Seeking advice interpreting Oscar

Good evening;

(The following is based on posts to Reddit/r/CPAP and Reddit/r/SleepApnea (https://www.reddit.com/r/SleepApnea/com ... ing_oscar/) from which I was advised to also post on ApneaBoard and CPAP.com)

I am male, 57.

In October 2020 I averaged 5 hours of sleep per night - out of habit, really - to bed around 11pm, up at 0430 for my commute to work.

The reason I requested the sleep study was because my spouse complained I snored, to the point she wanted me to move to the sofa. I responded ‘never’ to the initial questionnaire about falling asleep in meetings/driving/etc., because those never happened - it was just snoring.

My home sleep-study determined I had an AHI of 38, so a CPAP was ordered. On Nov 13 I began using ResMed AirSense 10. It took me several weeks to get used to breathing during the first hour of use each night; currently, it takes me about 30 mins to fall asleep, which still feels weird as I almost always fell asleep in under 10 mins before CPAP. Between following the CPAP advice - and because since January I no longer have a daily commute - I am now in bed between 1000 and 600.

Most mornings I wake up an hour or so earlier than I need to - I lay in bed, trying to fall back asleep, so as not to get a bad score from having less than 7 hours of “sleep.” Despite that, I wake up groggy every day. Mid-day I am exhausted, to the point I have nodded off several times each week after dinner; this is a new behavior. When I do nap, it is without the CPAP and no snoring is reported.

My spouse reports a change in my personality: I am less engaging, and apparently, I am persistently in a sour mood. I now have horrible morning breath, but my mouth is never dry when I get up.

I have a periodic need to drive long distances - 2-3 hrs at a time - for both professional and personal reasons; the late-day tiredness is becoming a concern with these drives. In the summer of 2019 I weekly drove 430 miles in one sitting (with 2 pit stops) so I am no stranger to long hauls.

I am beginning to conclude this ‘therapy’ is causing me to be fatigued. Before CPAP, my spouse wanted me to sleep on the sofa because of snoring; if what I describe above is the price I pay for CPAP, I may as well give it up and move to the sofa.

My physician has kept saying 'give it time' but I am frustrated. Neither the physician nor equipment provider have offered any suggestion to modify my CPAP settings

In r/CPAP (https://www.reddit.com/r/CPAP/comments/ ... yt_videos/) I posted these pics and have received adjustment advice which I will try this evening. Further comments suggested I post Oscar screen caps:


1a https://imgur.com/ODrOqAw
2a https://imgur.com/n3GRHqQ
2b https://imgur.com/6HzRRwh
2c https://imgur.com/50aZMtd
2d https://imgur.com/zjU4EJK

Since posting to r/CPAP this afternoon, I have changed MIN PRESSURE from 5 to 8, RAMP was auto, and is now off, ERP level was 2 now 3.


I appreciate any input.

How many hours of real sleep...not laying in bed trying to sleep...do you think you are averaging?
Be honest.

Are those hours of real sleep fragmented? If so, how much meaning approx how many times do you remember waking up?
We already know usually at least once...any idea why?

Your leaks aren't horrible in the sense of affecting therapy but they are potentially capable of disturbing sleep...do the leaks wake you up any?

Are you having any nasal congestion? The flow limitations graph is a bit active...while I have seen worse I have also seen not nearly so active. It is likely what is driving your pressure all over the place. It is important to know if you are having much nasal congestion...so please answer this question.

Take any medications of any kind? If so, what?

Any other mental or physical health conditions going on?

There's a lot more to OSA than just snoring annoying the wife. You might want to watch this video.
https://www.youtube.com/watch?v=-gie2dhqP2c
A diagnostic AHI of 38...that's severe and eventually it will take a huge toll on your body and sleep even if it isn't now.

Please read this thread
viewtopic/t158560/How-to-post-images-for-review.html
We don't need all those graphs and you can include the basics we need on one image with a bit of graph resizing.
More work for all of us and it just isn't needed.

So tomorrow when you post after the adjustments you made...use the format in that thread I made.
Those adjustments you made...good ideas to try.

Oh...what mask are you using?

Thanks for your response. Lots to answer:

- I’d say I sleep 5 hrs, give it take. I think I wake up once before 5am, but I don’t have a bedside clock. I have no explanation for waking, and I think it’s about the same as I did before cpap.

- I haven’t had any nasal congestion in months; I always get a little in Jan/Feb, but nothing in summer.

- I am on Atorvastatin, 40mg daily

- I use dream ware Nasal Plllows.

I’ll update the data tomorrow. Thanks