Vibratory Snore Problem and Crazy OSCAR Data: Please help!

[KMalavathu]

I'm trying to make sense of my cpap data. I've been having unending issues for several months with SH/OSCAR saying I'm leaking too much and I can see on the data I'm snoring like it's my job. When I go to the doctor, the tech makes sure my mask is fitted correctly, of course in the moment it doesn't leak no matter what I do, and I'm sent home. I've been lurking on cpaptalk.com for probably a year and a half and for whatever reason it just occured to me to post my data tonight.

Also, I don't think OSCAR is considering that my machine is a Respironics when it's calculating the leak rate, but I don't know how to change that. According to the paperwork, at my pressure level, I should expect between 31-41 l/min in terms of the flow. So do I actual have a leaking problem or not? I'm not waking up due to air in my eyes, but I could also sleep through the 2nd coming, so that's not necessarily an indicator. And if I don't have a leaking issue, why am I snoring so much?

I just want a good night's sleep. Please help. Info below.

Machine: Philips Respironics Dream Station
Mask: Mirage Quattro
Tube: 15 mm

Machine settings:
APAP 10-12 (based off my sleep study data and Dr.'s recommendation)
EZ Start Off
Auto-humidifier
Ramp time: 30 min
Ramp starting pressure: 10
Flex: Off
Tube Type: 15
Tube Type Lock Off
Mask Type x1
Check Mask Fit On

Sleeping arrangements: CPAP Pillow, 3M Nextcare mouth tape (to prevent drooling), side sleeper to start but I inevitably roll onto my back.

If you're wondering why I tape my mouth AND use a FFM, it's because when I used nasal pillows and taped, my mouth would ALWAYS blow open no matter what tape I used. With the FFM and the tape, my drooling is minimized for a good chunk of the night and when the seal on the tape inevitably breaks I can still stay up to pressure. Is this a bad idea?

Data from Jan 11 2020.jpeg (390.33 KiB) Viewed 1659 times

Thank you all so much in advance.

[Pugsy]

You are having some large leaks but not as bad as SH/OSCAR is reporting. The gray blocks on the graphs.

The software defaults to a ResMed leak number for red line threshold and that number is 24 L/min and that's excess only leak.
Respironics machines report leaks differently and ResMed's line in the sand doesn't work for Respironics machines because Respironics reports the total leak (that top line on the leak graph which is excess leak plus the normal vent rate).

Change the red line threshold to something more fitting for your machine at your pressures.
Respironics doesn't use a fixed red line threshold because the actual line varies with pressure and mask used. More pressure means more vent rate so more total leak.
Go to Preferences/CPAP tab and change the 24 L/min threshold to something around 75 or 80 L/min or just turn that particular statistic off and just use the LL (large leak) on the graphs and the gray areas to monitor large leaks.

Welcome to the forum.

Why are you using such a tight pressure range? Any specific reason?

You still need to work on the leak though...that's still too much leak....the gray areas are too large and too prolonged.

[Bill44133]

It would be a good idea to plug up the leaks. Snoring is usually cured with extra pressure. I would start it out at 12 and let it go up to 20 if it needs to.
Give it a few days and see what your results are.

[Pugsy]

viewtopic.php?f=1&t=155478&p=1182872#p1182872

scroll up to the top of the page at the link above and read what robysue says about VS2 snores.

[KMalavathu]

You are having some large leaks but not as bad as SH/OSCAR is reporting. The gray blocks on the graphs.

The software defaults to a ResMed leak number for red line threshold and that number is 24 L/min and that's excess only leak.
Respironics machines report leaks differently and ResMed's line in the sand doesn't work for Respironics machines because Respironics reports the total leak (that top line on the leak graph which is excess leak plus the normal vent rate).

Change the red line threshold to something more fitting for your machine at your pressures.
Respironics doesn't use a fixed red line threshold because the actual line varies with pressure and mask used. More pressure means more vent rate so more total leak.
Go to Preferences/CPAP tab and change the 24 L/min threshold to something around 75 or 80 L/min or just turn that particular statistic off and just use the LL (large leak) on the graphs and the gray areas to monitor large leaks.

Welcome to the forum.

Why are you using such a tight pressure range? Any specific reason?

You still need to work on the leak though...that's still too much leak....the gray areas are too large and too prolonged.

Thank you so much for your feedback. This is really helpful. I'm using a tight range because when I had my sleep study done my doctor said my range was between 9-12. 9 is useless for me, so I bumped it up to 10. I've been afraid to go over 10 because my doctor said a lot of horrible things about what happens if your pressure is consistantly too high. However, he didn't address the snoring issue, so I'm not sure what to think. I'll try increasing my range and see what happens.

I want to address the leaking, but my biggest issue is that I'm not waking up and noticing the leaking so I have no idea why it's happening. Everything fits fine and I test rolling my head side to side before bed, and at some point things go wrong, but I don't wake up.

[Pugsy]

When you have time please go to your profile and update your equipment so we can see what you are using easily at a glance.
I am lazy...don't like to have to go back and sort through a bunch of posts to maybe find the equipment....and even if I did read it the other day...I won't remember it today.

You are using the Mirage Quattro....not a mask I have any experience with (other than take one look at it and say no way in hell) so I can't help with specific ideas on what you might try.
But read this
https://maskarrayed.wordpress.com/tamin ... e-quattro/

Consider adding a mask liner to the mix. It helps a lot of people.

Probably as the night goes on your normal facial oils get produced and things get a little slick and the mask moves around a bit.
That would be my first suspect since you say you do well at the beginning of the night and not so great later on in the night.

Also consider trying a different mask...the Quattro might not be the best mask for your type of face or something. It's quite old in terms of design years as it was available when I started cpap therapy over 10 years ago. Lots of masks available now with new designs.

[Miss Emerita]

“I've been afraid to go over 10 because my doctor said a lot of horrible things about what happens if your pressure is consistantly too high.”

Just curious: what horrible things did he say could happen? Such an odd thing for him to say.

[Julie]

Not really Miss Emerita (you haven't been here that long, tho' long enough to be a valuable asset). A very few people develop real centrals (not the sleep=wake junk kind) if their pressure is set tooo high (for them - there's not a specific no. to point to unfortunately, but it's generally 15 or more).

[palerider]

I've been afraid to go over 10 because my doctor said a lot of horrible things about what happens if your pressure is consistantly too high.

Your doctor is talking about things he doesn't seem to understand.

A *small percentage* of people can develop some central sleep apnea *at pretty much any pressure*, there's nothing magical about 10.

Raise the pressure, and see what happens, there's nothing at all 'horrible' that might happen.

[Miss Emerita]

Not really Miss Emerita (you haven't been here that long, tho' long enough to be a valuable asset). A very few people develop real centrals (not the sleep=wake junk kind) if their pressure is set tooo high (for them - there's not a specific no. to point to unfortunately, but it's generally 15 or more).

Sure, I understand that high pressure could induce CAs for some people, but the OP wasn't showing any CAs at all and didn't indicate that the doctor saw that as a potential issue. So I'm just curious what the doctor said.