Understanding OSCAR Data

[mmp5000]

Hi everyone, 

I've been using my CPAP since the end of May.  I finally had time to download OSCAR and import the data.  I screenshotted my Overview data, lowest and highest AHI night. 

A few things I am curious about... beginning of July I switched from a dreamwear full face mask (which just goes under the nose & Covers the mouth to a full face AirTouch (over the nose cushion pads).  I am not sure If, from the data, one is better than the other.  Any insights would be helpful. 

Secondly, I just wanted thoughts/insights on the data and help me understand what it means really.  And if there are any suggestions or anything I can do or adjust to get even better sleep. I will check in with my doctor, but was excited to get immediate feedback. 

Thanks all! 
-M

           

[staceyburke]

Min is at 5 that is to low.  I would try 9.  Max pressure is 15 and it looks like you have topped out in some places.  Increase to 17.

I'm sure you will get others to comment.  There are some very excellent people on this site.  I'm not sure of some of these being pressure or position types of events so look for that type of posts.

Leaks are an important part of the first chart. Which ever mask you were using for it you need adjustments. your chart on the left shows full face mask. If that is not correct Change the type of mask to the one you are using on the machine.

[Gideon]

Welcome to the forum.

Your Min Pressure is too low under any circumstance and your flow limits are bad.
Set Min pressure = 9 and
Set EPR = 3 to better manage the flow limits.

[Melman]

I agree with Bonjour's recommendations. I will add  that your Sept chart shows too many leaks with the Airtouch masks (the gray shading). I'm sure they are disrupting your sleep. It may not be the mask but how it's adjusted. See the link to the mask primer in my signature. The AHI is much better with the airtouch mask but again I doubt it is because of differences in the masks. Most of your events in June are clustered indicating a positional problem such as tucking your chin to your chest. See the wiki article on positional apnea. Go to that article on soft cervical collars (below) and select the embedded lnink for positional apnea.

[mmp5000]

Thanks Bonjur - that is helpful information.  Would you mind explaining what EPR is? I googled it and read but I am still not quite sure.

[mmp5000]

I agree with Bonjour's recommendations. I will add  that your Sept chart shows too many leaks with the Airtouch masks (the gray shading). I'm sure they are disrupting your sleep. It may not be the mask but how it's adjusted. See the link to the mask primer in my signature. The AHI is much better with the airtouch mask but again I doubt it is because of differences in the masks. Most of your events in June are clustered indicating a positional problem such as tucking your chin to your chest. See the wiki article on positional apnea. Go to that article on soft cervical collars (below) and select the embedded lnink for positional apnea.

Thanks for the info @Melman.  I do sleep on my stomach a lot.  I have been trying my side more and never my back. So it could be leaks due to position as well as positional apnea, too.

[upsman]

 Would you mind explaining what EPR is? 

EPR is Expiritory Pressure Relief. 

This is a comfort feature that delivers less pressure when you exhale making it easier to exhale against your prescribed pressure.

[Gideon]

EPR,  is listed as a comfort feature that reduces exhale pressures.  On PR machines the similar feature is Flex.  
EPR's implementation is considerably different than PR's Flex.  EPR chart patterns are identical to Pressure Support (PS) on ResMed BiLevels such as the VAuto.  It is limited to the values of 1,2,and 3 cmw.  PS allows fractional increments and can go considerably higher, easily 15+ cmw, which is way too high without other medical reasons.
We often utilize the ResMed AutoSet with EPR as a BiLevel substitute, (The actual BiLevel is a more flexible machine)
 
ResMed AutoSet Dreamstation Auto comparison
Why ResMed?
1. Faster algorithmic response to events than PR.
2. ResMed Responds to Flow Limits
   PR responds to Snores
3. Lower average pressure (PR require a higher pressure to ward off obstructive events)
4. Better to avoid Aerophagia.
5. EPR provides for better treatment of hypopneas, RERAs, Flow Limits, UARS, and snores
6. EPR acts like a BiLevel up to a limit of 3cmw (1,2, or 3cmw) and a max pressure of 20 cmw
7. EPR follows your breathing whereas Flex predicts it with a feeling of fighting to get a breath when it predicts incorrectly
8. More flexibility in treating a greater variety of Apneas and respiratory events.
9. In general provides better therapy.
I have frequently told many DreamStation users that they need to get either the ReaMed AutoSet or BiLevel to get better therapy. 

What is BiLevel?

BiLevel 101:
Pure CPAP delivers a single constant pressure.  This pressure is what splints open the airway.  APAP (AutoSet) is what we prefer to see as it can vary the pressure to suit the situation.  For now, let's forget about APAP.

Basic BiLevel delivers two fixed independent pressures, EPAP is Exhale Pressure and is what actually splints the Airway open, It is the equivalent of "Pressure" in a CPAP and does the same thing.  
IPAP or Inhale pressure is the higher of the two pressures.  Once the Obstructive Apneas are resolved with the Exhale pressure (EPAP), IPAP is used to resolve hypopneas, flow limits, RERAs, and UARS.
The difference in these pressures is called Pressure Support or PS.  PS is always added to EPAP by convention to get IPAP so IPAP = EPAP + PS
FYI if you were to set the EPAP = IPAP you would have a basic pure CPAP functionally.
The above info is derived from Titration guides.

[mmp5000]

Hi All, 
Happy new year to you!! 

I have 3months of new data...  would love some further inputs!   It's clear that my apena has increased over the last few months as well as my leaks.  I have been using a full face mask, which is fairly invasive to sleep.  I will go back to the original one I was using (the cord comes from the head) and see if that makes a difference in leaks. 

As far as the settings, I took feedback I had recieved from this group and updated them mid- sept.  It is very clear in the pressure graph.  Seems like i could lower the max to 18 or so?  Would that make sense?  

Any insights that you find would be very helpful! Let me know if there is more information I can provide.  

Thanks all! 
-M

   

[Sleeprider]

Please post Daily details. The overview is not particularly useful for making the kinds of input you are asking for.