Help Interpreting OSCAR Data for Optimal Treatment

[kalensk]

I am trying to find the optimal settings. Currently using bipap Aircurve 10 with N30i nasal pillows. I tape my mouth as well. Here is some data from various nights at a few different settings. You can also use the following sleephq link to zoom into the data, and if it helps I can also upload a .zip of the actual SD card to import on your end. 

https://sleephq.com/public/teams/share_l...0710bc610d


Any insights or suggestions greatly appreciated! Should I try CPAP (ie: no PS)?

01.05.2025 with PS 3 over 5.8-11 resulted in terrible bloating
   

01.02.2025 with PS 1 over 6-10
   

12.25.2024 with PS 1 over 5-8
   

[Deborah K.]

You are doing much better with your max set at 11.  I cannot see your trigger setting, but if you don't have it set at high or very high, you will benefit from moving it to that.  It would help lower your CAs.

[kalensk]

You are doing much better with your max set at 11.  I cannot see your trigger setting, but if you don't have it set at high or very high, you will benefit from moving it to that.  It would help lower your CAs.

Thanks for the suggestions! Yeah, all those settings I have as default. I will try setting the trigger to high and seeing how that goes especially with regard to CAs. 

Any thoughts on crazy bloating from on the top chart with PS 3 over 5.8-11?

It looks like increasing the PS (pressure support which is similar to EPR) reduces the flow limitations. I am just not sure what pressure settings to use. I am thinking of trying tonight with PS 2 with 4.8-12.

[Deborah K.]

Do you mean that you are suffering from stomach bloating or that the pressure looks high on your chart?  If you mean the chart, it is because that is the pressure you need.  If you mean the chart, do not change your settings unless you just want to make your upper setting 12.  That part would be okay.

[kalensk]

Do you mean that you are suffering from stomach bloating or that the pressure looks high on your chart?  If you mean the chart, it is because that is the pressure you need.  If you mean the chart, do not change your settings unless you just want to make your upper setting 12.  That part would be okay.

Yeah terrible stomach bloating from aerophagia! Can't stand that pressure from a comfort or physical stand point.

[Deborah K.]

If you did not aerophagia while using 10 as your max pressure, I suggest you try 8.4 to 10.  Later we can see what to do about pressure support.

[kalensk]

I just realized something interesting looking at my oura ring data from last night (01.05.2025) and all my CA events occur during REM sleep (ie: roughly around 2:30-3:00am and 5:45-6:15am).

[Deborah K.]

Did you change your pressure to 8.4 to 10? If so, did it stop the aerophagia? If not, you may have to drop the 10 to 9 and see how it goes.

I don't know of a connection between REM sleep and CAs, but maybe someone else will comment.

[kalensk]

Last night (see attached OSCAR data) for the first hour only I started the night off with PS 3.4 and cycle high. For whatever reason my body doesn't like cycle high. Felt like too much. And the PS seemed too high to sleep comfortably.

Around 12:30am I lowered the PS to 1.8 and turned off cycle high and lowered the settings as shown. It's only one night, but those lower settings seemed better. I think my new goal is to dial in the PS to the lowest value such that flow limit is 0 for 95% and ~.1 for 99%. Then I can adjust the minimum pressure based on the medium and 95% statistic. Not sure if this is correct or anything, but worth a shot I suppose.

   

Tonight I think I am going to try PS 2 with 4.2-8. I know 8 is quite low, but we'll see. It looks like my REM sleep might be around 3am and 5am and the pressure maxed out around 8.2.
It looks like I want to target my therapy for REM sleep and looking at last nights data (attached chart). My guess is a fixed setting of around PS 2.2 with 5.2-7.4 give or take a few ~.2's.

Some other settings to try that may benefit others:
- cycle medium/high
- trigger high
- even though I use pillows set it to full face mask to reduce the pressure being blown at you
- Some like the F&P novo micro mask.

[kalensk]

Below is last night's data of PS 2 with 5.0-8.0. It still looks like CA events occurring during REM, and I am still waking up with a bad headache and brain fog. Not good. From looking at the data while primarily targeting CA's during REM I am wondering if PS 1.8 with 6-8.4 would work. It seems like a PS 2 is a bit hard to sleep from a personal comfort level when trying to fall asleep...