Can't get past 3.5 hours

I just can't get past a few hours at a time with APAP. I can get it sealed and I fall asleep okay but wake up with leaks every night. It's gotten to where I pull the thing off and fall asleep again without becoming fully conscious. Then I wake up late and think, "I didn't make compliance again."

Other than putting tape around the mask which might leave a rash on my skin, I'm just at a loss.

Settings:
Autoset for her
Pressure 5-20 (per doctor - waiting for first follow up visit to address pressure setting)
10 min ramp
Humidity 4
ESP Full time (set to 1)
Using lanolin around full face mask for seal
<1 AHI
Average pressure reading from last night was 11.2.
Leak rate is 16. Which is confusing. Maybe it's not a leak after all?

Not everyone's face will work well with all the faces out there.

That's why we get to try different masks.

I just switched to a new one (2nd one) . I'm not sure how many my DME will let me get.

PS happy 3 week anniversary to me. You guys and gals got me this far, so thank you.

KittyMom22 wrote: ↑

Wed Nov 09, 2022 7:49 am

I just can't get past a few hours at a time with APAP. I can get it sealed and I fall asleep okay but wake up with leaks every night. It's gotten to where I pull the thing off and fall asleep again without becoming fully conscious. Then I wake up late and think, "I didn't make compliance again."

There are two separate problems here:

(1) Making compliance so the insurance company continues to pay for the machine and the DME doesn't take it back.

(2) Learning to sleep the whole night with the machine so that you get the best quality therapy.

Yes, the two problems are tied together: If you could solve #2, then #1 would be solved. But if #1 is not solved then #2 might never happen because you might lose the machine.

So if you want more time to make #2 happen before the DME takes the machine back for lack of compliance, then a bit of "cheating" may be in order: When you wake up later and you realize you didn't make compliance again, just put the mask back on and lie in bed (or even sit up in bed) with the mask on your face while the machine is running for another 30 minutes or so. You could use that time to read if you wanted to. And for what it's worth, using the machine while awake is often suggested by a decent DME's respiratory therapist who knows you're trying, but having real difficulty with making compliance.

If you can't put the machine on and use it for 30 additional minutes after waking up and realizing that you once again pulled the mask off when you weren't fully awake, then consider masking up 30 minutes or so before you intend to lie down and go to sleep. While wearing the mask, read in bed. Then before you turn the light off, refit the mask so that you know it's well sealed and turn the light out and hope you make it for another 3.5 hours before pulling the mask off your face.

By using the mask while you are awake, you will satisfy the compliance requirement and the machine won't be taken away by the DME/insurance company for lack of use. This will give you all the time you need to learn to sleep the whole night without pulling the mask off.

Now---how do you fix the problem of pulling the mask off while you are not fully awake?

Step 1: Look at the data in Oscar or SleepHQ and make sure that there is evidence to support your reasonable hypothesis that leaks are what is waking you up and causing you to pull the mask off your face. Oscar/SleepHQ won't lie: Either there will be a leak right before you pull the mask off and you'll know that leaks are objectively happening. And fixing the leak problem ought to go a long way towards helping you get past the 3.5 hour mark in terms of usage. Or there won't be a leak right before you pull the mask of and you'll know the wake is being triggered by something else (possibly just a plain old normal post-REM wake/arousal) and your brain in its befuddled half asleep state thinks it should just remove this thing that has attached itself to your face.

Step 2: Address the reason you are taking the mask off in the middle of the night when you are not fully awake.

If the problem is waking up to leaks that show up in Oscar/SleepHQ, consider changing the mask. A given mask doesn't fit everybody's face the same way and the mask that you are currently using just might not be a good fit for your face. Also consider whether moving around in bed before the wake might be triggering the start of the leak. In that case, looking at hose management might be the starting place. If you're not hanging the hose overhead, that might give you more freedom to move around in bed without the hose tugging at the mask and pulling it off just enough to create a leak. If you don't want to hang the hose, consider running the hose under the covers and holding on to it when you fall asleep. That way when you turn over, your hands can move the hose with your body and create less tension on the hose when you turn over.

If Oscar/SleepHQ shows that leaking is minimal or nonexistent at the time you turn the machine off, then the fix may be as simple as time trying to remember to put the mask back on whenever you wake up in the middle of the night and it's not on your face and it's also not yet time to get up. If you have SmartStart turned on, you might want to turn SmartStart off. That way when you pull the mask off your face, the machine does not automatically turn itself off after a few seconds. And maybe the hissing of the air still being blown through the mask will wake you up enough for you to realize that you need to put the mask back on.

Other than putting tape around the mask which might leave a rash on my skin, I'm just at a loss.

Taping the mask on may be a partial solution, but you don't need to put tape all around the whole mask. Just one or two strips is enough. The idea is not to secure the mask to your face; rather the idea is to create an unpleasant sensory stimulus of tape being ripped off that will cause you to wake up enough to realize what you are doing. If there's a brand of a band-aid that you can use without creating rashes on your skin, just slapping a bandaid or two on so that one half of the bandaid is on the mask and the other half is on your face might be all you need to discourage taking the mask off when you are not fully awake. If you want to use two bandaids, put one on each side of the mask.

Leak rate is 16. Which is confusing. Maybe it's not a leak after all?

That leak rate number from the sleep report is the 95% leak rate. In other words, for 95% of the night, your leak rate was at or below 16 L/min.

A leak of 16 L/min is acceptable to the machine in terms of its ability to track your breathing and deliver high quality therapy. So you saw Mr. Green Smiley Face for the "Mask Fit" icon in the sleep report.

But even a short leak at 16 L/min might be enough to wake you up---if the leak was causing air to blow in your face or if it was making loud farting noises as it was emerging from the sides of the mask.

The meaning of that number is that it tells you there is some probably minor leaking (in terms of therapy) going on, but it does not tell you if had one very short large leak that may have woken you up. In other words, when the AirSense's LCD is saying that the 95% Leak rate is 16 L/min, that's an invitation that looking at the leak data in Oscar is worthwhile, particularly if you suspect that leaks are waking you up. Because leaks that wake you up have to be fixed (so you can sleep) even if they are not clinically significant in terms of their affect on the quality of therapy the machine can provide.

Thanks Robysue, those are good suggestions.

I just switched masks a few days ago, and yes I'm hugging the hose. I can't tighten this headgear too much because it really hurts my ears but I see there's a "for her" version I may buy for myself.

Re: Oscar, I am so overwhelmed right now I can't spend a whole day figuring out the software and how to read the data. Even if I take the time I know I won't be able to mentally focus on it and will likely screw it up somehow. So I'm trying to just work with what MyAir / ResMed gives me. (Also my laptop is verrrrry old and slow.)

I may just look at the SD card data in Excel. That I could do on my work laptop without installing new software, which the Data Gods do not permit without IT authorization.

Don't worry about reading data - Pugsy and Roby Sue will do it for you (and a bunch of others too).

KittyMom22 wrote: ↑

Wed Nov 09, 2022 9:32 am

I may just look at the SD card data in Excel.

Waste of time. Excel won't have a clue what the data means.

Depends on how the columns are labeled. If the headers are clear, it's pretty easy to drop a line chart.

Julie wrote: ↑

Wed Nov 09, 2022 10:06 am

Don't worry about reading data - Pugsy and Roby Sue will do it for you (and a bunch of others too).

Thanks, but when I try to read threads where Oscar data is being discussed it just seems like a bunch of gibberish. I need to understand what they're talking about to even make sense of the discussion.

I analyze data for a living (or used to) so it's just a matter of getting myself up to speed.

On reflection, I'm wondering if a hose hanger would help lift the weight off the front, which might also help with leaks? I've been resistant to the idea because the only way to make a long snaky thing MORE attractive to cats is to dangle it overhead, but maybe it would help with leak prevention.

KittyMom22 wrote: ↑

Wed Nov 09, 2022 9:32 am

I may just look at the SD card data in Excel. That I could do on my work laptop without installing new software, which the Data Gods do not permit without IT authorization.

The problem is that the data on the SD card is not written in a format that Excel can use.

Even if I take the time I know I won't be able to mentally focus on it and will likely screw it up somehow. So I'm trying to just work with what MyAir / ResMed gives me. (Also my laptop is verrrrry old and slow.)

Oscar should run just fine on a laptop even if it is verrrrrry old and slow.

Re: Oscar, I am so overwhelmed right now I can't spend a whole day figuring out the software and how to read the data.

Downloading Oscar takes a few minutes. And you just hit a button that says "Install" to install the program.

When you open Oscar for the first time, you will need to set up a profile, which is quite easy:
Step 1: Click on the button that says, "Profile" in the window that pops up when you start the program. Then click on the button says "New Profile" in the right sidebar of the Profile window and you get a panel that looks like this:


Type the name you want to use for the username. You can use a fake name, say KittyMom22, for the username in the profile if you want to. You'll notice that other than asking for a (fake) username, the profile only needs your time zone and a check if you are in an area that uses daylight savings time. That's all it takes to create a profile.

To import the the data do the following:

Step 1: Insert the SD card into the SD slot on your computer (if there is one). If you don't have an SD slot, you will need to buy an SD card reader that attaches to a USB port.

Step 2: Open Oscar and if necessary select the the profile. (Oscar will step you through this if necessary.) Once the profile is open, you should have a page that looks like this:

Then click on the SD card icon or select "Import CPAP Card Data" from the File menu. In either case, Oscar should automatically find the SD card and it will give you a chance to confirm you want to import the data. Once the data is imported, you'll get a message box that says the data import was successful. At that point, you can click on "Daily View" to get to the graphs of the data that we are always talking about.

You don't need to understand anything about that data (yet), but look for the graph labeled Leak Rate. If there's a leak that is waking you up right before you take the mask off in the middle of the night, you should see a graph that is above the 0-line right before the data ends. If there's no leak line present when the data ends, that means you took your mask off when there was no discernible leaking when you woke up and took the mask off your face.

KittyMom22 wrote: ↑

Wed Nov 09, 2022 10:16 am

Depends on how the columns are labeled. If the headers are clear, it's pretty easy to drop a line chart.

Excel needs the data stored in a format that looks like a comma separated string or list of some sort.

But the data on the SD card is stored in a long list of short binary files, not a comma separated string. To "read" the data, the Oscar program has to import all of those short files and put them together into a coherent whole.

Here is what the file organization of some of the contents of my Resmed AirCurve 10's SD card looks like in a file browser:

The folder I've highlighted contains the multiple data files that were written directly to my SD card last night by the AirCurve. Those files range in size from 8 bytes (the *.crc files) to 808 bytes to 77 k (the *.edf files). None of them are readable by Excel, and to make meaning out of the data, you have to have all of the data in all of those files available at the same time.

KittyMom22 wrote: ↑

Wed Nov 09, 2022 10:21 am

Julie wrote: ↑

Wed Nov 09, 2022 10:06 am

Don't worry about reading data - Pugsy and Roby Sue will do it for you (and a bunch of others too).

Thanks, but when I try to read threads where Oscar data is being discussed it just seems like a bunch of gibberish. I need to understand what they're talking about to even make sense of the discussion.

I analyze data for a living (or used to) so it's just a matter of getting myself up to speed.

Once you make the decision to get yourself up to speed, you should find analyzing the graphical data presented in Oscar is pretty easy.

When you are ready to start learning how to make sense of the data, let us know and we can point you to sources to help you learn what you want to know.

What OSCAR does is read the data recorded by the machine and present it graphically. It does not analyze.

https://en.wikipedia.org/wiki/European_Data_Format

European Data Format (EDF) is a standard file format designed for exchange and storage of medical time series. Being an open and non-proprietary format, EDF(+) is commonly used to archive, exchange and analyse data from commercial devices in a format that is independent of the acquisition system. In this way, the data can be retrieved and analyzed by independent software. EDF(+) software (browsers, checkers, ...) and example files are freely available.

EDF was published in 1992 and stores multichannel data, allowing different sample rates for each signal. Internally it includes a header and one or more data records. The header contains some general information (patient identification, start time...) and technical specs of each signal (calibration, sampling rate, filtering, ...), coded as ASCII characters. The data records contain samples as little-endian 16-bit integers. EDF is a popular format for polysomnography (PSG) recordings.

(my emphasis)

robysue1 wrote: ↑

Wed Nov 09, 2022 10:56 am

Once you make the decision to get yourself up to speed, you should find analyzing the graphical data presented in Oscar is pretty easy.

When you are ready to start learning how to make sense of the data, let us know and we can point you to sources to help you learn what you want to know.

Well said.
And then (when it feels like fun...) you can export to Excel and analyze it to your heart's content.
I used to do that (export and analyze) way back when I had a PB 420E.