[CPAP] Understanding OSCAR data to establish pressure range?

[RoyMunson]

Hello,

I'm quite new to all of this; it's been almost a month? Quick quick overview: haven't slept well in years. Was suggested to do a sleep study and determined to have moderate sleep apnea (19 AHI).

I was given my machine and told my pressure range is 4-20; I'm using a ResMed F20 which I like other than some nose bridge annoyances. I still find myself waking up several times a night, usually when pressure seems like its high-ish (12+). The past few nights I woke up feeling a bit bloated. I'm a solid 3 months away from my follow up appointment with my sleep doc; it already seems like getting time from them is going to be difficult. I'm hoping to understand how to read the data; time spent reading threads here I'm hoping will help.

I don't know what my actual prescription is; it sounds like the intent was to have my starting pressure be 4. I bumped it to 5 myself just to see if it would make breathing feel slightly easier. Is it normal to just have the full allowable range set (4-20)? I wake up quite a bit and find the pressure at 15+ and it's just uncomfortable when it seems like I'm at a much lower number most of the night.

Would anyone be kind enough to take a quick glance and see if anything jumps out with my settings / results?

Thanks!

[lparent9]

4 is the minimum a machine can go.

20 is the maximum the machine can go.

I use the EPR to relieve pressure when exhaling. You could use it. I set mine to 3 full time. You want to add 3 points to your min pressure otherwise at 4 it won't do its job with the EPR enabled.

You seem to be suffering from aerophagia, swallowing air.

I'd look at the 95% average your max pressure goes and use it as your max pressure.

For the min pressure, increase slowly. I increase by 0.5 point.

Give it time, you're starting a new therapy and your body isn't used to this new way of breathing and sleeping.

[staceyburke]

Your min is at 4. You need it to 7 to get EPR 3. 

Min 7
EPR 3

Inhale would be 7,  exhale 4. That will help your flow limits. Flow limits are apnea just the same as O and H events but they are not calculated in the AHI.

[RoyMunson]

Thanks for the tips thus far; I'll set min to 7 to take advantage of EPR 3. My DME actually set this for me but didn't seem to know the min pressure had to go up from 4. I'm also tempted to cap the max at 95% percentile and see how it goes. Thanks for the tips!

[Crimson Nape]

You may wish to try 8 cm to 16 cm, with an EPR of 3, set to Full Time. An 8 cm pressure range may still cause arousals. If this occurs, we can look at further narrowing of the range. Turning off the ramp feature is also recommended. Again, this will reduce the range of your pressure changing, and you will immediately be in your therapy pressure envelope.

Keep us informed of your decision and progress.

- Red

[Gideon]

It is flow l{mits that are driving your pressure, set Min pressure to 7 and then let's see. What happens. Unle# we need to artificially limit max pressure leave it there for now.

[RoyMunson]

Hello; back after a couple of days. The min pressure at 7 definitely makes it easier to breathe. The flow limits are still there, but seem to have calmed down a bit. I'm not sure what level is considered above normal for some of these, such as, central apnea events (17 total last night). I caught myself waking up a few times feeling like I wasn't breathing, some of those correlate to the CA events I see on the graph. Seems there isn't too much I can try to do for CA events and CPAP?

[staceyburke]

The central events you have are called treatment emergent and go away as you get use to the EPR therapy. Keep track and if they stay constant for a few weeks they should start  to deminish over time.  If they increase or are causing you problems you can reduce the EPR.