14, as I have one that is consistent at 7 (but only on one machine). Completely different machine and mask, but the similarity is remarkable. I’ve tested everything (mask, hose, connections, machine) for leaks, but nothing shows any signs of leaking (even a water and air test on the hose). It will be interesting to read what you find…

[zonker]

Thanks for the replies. I'd like to titrate down if I can because of some gas and boating issues that I have always just kind of "lived with". Any recommendations on a schedule to follow?

oh the dreaded aerophagia! how it has plagued me in the past. i know just what you are going through.

you're in luck in that with a resmed machine, you can change your pressure by increments of .2. this is important in that you can dial in to just the right pressure balance so that you are getting decent therapy and yet not have to put up with the gas.

this will take some time but it can be done. first, dial back your minimum pressure. (btw, i'm assuming you know how to change your pressure, right?) you can start wherever you please. as you are at 15 minimum(sorry, that's what it looks like to my elderly eyes!) you can go back to say 10 or 11. then see what your charts says and compare it to how you feel. if all is great, feeling-wise, but not ahi-wise, bump up your min by .2 and see how that goes.

if you get to the point where aerophagia returns, merely back off and lower the min by .2. stay there for a few nights. then push up .2.

as i say it takes some time. if irrc, this took me about six weeks before i found my sweet spot.

good luck!

[ChicagoGranny]

Haven't some reported a baseline leak because the humidifier wasn't seated perfectly?

[Pugsy]

Haven't some reported a baseline leak because the humidifier wasn't seated perfectly?

Yes...but every time I end up not having the water chamber inserted fully that isn't a leak I can ignore...the noise is deafening.
If it's really bad the machine won't even turn on.
That leak line looks more like mine did when I had a hole in the hose and didn't/couldn't find it until I did the water check thing.

[ChicagoGranny]

Any help would be appreciated with interpreting the data.

Your machine is set to 15 min/20 max pressures. During this night, the machine did not raise the pressure above 15 min. This is an indication that you probably can use a lower min. I would drop the min to 13 and check OSCAR the next morning. If you still have a low AHI, I would drop the min one point (1.0 cmH2O) each night until OSCAR doesn't look so good. Then you can bring the min up one point, and hopefully, your pressure settings will be optimized. The max can be left at 20.0 permanently.

Once your settings are optimized, a glance at the machine display each morning to check the night's AHI and leak level may be all you need. You can have a look at OSCAR when the display shows suboptimal results. Otherwise, you don't need OSCAR on a daily basis.

[Sleepy_Sam]

I haven't had access to my ResMed AirSense 10. For about a month I've had to use a Resvent iBreeze 20a machine (it's a long convoluted story) but I did get the ResMed back last night so I was able to take data. I dropped the pressure down to 13 and the machine felt like it was pumping a little.

Regarding the leakage, I used a brand-new humidifier, mask, and tubing last night.
I slept pretty well and feel okay today. Please see the results below.

There is an hour plus Gap in the data because sometimes I take my mask off to get up and go to the restroom but I actually never get out of bed and fall back asleep before getting up.

Thanks for all your help!

https://imgur.com/eXdfSbG

[Miss Emerita]

I'd suggest turning your EPR back on. This might help with the aerophagia, and it would certainly help with the flow limitations that have your pressures bouncing around. You had it at 2, I think, so try 2 again. If that feels good and your numbers stay good, you could try 3.

About the leaks: have you held your hand over various possible points of leakage from your mask?

[Sleepy_Sam]

I returned to my initial settings of 15 and ERP of 2 because I was concerned about getting a good night's sleep for work. I'm not sure where the leak would be. The only air I feel coming out is from the vent on the mask.
I fall asleep on my back and wake up on my side every night.
Tonight I'm going to try to fall asleep on my side and stay there.

Below is last night's data.

https://www.dropbox.com/s/objl0dxvkzgrt ... 4.png?dl=0

[Sleepy_Sam]

Tried something new last night. Still trying to find good settings, I went full Lanky Lefty mode last night.
CPAP only, No EPR although I did use my humidifier (I'm not that crazy)
I tried running at 13 cm of pressure, should I go lower? Any suggestions?

https://www.dropbox.com/s/70dt5bs0vb5wc ... 0.png?dl=0