Newbie with OSCAR settings questions and guidance

Hi, I've been using the Airsense 11 with a full face mask since middle of February 2023. I was diagnosed with mild apnea/snoring (5.1, but oxygen level around 88% for long enough that they were concerned). 51 year old female, not overweight, side sleeper, uses a bed pillow with cutouts for CPAP gear.

I started with the Airfit F20, also tried the Airtouch F20, but I was only able to keep both on about 4 hours/night and was super uncomfortable on my side. I recently switched to the F30i, and it is so much more comfortable! I've been using it about 6 weeks. I am a mouth breather with deviated septum, and often have plugged up nose--therefore feel that a full face mask will work best on me.

I was getting less leaks with the F20 masks, but I'm determined to keep at it with the F30i because the comfort level makes a big difference for me.

My primary care doctor prescribed the APAP after a 3-night home sleep study. I use Apria as my DME, and was referred there by my doctor. I initially spoke to a respiratory therapist on the phone with a few questions, but I pretty much feel like I'm on my own to figure out the best settings. I wasn't sleeping terribly before APAP, and haven't really noticed a huge difference with it. I'm just feeling like I'm prob not getting the full benefits with my current settings and OSCAR data. I'm very much not a stats person (English major), so I'm struggling with all of the info.

My pressure settings were set at 4-20. My EPR is set at 3, ramp is turned off. I'm not impressed that my AHI seems to average around 4-5, given that I tested at 5.1 I had a couple good nights when traveling in CO recently (from MI) where my AHI was 2 or below, but I have no idea why. I'm really hoping someone here can assist me with my settings if I need to adjust them? I'm wondering if 4 is too low for my minimum pressure, and what I should potentially raise it to.

Thanks so much for any help!! I can attach more images if needed or helpful.

Some data from recent nights (the one with low AHI was while travelingt)
https://imgur.com/a/x4ViiZs


Sleep study results:
https://i.imgur.com/HEC5Li3.jpg

Lisaweldy wrote: ↑

Sun Jul 02, 2023 1:58 pm

I'm very much not a stats person (English major), so I'm struggling with all of the info.

You did fine to get the charts posted nearly perfectly on the first try. With an English background, you actually read the instructions.

Lisaweldy wrote: ↑

Sun Jul 02, 2023 1:58 pm

I pretty much feel like I'm on my own to figure out the best settings.

That is better than relying on Apria or most doctors.

Lisaweldy wrote: ↑

Sun Jul 02, 2023 1:58 pm

My pressure settings were set at 4-20.

If those were my charts, I would change the minimum to 8.0. Your pressure is almost always running at 9.0 or above.

Of course, anytime you make changes, you can post another chart the next day. Keep them in this one thread.

Lisaweldy wrote: ↑

Sun Jul 02, 2023 1:58 pm

I am a mouth breather with deviated septum, and often have plugged up nose

I would have an ENT visit and see what she recommends. A successful treatment could make CPAP much easier and life in general better. Nasal breathing is the healthiest.

Lisaweldy wrote: ↑

Sun Jul 02, 2023 1:58 pm

My pressure settings were set at 4-20. My EPR is set at 3, ramp is turned off. I'm not impressed that my AHI seems to average around 4-5, given that I tested at 5.1

You shouldn't be impressed, because you were set up with a minimum effort machine, ie, it's not actually set it's just the way it comes from the factory, which is right for almost nobody.

Your minimum needs to be much higher than what it's set to, because you're spending the whole night having repeated breathing issues (that's what drives up the pressure, so spectacularly when the night starts.

I'd suggest a minimum of 11, based on what the pressure curve looks like.

Also, your EPR isn't set to 3, (maybe it's set to 3 ramp only, but with ramp off, you're not getting any EPR. Whether you like EPR or not, we can't guess, you'd have to try it.

If you *do* use EPR, then set the min pressure to 14, with EPR full time. (which will give you that 11 that I was suggesting above to keep your airway open. (might need more pressure, but 11 looks close to where you spend most of the night having events (you look at the bottoms of the pressure curve, where it gets down to before it spikes back up, and set the min pressure a little above those levels).

Thanks for the guidance!

I made a few changes for the past 2 nights. Changed minimum pressure to 7, kept max 20. Changed to "Auto For Her" vs. plain Auto. Kept EPR and ramp off.
Definitely felt different. Was feeling the increased pressure when I first went to bed and it took some getting used to. I'm curious if anyone familiar with OSCAR data could look at this link below and tell me if anything looks improved? Obviously my AHI is lower, which is good, but I'm just wondering if I should still increase minimum pressure or make any other changes. I did have a pretty bad mask leak last night, which didn't help anything. I started at 7 vs. 8 or higher for minimum because I was nervous about jumping from 4 to anything much higher--I am willing to try going higher than 7 though.

Thanks!

https://imgur.com/a/tmUQ8ml

Lisaweldy wrote: ↑

Wed Jul 05, 2023 11:19 am

https://imgur.com/a/tmUQ8ml

1. If that were my chart, I would change the minimum pressure to 9.0. Your pressure line is not running below 9 anyway.

2. I would change the EPR to 3 and look to see if it clears up some of the Flow Limitations.

3. You didn't include the leak line on the chart. Your summary statistic shows acceptable leak. The machine compensates for leak up to about 25 lpm. However, if the leak is awakening you, that is a problem. Find your mask on youtube and watch some videos on fitting and adjusting. Please include the leak line when you post a chart for subsequent days.

ChicagoGranny wrote: ↑

Wed Jul 05, 2023 12:04 pm

Lisaweldy wrote: ↑

Wed Jul 05, 2023 11:19 am

https://imgur.com/a/tmUQ8ml

1. If that were my chart, I would change the minimum pressure to 9.0. Your pressure line is not running below 9 anyway.

2. I would change the EPR to 3 and look to see if it clears up some of the Flow Limitations.

3. You didn't include the leak line on the chart. Your summary statistic shows acceptable leak. The machine compensates for leak up to about 25 lpm. However, if the leak is awakening you, that is a problem. Find your mask on youtube and watch some videos on fitting and adjusting. Please include the leak line when you post a chart for subsequent days.

I'd change the minimum pressure to 12, since it's never getting below 11, and it's spending all the time with repeated breathing events causing the pressure to go back up.

2. in that case, add 3 to the minimum pressure.

Hello again,
I've played around with some setting changes since last Sunday. M/T I upped minimum pressure to 7 from 4 (no EPR), changed setting to "Autoset for Her", and had decent AHI. Th/F I upped minimum pressure to 9 (EPR 2), took off "Autoset for Her" and replaced with original "Autoset" and had higher AHI. Wed. I forgot to put SD card back in machine.

I'm attaching a ridiculous amount of my screenshots from OSCAR from each of these days. Can someone look at them and recommend where I go from here? Should I not be using EPR and just upping my minimum pressure to 9? It seems that I had better AHI scores without EPR (when min. pressure was set at 7). Also, is "Autoset for her" anything useful for women is "Autoset" fine?

Sorry for all of my questions! Really trying to fine-tune my settings and get the most out of the machine. Thanks!!

https://imgur.com/a/MMxSPht

Hi, have you looked at the Imgur 'link' you left (twice)? No Cpap stuff, but lots of ... 'party personal'!

And you've been so afraid to raise your min. pressure beyond 7, even tho' experts have said it's OK (and needed).

Look at the links you post before hitting save - you might want to change the message .

Huh, I did preview my post and links—they look like normal cpap screenshots on my end and on imgur. My husband also sees normal cpap images in his phone with separate account. But, I’ll look into it, sorry!

I’m not afraid to go to 9 or higher—just wanted to do so gradually and wasn’t sure how to play around with EPR while doing so. I’ve had the minimum at 9 the last 2?nights, just had added in a EPR of 2 to try to adjust more easily to higher pressure.

Make ONE change at a time and allow at LEAST 3 or 4 days/nights at that setting before going on to another change unless results are a disaster.

Always include a brief summary about how you slept and how you are feeling when you post reports.
Numbers don't tell the whole story.

Lisaweldy wrote: ↑

Sat Jul 08, 2023 9:37 am

Huh, I did preview my post and links—they look like normal cpap screenshots on my end and on imgur. My husband also sees normal cpap images in his phone with separate account. But, I’ll look into it, sorry!

This is what I see:

This post may contain erotic or adult imagery.
By continuing, you acknowledge that you are 18+ years of age.

I’m not afraid to go to 9 or higher—just wanted to do so gradually and wasn’t sure how to play around with EPR while doing so. I’ve had the minimum at 9 the last 2?nights, just had added in a EPR of 2 to try to adjust more easily to higher pressure.

There's no benefit in doing it gradually - your machine routinely changes pressure by several cm over the course of a few minutes. Just go straight to the suggested pressure.