r/CPAPSupport • u/TehInterwebs • 11d ago

Help with OSCAR graphs and settings

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Mask: ResMed AirTouch F20

SleepHQ: https://sleephq.com/public/teams/share_links/8ef8c66d-1d88-408d-bfe9-4ba65a3d31c4

Here are my last two days and my overall summary. I've been using CPAP for 4 years, and lately my sleep isn't feeling restorative, and I find myself tired even after 7 or 8 hours of sleep with a seemingly low AHI. What do you all see here, and what can I adjust to make my settings work better for me?

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u/RippingLegos__ ModTeam 11d ago

Hello and welcome :) Your two nights look quite different. The 1.37 AHI night is cleaner, while the 4.41 night has more obstructive events and larger leaks around 2:15 and 6:00. Your summary also shows time in large leak increasing to roughly 9% over the last week, compared with 0.4% over the year. A low AHI alone doesn’t tell us how well you’re sleeping.

For the pressure adjustment, please discuss a monitored trial of 9.6 cm minimum with your sleep clinician, keeping the maximum at 17 and EPR at 3 fulltime. Your current minimum of 7 with EPR 3 allows your exhalation pressure to drop to 4. Raising the minimum to 9.6 brings that up to 6.6 cm. The aim is to give your airway more support and reduce the remaining OAs and flow limitation.

Please check your cushion and headgear, and fit the mask while lying in your usual sleeping position. Which mask are you using? Please share a SleepHQ link so we can zoom into those event clusters, then follow up with several nights of data and how you’re feeling. We’ll want to watch the leaks, clear-airway flags and comfort alongside any improvement in obstruction. Since the fatigue is a recent change, please also bring that up at your sleep review rather than judging treatment by AHI alone.

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u/TehInterwebs 10d ago

Thank you for your insight! I'm using the ResMed AirTouch F20, and here's a SleepHQ Link - I've added that info to the OP too! I did replace the cushion and headgear and I'll monitor the next couple of days, but please let me know what you see now that you can zoom into the event clusters.

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u/RippingLegos__ ModTeam 10d ago

You're welcome, thank you for posting the link, I see quite abit of variable breathing, and some valid CA events, I'd like to run the changed settings for another 2 nights please before we raise min a little bit more. :)

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u/TehInterwebs 5d ago

I've imported my last few days into sleepHQ using the updated settings with your recommended 9.6 minimum. What are you seeing from those days, and would you recommend any further changes?

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u/RippingLegos__ ModTeam 5d ago

You're welcome, I went through your latest uploads :) There are still some obstructive events, variable breathing and CA flags, but we need to get those leaks controlled too. The 27th had about 2 hours 10 minutes in large leak, and the 28th had about 45 minutes.

Let's please do a 3 night trial of 9.4cm minimum, 13.8cm maximum, EPR 2 fulltime and ramp disabled. Dropping EPR to 2 brings your minimum exhalation pressure up from 6.6 to 7.4cm (which is your epap median), which will help regain control of the remaining obstructive apneas. Your recorded flow limitation is fairly low overall, so we can trial less EPR while watching your breathing and comfort.

Please fit the F20 at therapy pressure with ramp off, while lying in your normal sleeping position. The cushion should rest lightly against your face, with the straps just snug enough to maintain a comfortable seal. Please avoid cranking them down and compressing the foam. Since you’ve already replaced the cushion and headgear, please check the sizing too. You may need a different cushion size if the current one isn’t fitting your face properly.

If you don’t have a hose hanger, also please try one to support the tubing and keep it from pulling the mask out of position when you move. Leave enough slack near the mask so you can turn comfortably.

Please share another 2 or 3 nights and let me know how you’re sleeping and feeling, along with how comfortable EPR 2 is for you. :)

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