OSCAR Data Interpretation Help

Some background:

Diagnosed with 37 AHI, 50 AHI when sleeping on back and 21 AHI when sleeping on side.
Have had Airsense 10 for Her + P30i nasal pillows for about a week now.

For this particular day's data, I definitely woke up a couple times due to mask leaks, and feel about 6/10.

Questions:
1. Could I have some advice based on this graph? What min and max pressure is recommended?
2. I seemed to have lower AHI around 3 when I set the pressure lower, 6-9, as opposed to 8-11. I thought higher pressure causes lower AHI; is this because of mask leaks at the higher pressures or some other reason. Unfortunately, don't have the graph, but I did upload a summary of a 3 AHI day.
3. Sleeping on side vs back? Like I said I have 50 AHI on back and 21 on side and usually prefer to sleep on side, but with the pillow pushing the side of my face and mask, I think sidesleeping has been causing these mask leaks. So should I try to teach myself to sleep on back instead? My mask headgear is already really tight, and I've tried adjusting it a lot.

Thank you so much in advance

Why did you increase the pressure when lower was giving decent results?

Are you aware that CAs/central apneas can't be reduced with more pressure and in fact might make more centrals happen?

You are probably going to need to take a crash course in flow rate evaluation to see if those centrals are arousal related or for sure asleep related.

http://freecpapadvice.com/sleepyhead-free-software

Zargonorix wrote: ↑

Sun Sep 05, 2021 3:15 pm

3. Sleeping on side vs back? Like I said I have 50 AHI on back and 21 on side and usually prefer to sleep on side, but with the pillow pushing the side of my face and mask, I think sidesleeping has been causing these mask leaks. So should I try to teach myself to sleep on back instead? My mask headgear is already really tight, and I've tried adjusting it a lot.

welcome to the zoo! you are in good hands with pugsy, so please follow here advice.

i'm here regarding the chunk that i quoted. i would advise you look at a couple of youtube videos for mask fitting. search term like "cpap mask fitting p30i". it's most likely you are over tightening the mask. that may seem like the thing to do, but it isn't.

also, back vs side sleeping is a well known trope here. side sleeping, particularly on your left side, is best. doing that with a mask can be tricky indeed. i use a nasal pillow mask (p10) and what i do is hang that sucker over the edge of the pillow. let the pillow support your cheek and head and such, but leave the mask free to dangle.

the above takes practice. i can't remember how long it took, but now it's as natural as breathing. (HEH)

good luck!

There are various places that sell pillows for Cpap sidesleepers... Google Cpap bed pillows and see what's what.

Also - overtightening straps, etc. to avoid leaks (?) is counterproductive as FF masks can't inflate properly to do their job.

And back sleeping is a huge no no for apnea/hypopneas.

Pugsy wrote: ↑

Sun Sep 05, 2021 3:36 pm

Why did you increase the pressure when lower was giving decent results?

Are you aware that CAs/central apneas can't be reduced with more pressure and in fact might make more centrals happen?

You are probably going to need to take a crash course in flow rate evaluation to see if those centrals are arousal related or for sure asleep related.

http://freecpapadvice.com/sleepyhead-free-software

At that time, I didn't have my SD card; my machine just reported 'x' AHI, but not what types, so I assumed they were OAs since that was what I was diagnosed with, which is why I increased the pressure, but you're totally right that they are CAs and hyponeas. It's really interesting that I have had 0.0 OAs everyday so far, so I will definitely be lowering my pressure to 6-9 and even lower after some more testing. Really pleasantly surprised to be cured of OSA completely already.

Now for CAs, I've tried researching a bit on how to reduce them: going to reduce pressure and range of pressure, sleep on side, reduce EPR. Anything else you would recommend? Also not sure what you meant by crash course in flow rate evaluation to see if those centrals are arousal related or for sure asleep related; could you elaborate and link me a resource?

Thanks!

I can't elaborate much because I am one finger typing due to surgery on my hand but if you watch the videos you will get an idea.
If you go to my profile and just search my posts for "false positives" you will see my usual speech.
Sorry but one finger typing severely limits my usual responses.

If you weren't asleep when those centrals were flagged then we worry more about why you weren't asleep.

Are you having much nasal congestion going on at night?

To help you with side-sleeping, another idea is to try a firmer pillow.

I'm attaching a zoomed-in view of a central apnea following an arousal, probably a full wake-up. So zoom in on your flow rate and see how often you see this kind of pattern where your CAs are flagged. Feel free to post a few zoomed-in views if you're uncertain what you're looking at.

For CAs that are happening in this way, the key will be to settle in to a good sleep so you have fewer arousals. Returning your settings to the ones that were working better for you sounds like it'd be a good first step.

Down the road, when you're stabilized and comfortable with a low AHI, you might want to introduce some EPR to see how that goes. It might reduce your flow limitations, if they are occurring further along in your airway than your nose, and it might also help some with the hypopneas. Or not, but it could be worth an experiment.

But for now, no EPR and back to min = 6 and max = 9. If I were a betting woman, I would your pressure just goes up to 9 and stays there; the flow limitations can do that.