[Treatment] Help with Oscar data

[marcus10]

Hi all

I'm only two weeks into therapy. Feeling a little better and AHI is good but struggling with a bit of tiredness and frequent awakenings. Don't think I have my pressure settings correct, went from 7 - 12 APAP to CPAP at 9 last night and have EPR on 2. Thinking of turning this off to have a higher EPAP to help with the hypopnea, reras etc. 

Your advice would be really appreciated. 

Thanks,
Marcus

   

[Phaleronic]

Hi marcus10, I'd raise pressure by 1cm and see if the flow limits dissipate.

[staceyburke]

I agree that the flow limits are a problem.  To reduce them we use EPR.  I would set EPR to full time and set it to 3.  See how that improves your sleep...

[marcus10]

Thanks both. I tried CPAP and EPR reduced/off due to lankylefty27’s video. I can now see from my data that turning EPR off has caused flow limitations. I didn’t realise flow limitations were essentially apneas. I will turn EPR back to 3 full time. I’ve changed back to auto and edged my pressure up slightly to 8-12cm. Will let you know how it goes.

[CPAPfriend]

hey marcus10,

flow limitations aren't necessarily problematic but certainly can be. In fact, some percentage of the normal-sleeping population will demonstrate flow limitation without accompanying complaints of daytime symptoms or health complications. I did a video on this: https://youtu.be/8KUvoDnk9C4

That said, it is of course advise to treat them, as they represent obstruction, just in a less intense form than, say, an obstructive apnea.

Regarding your therapy, I suggest you continue to test increasing your minimum pressure and, preferably though not necessarily the only way to proceed, keep EPR enabled. On another note, your leak is not great and could certainly be contributing to fragmenting your sleep. There are countless resources on how to troubleshoot for leak, including here on apneaboard.

[marcus10]

Thanks so much for the advice. I did set my therapy back to EPR 3 which make therapy more comfortable. I then upped pressures to 9 - 13 APAP. 

Flow limitations generally lower over course of the night but a big cluster at the start of the night along with associated hyponeas and RERAs.

A couple of things stood out. The leaks could be better controlled, and they look to be mask leaks as opposed to mouth leaks from the graph in that they are blocky and extended. Secondly, once this is under control then I may still need a little more pressure, perhaps 10-14 to begin with.

Does that sound about right? I've attached the Oscar graph below.