Please help me review my OSCAR report

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
IamSleepyRyan
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Joined: Tue Jan 14, 2025 4:23 pm

Please help me review my OSCAR report

Post by IamSleepyRyan » Tue Jan 14, 2025 4:58 pm

I have been using my Resmed S9 for nearly a decade now.
When I did the sleep study back then, they put me on constant CPAP pressure of 16 / EPR 3 and they left me on my own. I recall someone saying I might have Central Sleep apnea.
For years I have just been using the same settings and taking their advice.
Just this past week I have recently switched out my equipment to a Climateline heated hose and swapped to a Airfit p10. Previously had a swift FX nasal mask.
I was curious how I have been doing with my sleep so I learned about OSCAR and this forum and loaded the reports.

Some things that I recently changed was mode to APAP and min pressure of 13 max pressure 16. This seemed to be worse.
I have been going for years with high AHI and did not realize it and in need of help from you folks to lower this.

1.) What pressure should I be at?
2.) OSCAR is reporting 99.95% Large leaks, this did not happen with my old mask, I feel there's way less leaks on this new one.
3.) What other things can I do to optimize my sleep and lower AHI?

Any advice would be greatly appreciated.
Thank you in advanced
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Last edited by IamSleepyRyan on Wed Jan 15, 2025 1:33 am, edited 1 time in total.

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Pugsy
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Re: Please help me review my OSCAR report

Post by Pugsy » Tue Jan 14, 2025 5:35 pm

It's impossible to really evaluate things because of the massive leak shown.

Go back and find a report without such a big leak and post it.

I don't see any central apneas being flagged but I do see a lot of UAs being reported. Normally that means the leaks were bad enough to allow some sort of apnea event to happen but the machine couldn't tell if it was obstructive in nature or central in nature.

Tonight....try autoset mode
Minimum pressure....10
Maximum pressure....15
Do you need EPR? Can you do without it or at least reduce it to 1? EPR can trigger central apneas in some people and at this point I am not even sure you have central apneas going on but let's reduce EPR just in case.
Make sure you run the mask fit check for leaks because if you have a large amount of leaking that will totally mess with the results.
Check to make sure you don't have a hole somewhere that you shouldn't have.

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robysue1
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Re: Please help me review my OSCAR report

Post by robysue1 » Wed Jan 15, 2025 1:37 pm

IamSleepyRyan wrote:
Tue Jan 14, 2025 4:58 pm
2.) OSCAR is reporting 99.95% Large leaks, this did not happen with my old mask, I feel there's way less leaks on this new one.
and
Just this past week I have recently switched out my equipment to a Climateline heated hose and swapped to a Airfit p10. Previously had a swift FX nasal mask.
You say that you're feeling "way less leaks" with the P10, but the data is showing a massive leak all night long.

Here's my two cents, as someone who regularly uses both the P10 and the Swift FX:

1) The Swift FX has an exhaust vent that blows air directly down onto the chest and arms of the user, and all those parallel exhaust hole seem to concentrate the flow in a way that feels like a jet airplane if it is blowing in a way that hits your arms or chest.

2) The P10 has mesh exhaust vents that dampen the feel of the airflow significantly, while not actually affecting the intentional exhaust rate itself. In other words, the mesh breaks up the flow so that it goes in multiple directions instead of concentrating it like the FX does. When my P10 is properly sealed, I sometimes have to pull the mask away from my nose just to feel any airflow to confirm the machine is on. That never happens with the FX.

Items 1 and 2 together can explain why you feel like there's less leaking with the P10---when you're awake and aware of the exhaust venting from the mask.

3.) What other things can I do to optimize my sleep and lower AHI?
There is something other than the normal difference in how the intentional exhaust venting in the P10 feels compared to the FX going on during the night you posted the data for. Something had to cause that massive leak, and if you are often seeing this kind of leak, the massive leak is the first thing that has to be fixed in order to optimize your PAP therapy and minimize your treated AHI.

So what might be causing this kind of a incredibly huge leak all night long? Here are some things you might want to double (and triple) check if the leaks were under control with the FX:

1) Has one of the interior nasal cones collapsed? That can trigger massive leaks sometimes.

2) Are you moving around in bed after you fall asleep and dislodging one of the nasal cones almost completely?

3) It there a hole somewhere in the nasal cushion that's leaking a huge amount of air?

4) Is there a hole in the short hose for the P10 mask that's leaking a huge amount of air?

5) Is there a hole in your main hose?

6) Is there a tear around one of the hose couplings on either the short hose or the main hose?

7) Is the ClimateLine hose properly attached to the S9? If not, maybe air is being leaked right at where the hose is attached to the machine.

8) Is the humidifier tank properly attached? If not, maybe the air is being leaked as it goes from the blower unit to the humidifier.

9) Your S9 is almost 10 years old. It could be that something in the blower unit itself has finally worn out. In other words, maybe there is an interior gasket that is leaking air before its even blown out of the machine and into the hose. It might be worth your time to take the S9 in the DME that sold it to you and see if they can test whether the blower unit and the humidifier are still working correctly.

10) Last (because I don't think this is the issue): Mouth leaks might be (part of) the issue. But---you've been using a nasal pillows mask for almost a decade. So presumably you either don't breathe much through your mouth at night or you have already learned to figure out how to keep your mouth from dropping open for long, long periods during the night while you are asleep. But, just on the off chance you haven't---is there any chance that you are now spending most of the night breathing through a wide open mouth?
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IamSleepyRyan
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Re: Please help me review my OSCAR report

Post by IamSleepyRyan » Wed Jan 15, 2025 8:03 pm

So what I have tried to do was trying to identify the points of failure starting with the Machine itself going into the humidifier,
if I cover the hole there would be a smiley face signaling no leaks when doing a mask fit check.
I do this kind of check at all these points

Machine to Humidifier :)
Humidifier to exhaust hose :)
Hose to mask :)
Mask nose and Exhaust ports :)

If I release the Exhaust port on the mask :(
immediately get a sad face.
I am feeling all around the machine and at every point and I do not detect any leaks whatsoever.

I did add a new filter and I read that sometimes that can sometimes make it seem like there are large leaks
I tried the test without the filter and it does not make a difference.



Thank you for the reply's

To answer your question robysue1
1) Has one of the interior nasal cones collapsed? That can trigger massive leaks sometimes.
No
2) Are you moving around in bed after you fall asleep and dislodging one of the nasal cones almost completely?
Possibly, but as soon as the machine starts its already got a :( from just the exhaust of the mask
3) Is there a hole somewhere in the nasal cushion that's leaking a huge amount of air?
No
4) Is there a hole in the short hose for the P10 mask that's leaking a huge amount of air?
No, I tested with multiple short hoses and it does not make a difference, cant feel any air leaking at all
5) Is there a hole in your main hose?
No
6) Is there a tear around one of the hose couplings on either the short hose or the main hose?
No
7) Is the ClimateLine hose properly attached to the S9? If not, maybe air is being leaked right at where the hose is attached to the machine.
It is properly attached and no leaks.
8) Is the humidifier tank properly attached? If not, maybe the air is being leaked as it goes from the blower unit to the humidifier.
I took things apart and cleaned it and put it back together, even checking the humidifier flip lid seal for its integrity, everything looks good.
9) Your S9 is almost 10 years old. It could be that something in the blower unit itself has finally worn out. In other words, maybe there is an interior gasket that is leaking air before its even blown out of the machine and into the hose. It might be worth your time to take the S9 in the DME that sold it to you and see if they can test whether the blower unit and the humidifier are still working correctly.
I will have a professional check it, but I don't have any connection with the people who put me on this machine. I will have to try google. Thanks for the suggestion.
10) Last (because I don't think this is the issue): Mouth leaks might be (part of) the issue. But---you've been using a nasal pillows mask for almost a decade. So presumably you either don't breathe much through your mouth at night or you have already learned to figure out how to keep your mouth from dropping open for long, long periods during the night while you are asleep. But, just on the off chance you haven't---is there any chance that you are now spending most of the night breathing through a wide open mouth?
No problems with mouth breathing. But my mouth does get super dry lately.

Since my machine is old I might have to get a new one :(
Maybe some sensor is bad
Really sad because these things are so expensive, I payed out of pocket for this one $1000 but it did serve me well through the years and well worth the investment.

IamSleepyRyan
Posts: 3
Joined: Tue Jan 14, 2025 4:23 pm

Re: Please help me review my OSCAR report

Post by IamSleepyRyan » Wed Jan 15, 2025 8:09 pm

Pugsy wrote:
Tue Jan 14, 2025 5:35 pm
It's impossible to really evaluate things because of the massive leak shown.

Go back and find a report without such a big leak and post it.

I don't see any central apneas being flagged but I do see a lot of UAs being reported. Normally that means the leaks were bad enough to allow some sort of apnea event to happen but the machine couldn't tell if it was obstructive in nature or central in nature.

Tonight....try autoset mode
Minimum pressure....10
Maximum pressure....15
Do you need EPR? Can you do without it or at least reduce it to 1? EPR can trigger central apneas in some people and at this point I am not even sure you have central apneas going on but let's reduce EPR just in case.
Make sure you run the mask fit check for leaks because if you have a large amount of leaking that will totally mess with the results.
Check to make sure you don't have a hole somewhere that you shouldn't have.
I tried those pressure settings last night and I felt awful, I woke up multiple times and had to increase pressure. I will keep doing trial and error while trying to identify why the machine is saying there are leaks.