ejbpesca

I do the same snoozy suzie. It startles me sometimes to think my breathing is about to shut down. I begin to consciously breathe but very soon the bit of panic leaves. Conscious apnea (I made that up) has been happening to me as far back as I can remember. My cpap therapy goes back 17 years. I can't remember how far back I first noticed that I stopped breathing at times and took a startled breath to resume.

Just saw a post from an F40 user who also has auto-start fail with that hybrid mask set to Pillows. My Evora FF set to FF starts the AirSense with one breath, every time for six months. Set to pillows, no auto-start. I am very curious as to why.

Thank you for posting that OSCAR report.

I think it may be one from a nasal mask and I see single-pressure mode. I use APAP mode 9 to 19 cm. It is strange for me to see a straight pressure line, very little flow limitations, and even mask pressure. My reports are a varying mess of pressure changes, flow limitation spikes, and a range from 0.50 to 7.00 AHI. It has been suggested I record a video of my sleeping to see what goes on in my restless nights. My theory is that when I roll from side to back and then to the other side the mask loses its seal then regains it as I move again. When this happens all graphs spike and numerous apnea events are registered during the leak time.

Pain causes me to move a lot in my sleep. Once in a while, I realize I have slept in one position (left side) for about six hours. On these rare occasions, my OSCAR graphs are smooth with a low AHI, and I feel much better than usual. I have been doing better with the Evora FF to control leaks. Maybe my next mask, the F40 will be even better keeping a seal on my bearded, moving face. It has been a long 17 years of severe apnea with not very effective APAP therapy.

Some claim fixing large leaks will clear up AHI events. When large leaks occur everything goes up on my OSCAR report including mask pressure. Mask pressure does not drop off, it goes up but I don't think therapy is being delivered. I feel the whole system is compromised during large leakage including its ability to report events accurately. My leaks are out the sides of a full face mask. They wake me sometimes due to air rushing out of the periphery of the mask. This would be better described as a blow out.

Auto Start ceases to function with an Evora FF mask and AirSense 10 set to pillows. Return to the full face mask setting and Auto Start functions. I wonder if AutoStart not working with the pillows setting is trying to tell me something.

Your Flow Limitations graph is not visible on the posted OSCAR reports. It is below the visible graphs. The graphs can be moved up and down the report. I see the 199 Flow Limitation events which is something my APAP machine does not show in Events. My OSCAR has a graph and a number that is like a score to show the flow limitation level. Since I have chronic flow limitations my events would probably be a large number like yours, but I do not know what your APAP machine considers as an EVENT, that is, how limited must the airflow be before it registers it as an event. Your flow limitations graph may give you a better indication of your flow limitations than the events. My flow limitation graph is different each sleep session and is never flat which would be no limitations.

Flow limitations are a hot topic for CPAP users and those who give CPAP advice. If their AHI is decent, the next thing to improve is flow limitations. I have my EPR set to 2. I will take Sierra's advice and increase it to 3 which requires going into the Clinical Menu on my machine. You may have access to EPR settings on your machine but if not, do a net search for instructions on how to access pressure changes and EPR changes for your brand/model of CPAP machine. You will need to get into the Clinical Menu also to set pressure min. and max.

Your air pressure settings are surprisingly low. Do you have the report from your sleep study? It shows the pressure levels used to stop apneas. Did you DME (supplier of the machine) or a technician set the pressures or are those the default settings of a new machine? Your min. 4cm is as low as my machine goes. Ask whoever set your machine if that is the default or a prescribed setting for you. If no one sets the machine is has default pressures.

4 cm min. and 20 cm max. are the lowest and highest pressures of my machine. Your settings look very low and I see your pressure is maxing out to 8 cm, so at least increase the maximum level it can reach. The goal is to have it just high enough that the pressure graph does not show it maxing out. This is never perfect, maxing out may still happen at times. It is suggested pressure changes be done in small increments over several sleep sessions, eg .5 to 1 per adjustment.

Search Flow Limitations OSCAR for articles on how to interpret them on OSCAR. I have high flow limitations for reasons that I think I cannot change. Mine go up and down as does the effects on my airways due to my allergies. What I pay much attention to is the Leak Rate.

I have used an APAP machine for 17 years. I am not an expert in therapy but have been using and studying OSCAR for a few years. OSCAR can be overwhelming to me....so much data!

It is now a curiosity for me as to why the auto start of the AirSense 10 ceases to function with the machine set to Pillows. The auto-off still works. If I cover the exhaust ports on the mask and blow air through it forcefully, this will sometimes trigger auto-on to function.

I think I have been fretting over high AHI scores needlessly for years due to my often Large Leak cluster of events. It has always been a wonder as to why many times I may feel better with a 7.30 AHI than a 2.75 AHI and a frustration that for 18 years I could never get an AHI below 1.75 yet I see other's OSCAR reports showing frequent < 1.00 and even 0.00 scores. I am concluding that if you Large Leak for more than a few seconds your AHI is not accurate. Take out the OAs, CAs, and UAs of a Large Leak cluster then calculate the AHI for a more accurate score especially if the events are within a tight cluster of an event every minute (AHI 60.00) which seems like more suffocation, not apneas. Why average in a short time period of AHI 60.00 with hours of AHI < 2.00? Does this not skew the AHI?

The possibility that my AirSense 10 is false flagging of events during a Large Leak gray area is part of my issue with a possibly skewed AHI. I can have 20 events within a 20-minute cluster within a gray area. The large amount of compacted events raises the AHI giving a false indication of the quality of therapy over a total sleep session. In other words, pull out the Large Leak time and its cluster of events from X hours of sleep and the AHI score will drop dramatically. Why be concerned over a 7.00+ AHI when it was a 20-30 minute cluster of events within a Large Leak gray area that caused the score? The AHI would be < 1.00 with the cluster excluded. Even if the events are accurate, they skew AHI's meaning toward the overall sleep session with over 90% of the sleep time in an AHI of <.50.

If a cluster of events is seen on a report even though over a gray Large Leak area the interpretation includes, "positional," and "chin tucking." The advice will be to use a low pillow and a soft cervical collar and may give suggestions on how not to roll to the back during sleep. Some CPAP users strap their chins, tape their mouths, collar their necks, and put nostril-opening spring strips to their noses when another mask could be all that is needed to get AHI down by reducing Large Leaks.

I don't expect perfection from anyone or a machine, but I would like those concerned with CPAP therapy to take a closer look at apnea clusters within Large Leak gray areas and give more consideration to the possibility that these event clusters may not be caused only by sleeping positions that restrict airflow. They could be false flagged events due to a Large Leak. How can the machine flag events and measure airflow limitation if the air pressure is lost in the mask by air freely flowing out its perimeter? Does the rate of 75 events an hour make sense inside a Large Leak gray area? Could not the cluster of events be eliminated by fixing the leak problem as opposed to wearing a soft collar, mouth tape, or a chin strap? I do understand that it is jaw-dropping that may cause the Large Leak, but is it worth disturbing sleep with a collar if one or two event clusters in a gray Large Leak area are showing nonexistent events? Would not a mask that functions with a jaw drop be better advice than a collar or at least give it as an alternative try before a collar?

Thank you very much. ejbpesca

The reason I asked this question is that no setting is offered by Fisher Paykel for their Evora hybrid. ResMed says to use the nasal setting for their hybrid. The two masks look much alike and both send air to the nostrils. Fisher Paykel has no answer and ResMed cannot be contacted by consumers. My healthcare provider does not know anything about CPAP and my DME is sales only.