Help interpreting Oscar

I've been lurking at this forum since I restarted CPAP about 6 months ago. I had been using a mandibular advancement device but it was moving my teeth. I went back to my sleep clinic and they thought it was reasonable to try a cpap again (I used one many years ago and gave up) I requested an airsense 10 for her based on what I'd learned here. Without going into details about why, I have been able to try both the dreamwer under nose mask and pillows ( in a small size. I was having lots of leaking and they sent me the resmed N30i. I also requested the P30i small pillow to try. I feel kind of dumb because I just assumed I had a "small" nose. Just recently I tried the N30i medium and I had much less leaking. I was able to try the medium dreamwear under nose mask and it leaks less too. I'd like to try the p30i pillows (I like the diffuser). I'd like to settle on a mask and now I have an idea what works well.

I've learned a lot here and have tried various things like using lanolin to help reduce leaks and a sore nose with the pillows. I've tried going from the original prescribed auto settings (5-15) to experimenting with fixed pressure. I looked at the range of pressures on auto and have been playing with fixed pressures between 7-8. I tend to sleep better with the fixed pressure because there aren't sudden bursts of air. I've set the pressure relief to the maximum possible which has also increased comfort. I'm trying to understand flow limits and leaks and when it's a problem. But the data looks different every day and I need help making sense of it. I know the bottom line is how I feel and I'm not sure. I don't feel awful and I don't feel fantastic. I realize that sleep hygiene is important too and I may need to pay more attention to that.

I've had 3 sleep studies over the years. My apnea is much worse on my back so fortunately I'm a side sleeper most of the time. In a sleep study in 2019 I had a supine AHI of 47. I had a lateral AHI of 1.8 but a lateral RDI of 10.7 and lots of RERAs. I had another sleep study with the MAD and the RERAs were almost completely eliminated but I am not happy with having my teeth impacted. I'll continue to use the MAD when I travel.

I thought about posting an Oscar screen with the auto settings and with fixed but I think I'm just going to post last night which was fixed at 7.2 wearing the dreamwear under nose medium. I'm sure I was awake a few times during the night. I wake up 3-4 times at night and get back to sleep quickly. I think the big leak at near the end of the graph is me pulling off the mask and jumping out of bed with a charlie horse and can be ignored. I'm mostly not sure I understand what is going on with the leaks and the flow limit. I'm open to suggestions. I think I've posted the image correctly. Let me know if not.

Thanks for your help in understanding Oscar. It is a great service this community provides and what is good about the internet.

in this instance, i don't have enough knowledge to be helpful here. but i wanted to thank you so much for taking the time to read up about how to present your charts. so many folk don't and it's important if one wants to get good help.

mainly, i'm answering to bump this thread. friday night is usually dead here, unless pugsy comes by and sees your post.

good luck!

You leaks are either mask movement leaks or mouth breathing/opening leaks. Impossible to know for sure what they are unless you tape your mouth shut and see the if leaks reduce or not.
To be honest though....if you are sleeping through those leaks I wouldn't worry about them. Except for the last large leak flag the bulk of the night your excess leak was below 24 L/min and the machine can easily compensate for that amount of leak.
They aren't bad enough to negatively impact your therapy....now if they cause repeated wake ups then that is a whole different story no matter how big or little the leak might be. Anything that disturbs our sleep is unwanted.

Overall a very decent report. Not a lot I would offer to change as long as sleeping good and feeling decent.

The flow limitation graph is a bit active but far from horrible. I have seen much, much worse. If that were my report and I was sleeping good and feeling good I wouldn't worry about it. Are you having any nasal congestion? Sometimes nasal congestion shows up on the FL graph as more activity.

Awesome amount of initiative and problem-solving, Amy! I think you may be on to something when you mention working on sleep "hygiene." (I hate that expression; suggests that without it we're nasty!) You're so well-informed you probably know all of this but just in case:

• Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
• Set a bedtime that is early enough for you to get at least 7 hours of sleep.
• Don’t go to bed unless you are sleepy.
• If you don’t fall asleep after 20 minutes, get out of bed.
• Establish a relaxing bedtime routine.
• Use your bed only for sleep and sex.
• Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
• Limit exposure to bright light in the evenings.
• Turn off electronic devices at least 30 minutes before bedtime.
• Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
• Exercise regularly and maintain a healthy diet.
• Avoid consuming caffeine in the late afternoon or evening.
• Avoid consuming alcohol before bedtime.
• Reduce your fluid intake before bedtime.

You might try seeing how you feel if you give yourself more like 8 hours in bed. And for what it's worth, when I finally started paying attention to these rules, the one that I think helped the most was to keep regular hours, with a kind of wind-down routine before bedtime.

Miss Emerita wrote: ↑

Sat Dec 19, 2020 11:32 am

working on sleep "hygiene." (I hate that expression; suggests that without it we're nasty!)

I so agree. I wish they used something like maybe sleep habits instead of hygiene. Sounds so much less negative.

I don't like the term "hygiene" either. The word "habit" is better. I think I know what I should be doing Miss Emerita but doing it is a challenge. But it may be the think I need to pay attention to.

I forgot to mention my nose. I have that vague thing called non-allergic rhinitis so essentially chronic congestion. However, it's not horrible and I'm still a nose breather except perhaps with some exercise. I've had turbinoplasty and septoplasty which didn't help at all. I don't think I'm opening my mouth during the night but I'm not sure. I know not everyone is a fan here from a few posts I've read, but my dentist recommended I see a speech therapist and I'm doing myofunctional therapy. It makes sense to me and I feel like my nose breathing is a bit better as I learn these new tongue habits.

I think I was waking up with the leaks when I had on the auto setting and I'd get these huge blasts of air. I'm not aware of waking up because of leaking although I do still just wake up 3-4 times a night that I'm aware of. I bought a medium nose pillow for the Resmed N30i headgear to try thinking I may have fewer leaks with it. I bought one on ebay but unfortunately the seller must have had it near laundry that was dried with dryer sheets. The smell is horrible and that stuff just does not come out. I tried soaking it in vinegar water. The seller, to her credit, refunded my money right away.

I just feel ok. Not awful and not fantastic. Getting 8 solid hours may be the thing to focus on. I might post my Oscar results again to help me understand.

Thanks everyone.