OSCAR data interpretation help please!

[princcesskittydog]

I really would love any and all feedback regarding my oscar data!
Thank you so much, please let me know if I can attach any additional information.

More about me:
26 year old female, 5ft4in, 125 lb, AHI from sleep study was 18.
My biggest complaint is debilitating fatigue for as long as I can remember. It has gotten so bad I don't even want to spend time with my family and I want to quit my job. I feel so pathetic. I honestly feel like I cannot take one more day of feeling like this.
Other effects include migraines, no motivation, depression, anxiety, trouble concentrating, extremely low sex drive, dry mouth, constant hunger, muscle aches, and various stomach problems. Overall, I am uncomfortable and constantly feel sickly.
I do have a hypothyroid that is under control with levothyroxine for many years now. My bloodwork, including vitamins like d & b, were all within normal limits.
For depression and anxiety I have tried many meds and different therapies for over 10 years, and nothing has worked. Currently on lexapro & vyvanse. The vyvanse 50 mg can't even keep me awake anymore.
We took my tonsils out last year, that didn't change anything. The ENT did say I have enlarged turbinates, but this was prior to knowing I had sleep apnea, and I didn't have him do anything about it at the time because I had no knowledge about it.
A few months ago I got diagnosed with an autoimmune disease called antiphospholipid syndrome. It is rare so there isn't a lot of information, but the few support groups I have found, people say the hydroxychloroquine (Plaquenil) helps with the associated fatigue. I've been on Plaquenil for about 5 months, but no changes with that either.
I also tested negative for Lyme & celiac diseases. So at this point, I am really convinced it is the sleep apnea that is causing all of my symptoms (or at least hoping because it is my last chance!)

I have only been on the CPAP for 5 nights now, my AHI has been consistently below 4, and I am not uncomfortable using it at all, which is great.
The only thing I am having trouble with nasal congestion with the nasal pillows and have been trying nasal sprays, increase humidity in the tube, allergy meds, etc.

Machine: Philips respironics dreamstation
Mask Type: Nasal pillows
Mask Make & Model: Philips Dreamwear nasal pillow
Humidifier: Philips respironics dreamstation
CPAP Pressure: 4-20
CPAP Software: OSCAR DreamMapper
Ramp: off

Screen Shot 2021-01-23 at 8.13.40 PM.png (501.47 KiB) Viewed 887 times

[Rob K]

Most people are not able to log in right now due to website problems so you may not get a lot of responses. I was able to log in for the first time in a week. I've been on xpap for nearly 8 years. Far from an expert but can offer a little advise until more knowledgeable folks show up.

Welcome to the forum and sorry to hear that you have so much going on in your life. There are many people here that have multiple health problems so it will be a good support forum for you. From my experience and reading others experience, there are many physical and emotional problems that arise from sleep deprivation. Your lucky to have figured out that you have apnea so you can get started on feeling better. Getting your apnea taken care of will hopefully help with sleep and a number of things. Some people when they start on xpap therapy take to it right away and it makes a big difference, others it might take months. Myself it's been years and I still don't have things dialed in like I would prefer. The more time you spend on this forum and the more you read about all aspects for sleep apnea the quicker you will get your therapy dialed in. We all have commonalities, but ultimately every person has a specific therapy recipe that works for them.

The first thing you can do is fill out your profile on this forum. People will need to know what machine and mask you are using among other things. I see you did put that info in your first post. Good job on getting you screenshot posted right away. Apparently that has become much easier for people than when I started out on the forum.

One thing I noticed right away from looking at your charts is the mask leak rate, it could be better. I'm an extremely active sleeper and my leak rate is below 10 most of the time. It never goes above 20. It's possible your mask may need some adjustments to keep leaks to a minimum. Also this is your first mask and it likely will not be your last. A lot of people end up trying many different masks before they find "the right one". Some of us never find the right one.lol We are always searching for that perfect mask. Full face mask is the hardest to get to stop leaking due to the large surface area, in the middle is the nasal cushion masks that go over your nose and the masks with the least amount of leaking are the nasal pillows due to having the smallest surface area that can cause leaks.

Start with these things and go from there. I don't want to overwhelm you with information right now. When I first came here my head was spinning with information for months. I know it didn't help my sleep at all.

Take care and good luck ahead.

Edit: I need to study that leak rate again. I just realized it is not what I'm used to seeing. It shows a double graph so I'm confused. After studying it a bit leak rate has room for improvement but doesn't look to bad. That graph threw me off for a bit.

[Pugsy]

One thing I noticed right away from looking at your charts is the mask leak rate, it could be better. I'm an extremely active sleeper and my leak rate is below 10 most of the time. It never goes above 20.

Your machine reports leaks differently than the OP's machine...so you can't compare the leak graph from a Respironics machine to your ResMed machine.
ResMed machines report excess only leak....Respironics machines report total leak which is the mask's expected vent rate plus any excess leak.
There's nothing wrong at all with the OP's leak rate graph...it goes up a bit as the pressure goes up which is normal and to be expected because the vent rate goes up as the pressure goes up.
The leak is well below large leak territory anyway. The bottom leak line would closely be what you would see with your machine. It's not 100% accurate but it is close.

The first thing you can do is fill out your profile on this forum. People will need to know what machine and mask you are using among other things.

While it is nice to fill it out and make it easy for us to see....that link is broken right now. No one's equipment profile is showing up right now...not yours or mine or anyone's.

[Rob K]

Yay Pugsy you made it, your logged in. At first the leak rate graph threw me off, I thought wow it's almost up to 40. After my eyes stopped deceiving me I realized that the leak rate is reported differently and that it is decent. I was editing my post as you were clearing things up, thank you.

[klm49]

I really would love any and all feedback regarding my oscar data!
Thank you so much, please let me know if I can attach any additional information.

More about me:
26 year old female, 5ft4in, 125 lb, AHI from sleep study was 18.
My biggest complaint is debilitating fatigue for as long as I can remember. It has gotten so bad I don't even want to spend time with my family and I want to quit my job. I feel so pathetic. I honestly feel like I cannot take one more day of feeling like this.
Other effects include migraines, no motivation, depression, anxiety, trouble concentrating, extremely low sex drive, dry mouth, constant hunger, muscle aches, and various stomach problems. Overall, I am uncomfortable and constantly feel sickly.
I do have a hypothyroid that is under control with levothyroxine for many years now. My bloodwork, including vitamins like d & b, were all within normal limits.
For depression and anxiety I have tried many meds and different therapies for over 10 years, and nothing has worked. Currently on lexapro & vyvanse. The vyvanse 50 mg can't even keep me awake anymore.
We took my tonsils out last year, that didn't change anything. The ENT did say I have enlarged turbinates, but this was prior to knowing I had sleep apnea, and I didn't have him do anything about it at the time because I had no knowledge about it.
A few months ago I got diagnosed with an autoimmune disease called antiphospholipid syndrome. It is rare so there isn't a lot of information, but the few support groups I have found, people say the hydroxychloroquine (Plaquenil) helps with the associated fatigue. I've been on Plaquenil for about 5 months, but no changes with that either.
I also tested negative for Lyme & celiac diseases. So at this point, I am really convinced it is the sleep apnea that is causing all of my symptoms (or at least hoping because it is my last chance!)

I have only been on the CPAP for 5 nights now, my AHI has been consistently below 4, and I am not uncomfortable using it at all, which is great.
The only thing I am having trouble with nasal congestion with the nasal pillows and have been trying nasal sprays, increase humidity in the tube, allergy meds, etc.

Machine: Philips respironics dreamstation
Mask Type: Nasal pillows
Mask Make & Model: Philips Dreamwear nasal pillow
Humidifier: Philips respironics dreamstation
CPAP Pressure: 4-20
CPAP Software: OSCAR DreamMapper
Ramp: off

Screen Shot 2021-01-23 at 8.13.40 PM.png

Welcome PrincessK! I'm glad you are comfortable wearing your mas, to me that was the hardest part to be able to sleep an entire night without the mask waking me up. Your leaks do not look bad to me. If you look in the mask user manual you will find a graph that show what the flow rate (Leak) should be for any given pressure. My copy is on page 12: https://www.philips.com/c-dam/b2bhc/mas ... or-use.pdf
Are you scheduled to go back to your sleep Dr. in the near future? Based on what I have learned on this board I would say that at some point you will need a higher minimum pressure. Given that your results so far a pretty good I wouldn't be in a hurry to make any changes. Getting comfortable using your machine/mask is likely more important for now.
You might try some Flonase for your nasal Congestion. It is fairly cheap in the generic brands.

[Okie bipap]

Looking at what you posted, I would recommend you set your minimum pressure to at least six. Your machine is staying at or above six most of the night. Try that for a few nights and see how you do. If you don't want to change that much at once, make smaller changes over several nights. From my own experience and my wife's therapy, two cm is not much of a jump to make at one time.