Any tips on how to interpret this data?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
User avatar
Shnoozer
Posts: 39
Joined: Tue Oct 22, 2024 4:56 pm

Any tips on how to interpret this data?

Post by Shnoozer » Mon Nov 04, 2024 10:03 am

Hi all,

I am doing OK with the CPAP (day 10) but still struggling a little to understand the OSCAR data. Last night I generally slept well, but once again I am a little torn about what this data means.

The data is here: https://sleephq.com/public/teams/share_ ... 3c0f23c18b

I like my mask but evidently it leaks from time to time, and i worry that it's waking me up. But the data doesn't exactly show that. Also, I'm not sure what a realistic leak rate is :)
And it seems like I am having OA from time to time, without a leak precipitating it, so perhaps the min pressure is too low?

I think it's overall going well but really hoping to learn how to read these charts so any tips or insights much appreciated.

thank you!

User avatar
ozij
Posts: 10370
Joined: Fri Mar 18, 2005 11:52 pm

Re: Any tips on how to interpret this data?

Post by ozij » Mon Nov 04, 2024 9:59 pm

You read the charts by trying to look at what they show at a certain point in time.

Points that stand out:
  • The sawtooth pattern in the flow chart
  • The fact that when the pressure goes down to the minimum the breath flow reduces, becomes limited, and the machine immediately responds by raising the pressure. Raising the pressure is the correct response
  • The fact that when the pressure goes down to the minimum you start snoring, and the machine immediately responds by raising the pressure. Raising the pressure is the correct response.
  • You're spending half the night at inhale pressures of 7.28 or above - that's what the Med(ian) pressure means.
Taken together, these mean that you're letting your machine go down to a pressure which isn't high enough to keep your airway as open as it should be.

If this were my data - and if it was a representative night - I'd set my minimum pressure at 7.2 or 7.4.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Machine: Resmed AirSense10 for Her with Climateline heated hose ; alternating masks.
And now here is my secret, a very simple secret; it is only with the heart that one can see rightly, what is essential is invisible to the eye.
Antoine de Saint-Exupery

Good advice is compromised by missing data
Forum member Dog Slobber Nov. 2023

User avatar
Shnoozer
Posts: 39
Joined: Tue Oct 22, 2024 4:56 pm

Re: Any tips on how to interpret this data?

Post by Shnoozer » Mon Nov 04, 2024 10:17 pm

Thanks for that info. I'll try bumping up the pressure.

What do you learn from the sawtooth pattern?

User avatar
ozij
Posts: 10370
Joined: Fri Mar 18, 2005 11:52 pm

Re: Any tips on how to interpret this data?

Post by ozij » Tue Nov 05, 2024 12:26 am

Shnoozer wrote:
Mon Nov 04, 2024 10:17 pm
Thanks for that info. I'll try bumping up the pressure.

What do you learn from the sawtooth pattern?
that you're letting your machine go down to a pressure which isn't high enough for you to stay on it for more than a very short time before your airway starts collapsing.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Machine: Resmed AirSense10 for Her with Climateline heated hose ; alternating masks.
And now here is my secret, a very simple secret; it is only with the heart that one can see rightly, what is essential is invisible to the eye.
Antoine de Saint-Exupery

Good advice is compromised by missing data
Forum member Dog Slobber Nov. 2023

User avatar
Shnoozer
Posts: 39
Joined: Tue Oct 22, 2024 4:56 pm

Re: Any tips on how to interpret this data?

Post by Shnoozer » Tue Nov 05, 2024 10:06 am

ozij wrote:
Tue Nov 05, 2024 12:26 am
Shnoozer wrote:
Mon Nov 04, 2024 10:17 pm
What do you learn from the sawtooth pattern?
that you're letting your machine go down to a pressure which isn't high enough for you to stay on it for more than a very short time before your airway starts collapsing.
Oh I see. I thought I needed to understand a complex interpretation of the pattern, like reading an EKG, but now I'm understanding that there there is simply an undesirable pattern of going too low (which causes snoring/flow limit) and then raising back up, and repeating that pattern.

I raised the pressure just a bit, to 6.4, and already see an improvement in the pattern. That's just one night data but it seems like it might be worth bumping it up one more time.

You also said:
ozij wrote:
Tue Nov 05, 2024 12:26 am
The fact that when the pressure goes down to the minimum the breath flow reduces, becomes limited, and the machine immediately responds by raising the pressure. Raising the pressure is the correct response
Am I understanding correctly that you are seeing a correlation in flow limit increase after the pressure has been low for a while, just prior to the increase of pressure which then lowers the flow limit? I guess the same pattern is apparent for snoring, though less prominent.

User avatar
robysue1
Posts: 1216
Joined: Sun Sep 18, 2022 3:39 pm
Location: Buffalo, NY

Re: Any tips on how to interpret this data?

Post by robysue1 » Tue Nov 05, 2024 10:13 am

Shnoozer wrote:
Mon Nov 04, 2024 10:03 am
I like my mask but evidently it leaks from time to time, and i worry that it's waking me up. But the data doesn't exactly show that.
When you say that you are worried that the leaks are waking you up, do you mean that you remember waking up a lot during the night, but you don't know or are not sure that you remember the mask leaking at the time you are awake?

Or do you mean that you are worried about a lot of mini-wakes/arousals that you just don't remember when you wake up in the morning?


[qute]Also, I'm not sure what a realistic leak rate is :)[/quote]Resmed machines report only excess, unintentional leaks. Your overall leak data indicates that yes, you are experiencing some frequent leaks. But most of the time those leaks stay well below Resmed's official definition of "large leak", which is a leak rate of 24 L/min or higher. And most of the time, your largest leaks are short lived. There's one largish leak that might be problematic: The leak between 12:25 and 1:00AM looks like this:
Image

That leak is just below the "red line" and because the flow rate is depressed throughout the period of the leak, this is an example where a leak is just barely large enough and long enough where it had the potential to adversely affect your therapy a bit. But having said that, I'll also add, that if you zoom in enough to see the individual breaths, they look like normal sleep breathing. The ragged breathing that starts at just after 12:50 does look like an arousal. And it is reasonable to assume that this long, persistent, and borderline large leak probably did wake you up, particularly since the leak goes to 0 after you re-establish good sleep breathing.

And I'll also add this: Roughly 30-40 minutes of largish leaks over a course of an 8 1/2 hour night is probably not something to get worried about, particularly if you're not waking up with a dry mouth and you are waking up in the morning feeling decent enough.

In other words, this is a leak line that is not "great" but is far from "awful". If it were my data, I would not base an intervention on just this one night. Now, if I were having a 30 minute leak every night that looks like that one between 12:25 and 1:00 AND if I was waking up with a dry mouth every morning, then I might start trying to figure out if there's an easy way to stop it from happening.

But there's also the fact that you are worried about leaks potentially causing wakes. My own view about wakes is this: If I have a few short wakes during the night and I get right back to sleep and I wake up in the morning feeling fine, there's no point in worrying about those few short wakes. If I know I'm waking up a lot or if I have trouble getting back to sleep after one or more wakes or if I'm waking up really tired and cranky, then some investigation into the wakes is worthwhile. The first thing I do to try to track troublesome wakes is to turn the machine OFF and then back ON. This provides a visual break in the graphs when viewed in Oscar or SleepyHQ. That in turn can help me figure out what might have caused the wake. And I can also usually tell how long it took me to get back to a sound sleep.


And it seems like I am having OA from time to time, without a leak precipitating it, so perhaps the min pressure is too low?
Like Ozij, I think your minimum pressure setting may be a bit too low, and for the same reasons: Your snores and your flow limitations seem to start when the pressure hits your minimum setting and they resolve as the pressure is increased. Your AHI is low enough that I wouldn't worry about the few events that are getting through the CPAP defenses. (Some of them may be "false positives" anyway since some of them occur when it looks like you may have been awake or transitioning back to sleep after an arousal.)
Joined as robysue on 9/18/10. Forgot my password & the email I used was on a machine that has long since died & gone to computer heaven.

Correct number of posts is 7250 as robysue + what I have as robysue1

Profile pic: Frozen Niagara Falls

User avatar
Shnoozer
Posts: 39
Joined: Tue Oct 22, 2024 4:56 pm

Re: Any tips on how to interpret this data?

Post by Shnoozer » Tue Nov 05, 2024 11:11 am

robysue1 wrote:
Tue Nov 05, 2024 10:13 am
When you say that you are worried that the leaks are waking you up, do you mean that you remember waking up a lot during the night, but you don't know or are not sure that you remember the mask leaking at the time you are awake?

Or do you mean that you are worried about a lot of mini-wakes/arousals that you just don't remember when you wake up in the morning?

I don't recall being woken up by leaks except once when I think the mask had been nearly off my face - that doesn't happen much. Most of these leaks I have no recollection of and don't remember being woken. So, I am just trying to dial it in and prevent wake-ups IF they are even happening. Perhaps I'm too concerned about it, but I have this feeling, a sort of intuition, that the leaks are disturbing my sleep. The nasal pillows are getting more comfortable, and I have learned how to quickly position them in the right place on my nose. That's good, but I wonder if I am doing that during the night more than I realize due to leaks, then not remembering it.

In the end, I am feeling great in the morning so the overall picture is positive. Thank you for your tips!

User avatar
Shnoozer
Posts: 39
Joined: Tue Oct 22, 2024 4:56 pm

Re: Any tips on how to interpret this data?

Post by Shnoozer » Tue Nov 12, 2024 3:56 pm

hi all -

A bit of time has gone by and things are going well. I've had the pressure at 6.8 min and hardly any events. But, still quite a lot of leaks.

I have switched over to the P10, just as a trial, and the leaks are definitely lower with that one than the p30i. ButI still worry it's just a bit higher than I'd like it since I now remember being woken up by a leak from time to time during the night. Attached is the OSCAR data, I wonder if anyone could take a look.

thank you!

Image

User avatar
zonker
Posts: 11189
Joined: Fri Jun 19, 2015 4:36 pm

Re: Any tips on how to interpret this data?

Post by zonker » Tue Nov 12, 2024 11:51 pm

Shnoozer wrote:
Tue Nov 12, 2024 3:56 pm

I have switched over to the P10, just as a trial, and the leaks are definitely lower with that one than the p30i.
I find that what works best for me and my P10 is to have it at a slight angle so that the bottom stays against my upper lip. also, I started using lansinoh (lanolin) when I began and still use it as I find it has a slightly tacky feel to it which helps the cushion adhere to my nostrils.
people say i'm self absorbed.
but that's enough about them.
Oscar-Win
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1-Win64.exe
Oscar-Mac
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1.dmg

User avatar
Shnoozer
Posts: 39
Joined: Tue Oct 22, 2024 4:56 pm

Re: Any tips on how to interpret this data?

Post by Shnoozer » Wed Nov 13, 2024 11:54 am

The lanolin does seem to help, yea! I tried it last night and it's kind of waxy and seems to help have a good seal. I also switched to the large size pillows and I'm pretty sure that's a better fit for me. I slept through the night, and the P10 is getting pretty comfortable now.

Except more LEAKS. A couple of times I noticed air coming from my mouth during the night I tape my mouth with Somnifix tape strips. They work pretty well and only occasionally does a little air sneak out the side, etc. But each time I look at my OSCAR chart I just see tons of leaking :) Last night the mask must have come loose for a bit cause there was an 8 minute leak-fest, but I guess that's not a huge deal. It's the all-night misc. leaks that worries me. I still don't quite understand how much I should worry about these leaks though - I know some leaking it normal, but how much?


Image

User avatar
zonker
Posts: 11189
Joined: Fri Jun 19, 2015 4:36 pm

Re: Any tips on how to interpret this data?

Post by zonker » Wed Nov 13, 2024 12:50 pm

Shnoozer wrote:
Wed Nov 13, 2024 11:54 am
The lanolin does seem to help, yea!
Image

in my humble opinion, if you are getting those nice low numbers AND are waking up refreshed, then those leaks don't matter. the only time it would matter is if the leaks are waking you up. then you have a problem.

and I'm really not the one to see about reducing leaks. i'll leave that to my betters here on the forum!
people say i'm self absorbed.
but that's enough about them.
Oscar-Win
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1-Win64.exe
Oscar-Mac
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1.dmg

User avatar
Shnoozer
Posts: 39
Joined: Tue Oct 22, 2024 4:56 pm

Re: Any tips on how to interpret this data?

Post by Shnoozer » Wed Nov 13, 2024 2:37 pm

zonker wrote:
Wed Nov 13, 2024 12:50 pm
in my humble opinion, if you are getting those nice low numbers AND are waking up refreshed, then those leaks don't matter. the only time it would matter is if the leaks are waking you up. then you have a problem.
I hear you, and my AHI is certainly good! More and more I think Im fussing with the mask during the night more than I should, and maybe the leaks are disrupting me. But, honestly I don't really know. It seems hard to imagine that the noisy leaks wouldn't be causing issues, but maybe I'm just getting OCD about it :)

User avatar
zonker
Posts: 11189
Joined: Fri Jun 19, 2015 4:36 pm

Re: Any tips on how to interpret this data?

Post by zonker » Wed Nov 13, 2024 5:45 pm

Shnoozer wrote:
Wed Nov 13, 2024 2:37 pm


I hear you, and my AHI is certainly good! More and more I think Im fussing with the mask during the night more than I should, and maybe the leaks are disrupting me. But, honestly I don't really know. It seems hard to imagine that the noisy leaks wouldn't be causing issues, but maybe I'm just getting OCD about it :)
heh. after nine years as a hosehead, I will STILL get the occasional night where my P10 leaks like a sieve. in fact, it happened a couple of nights ago, which is prolly what prompted me to reply.

I know it's easier said than done, but try to relax to it. all of this gets easier the longer you stick with it.
people say i'm self absorbed.
but that's enough about them.
Oscar-Win
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1-Win64.exe
Oscar-Mac
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1.dmg

User avatar
Shnoozer
Posts: 39
Joined: Tue Oct 22, 2024 4:56 pm

Re: Any tips on how to interpret this data?

Post by Shnoozer » Thu Nov 14, 2024 11:25 am

zonker wrote:
Wed Nov 13, 2024 5:45 pm
I know it's easier said than done, but try to relax to it. all of this gets easier the longer you stick with it.
I hear you :) I'm trying to just settle i and give it some time, but I love optimizing things in general and the CPAP is a big puzzle that includes hardware, software, metrics, graphs, etc. so it's hard to stop trying to dial it in. But ya I know what you mean!

User avatar
Shnoozer
Posts: 39
Joined: Tue Oct 22, 2024 4:56 pm

Re: Any tips on how to interpret this data?

Post by Shnoozer » Thu Nov 14, 2024 11:28 am

ozij wrote:
Mon Nov 04, 2024 9:59 pm
If this were my data - and if it was a representative night - I'd set my minimum pressure at 7.2 or 7.4.
I've slowly upped the pressure, now at 6.8. It's certainly improved. Is the goal to basically have zero instances of FL at the low pressure? I could increase it a bit more, but I wonder if there is a downside to having the min. higher than it needs to be.

Image