Are these good numbers for a beginner?

[PopIsGettingGrumpy]

Thanks. We'll try one more night at the same temp to see if the colder air still bothers him. So, at this point we switched the EPR from 3 back to 1 (as originally rx'd). And we're leaving the machine at min 7/max 10, same as last night (originally rx'd at 5/9). We'll see how it goes tonight and report back tomorrow. Much appreciated, as always.

[PopIsGettingGrumpy]

My father's chart from last night below. The only change we made was bringing the EPR back to 1, from the 3 we switched it to the night before.

1:30am Gap Note:
I came in to watch him breathe for 10 minutes last night. The mask was just a little louder and I thought he might be mouth breathing ever so slightly, and on sheer luck, I happened to catch him removing the mask in his sleep. (he unstrapped the back, pulled it off and set it on his chest). I quickly asked him why he took it off, and he said he "just woke up taking off the mask but didn't know why". He fumbled trying to put it back on, at which point I reassembled the mask and helped him put it back on. This morning he has absolutely no recollection of the event. So... I guess we know that he will remove the mask in his sleep, but not what prompted him to do it - for what value that's worth in reading his data.

This morning the only comment he made was that he remembers waking once (but not what I listed above), and that the air felt better/warmer (no setting changes, but we discovered before bed last night that his water tank was completely empty, so it could have been empty the night before).

Here is the full data from last night. Let me know if you want me to zoom in on anything:



And a closer view of just prior to the mask removal at 1:30am:

[Pugsy]

No changes tonight.
You may have to tape the mask straps to his cheeks so that when he attempts to remove the mask during his sleep the tape pulling will wake him up enough so he will stop that unwanted behavior.

[PopIsGettingGrumpy]

Will do. He'll be thrilled, but it will be my pleasure to do so.

[Petrodon]

These numbers are looking good with the low Obstructive events and only occasional hypopneas. It gets easier. And then after a while it becomes habitual, and then (like many of us) you find you can't sleep without it.

[PopIsGettingGrumpy]

Here is the data from last night. I think it looks better. Certainly less events, but the leak percentage is worse. I did attempt to tape the mask to his face but the tape didn't hold very well.

He vaguely remembers waking up twice to fix the mask but otherwise felt like he slept well. Let me know your thoughts, or if I should zoom in on any data points. We also made progress in getting a generic rx from his primary doc, so we are open to purchasing other mask types, if needed.

[Miss Emerita]

You might try getting some BSN Medical Cover Roll Stretch, which comes in a 4" x 10 yds roll and costs around ten bucks on Amazon. Just cut strips that are the right size for crossing the straps. Be sure to turn under one end on each strip so you'll have a tab you can grip when it comes time to take the tape off. This stuff adheres very well and doesn't cause any reaction on my (sensitive) skin.

[PopIsGettingGrumpy]

Data from last night. My father thinks he slept ok last night. He remembers one leak. Not sure how concerned we should be with the leak rate at this point or if anyone sees any other issues to address.

[PopIsGettingGrumpy]

Here is my father's data for the last 6 nights, all with the pressure changes suggested of min 7/max 10. I do suspect that we are up against mouth leaks/nasal mask as I can hear him switch to mouth breathing some parts of the night. His leak rate percentage seems to be increasing as well, but I have no idea how much that hinders his cpap therapy given his results below. Any advice or input is appreciated. Happy to zoom in on any data requested:

We also tried one night of mouth taping for the leaks (first image below), but he actually had more events than usual that night which surprised me - and his pressure stayed near the max for much longer than any other time. Perhaps the tape came off but he believes it stayed on. We didn't try mouth tape after that night since he seems to have had worse results with the tape on.

September 3 (The only night we tried mouth taping. Results looked good at 16:00 when I first applied it during his nap, but then we saw more events listed when we tried the tape again that night):


September 4:


September 5:


September 6:


September 7:


September 8:

[PopIsGettingGrumpy]

We could really use help interpreting my father's Oscar results between dreamwear nasal and full face mask. His AHI is good with the nasal, but he's been having more trouble with confusion and memory despite liking his mask/therapy. He very often mouth breathes and I'm wondering if that could result in sub-optimal therapy and possibly a false low AHI so we decided to try a full face mask.

However, with the full face mask his AHI skyrocketed each time, and he says it feels like the machine is constantly adjusting the pressure up/down with a loud leak so he takes it off. I snuck in last night to pinpoint anything obvious (at about 12:15-12:30am), but apparently that was a small window with few events. He was snoring for those 15 minutes so I believe he was asleep. I saw no events, but I can sometimes hear that small air pulsing that the machine can do. For the feeling he describes of constant rising/falling pressure, I can only guess three things - he's feeling the air pulsing, he's feeling the EPR, or his jaw is relaxing/falling back when he starts to snore and causing a leak. The leak line/flow rate might support the third option but I'm not sure (close-up screenshot included below).

So, I'm left wondering which is AHI accurate - the low AHI with the nasal mask/mouth breathing, or the high AHI with the full face? My fear is that perhaps the machine isn't detecting all events with the nasal mask when he mouth breathes. Is that possible? If so, I thought the full face mask would help but his AHI is much worse. I really don't know what this all means and would appreciate any input. Hopefully these screenshots might make sense to someone here:

dreamwear NASAL mask, typical night (using about a month, very often mouth breathes. low ahi but having more confusion/memory problems):


dreamwear FULL FACE mask, typical night (just started. high ahi and says it feels like the pressure always goes up/down and leak sound increases):


And one close-up of an event cluster with the full face mask:

[Pugsy]

He needs more pressure with the full face mask. Very common.

He needs less pressure with the nasal mask. Very common.

The AHI with the nasal mask and slight amount of large leak is accurate. Not enough leak for it to make much of an impact anyway.
The machine really doesn't start having a huge problem with compensation, recording or responding until above 35 L/min in excess leak....and the time above 35 L/min is extremely short.

Keep him on the nasal mask and unless you start seeing prolonged periods of time with leak over 40 L/min....ignore it.

He's not going to like the pressures needed when using a full face mask. Opens up several new cans of worms.

If my dad....nasal mask and accept that leaks will sometimes be ugly but for the OSA treatment itself is well within optimal limits.
You won't ever get "perfect"....heck I don't get perfect either. Quit looking for it.
Look for "acceptable". It's easier found. Nasal mask use more than just "acceptable"....actually very decent.

[PopIsGettingGrumpy]

Very much appreciated and I can't thank you enough Pugsy! My biggest concern was that perhaps his AHI wasn't accurate due to the mouth breathing/nasal mask, and I couldn't find any info online to determine if that could be true. I feel much better now and he'll be very happy to keep using that nasal mask. He's very happy with it overall.

We'll just keep up with healthy lifestyle changes and give the therapy adequate time to see if it can help with his other issues down the line. We do know it can take quite a long time to see cognition improvements but I wanted to be sure I had him on the right track.

[Pugsy]

The AHI with the nasal mask is accurate and the only problem with accuracy is if the really big leak time was so prolonged the machine simply missed events and that really won't happen until an over 40 L/min leak and usually before that would happen we would see a bunch of UA flags.

The time in large leak will only affect things that happen during the really big leak anyway.
The time actually spent over 35 L/min is so small it really wouldn't impact overall numbers even if it did miss an occasional event.
Now if he spent half the night over 40 L/min then we would have a different discussion.
Should he start complaining about leaks waking him up a lot...we will have a different discussion but more about sleep quality than therapy effectiveness.

I think he is doing great. Probably his leak report is better than mine right now.