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Machine: Lowenstein Prisma Smart Max Mask Type: Full face mask Mask Make & Model: Fisher & Paykel Humidifier: Lowenstein Aqua CPAP Pressure: 5-14cm CPAP Software: OSCAR
I've been watching lankyleftys vids on UARS in which he shows people with UARS Oscar Data. He says the top half of the flow rate should be 'nice and flat' and points out flow spikes as un-flagged RERAs/Awakenings.
I've been using CPAP for 6 months now after being diagnosed with an AHI of 18, it's reduced my AHI to pretty much zero but a lot of my symptoms persist which has me suspecting UARS.
Are all these spikes in the upper half of my Flow Rate un-flagged RERAs/Awakening ? ..and does this look like UARS?
Jason has his own take on things. It would be quite nice if we could all get a nice “flat-top” flow rate, but I not sure it is really necessary.
Regarding your chart, the spikes are arousals and coupled with your flow limitations could be indicative of RERA and/or UARS. FL’s are very typical in both RERAs and UARS. RERAs almost always have arousals, but UARS do not. If I would call your arousals anything it would be RERAs, not UARS.
Your current settings, which look to be a fixed pressure of 15 with SoftPAP set to 2, may not be optimal. I can’t see the entire left-hand table so am making a SWAG at the settings.
If I would suggest anything it would be to titrate for the best pressure range for you. I dislike guessing at what your correct pressure should be set to and would prefer allowing the machine to figure out the 95% on its own.
Machine: Lowenstein Prisma Smart Max Mask Type: Full face mask Mask Make & Model: Fisher & Paykel Humidifier: Lowenstein Aqua CPAP Pressure: 5-14cm CPAP Software: OSCAR
10-27-2024, 03:54 PM (This post was last modified: 10-27-2024, 04:15 PM by DougalMcGuire. Edited 1 time in total.)
RE: Are these RERAs?
I've been increasing the pressure by 1cm every 5 days or so which has decreased my flagged events but made me feel worse. After raising the pressure above 12 or so the algorithm wasn't responding much anymore so I stopped bothering with it altogether, hence the fixed pressure. I've got SoftPap maxed, which I think is 3, but it's deffo maxed.
I'm considering bi-pap at this stage but I'm worried about blowing the better part of 2k on a machine that might not make any difference.
Does my chart look especially bad and do you think bi-pap would make much of a difference for me?
Your chart is not that bad at all, compared to many we see. The arousals are sleep quality impacting, so we need to get to the bottom of that. I do not think at this time with the information available that a bi-level would be a magic solution. Maybe after we try some things, but not at this moment.
I suggest self-titrating first and working from there.
Try something like:
Mode APAP
Min pressure 8
Max pressure 18
SoftPAP 2
Ramp off
Depending on where things land you can try SoftPAP 3, raise/lower min/max pressure, etc. We will know more once you get a few nights in and post a new chart.
The burst of flow limitations could be an any number of things like chin tucking, hose kinking, nasal congestion, allergies, etc. It is hard to tell from a single nights chart whether it is an ongoing issue or just a one-off.
As you know, CPAP is not a magical device that solves all sleep problems. You likely have had these issues for years, so give it time to find the settings that will help.
