Help Interpreting OSCAR Data for Optimal Treatment

[kalensk]

One other potential idea is that I need even higher IPAP pressures closer to around 10 to target REM events. Looking at another night where I allowed for higher pressures and seeing how closer it treated the events. So maybe something like PS 4 with 6-10, or perhaps PS 2.2 with 7.8-10. That is something roughly around that 9-11 range for IPAP.

   

[kalensk]

So I have been trying a PS of 4 with basically around 6/10 pressures. The first two nights it felt great probably since I was so sleep deprived and everything. But the third or fourth night my AHI shot way up and have a headache again.

Basically, all of the events happen during REM which you can typically see around the ~3-4am mark and ~6am mark. I do like how the flow limits are much less with PS of 4, but the leak is quite high even though I am using a N30I nasal pillow mask with mouth taping.

01.08.2025 - This was on S-mode with fixed pressure of PS 4 and 6/10. This was the first and only night I slept without waking up!!! But again lots of CA's during REM and likely since I was quite sleep deprived from before.
   

01.09.2025 - I tried various pressures in the 2.6 to 4 range while keeping the high pressure at 10. This was to see what various PS would do. For example at the start of the night it was PS 2.6 with 7.4/10 and at 5am it was PS 3.4 with 6.6/10
   

01.10.2025 - This was vAuto seeing if an even higher pressure is needed so PS 4 and 6/11. Woke up with a headache. Tons of CA's during REM.
   


Any insights or suggestions on PS and pressure settings? S-mode vs. vAuto?

[kalensk]

I am still trying to figure out the best pressures. It appears having a small pressure support of around ~0.4 or so results in no flow limitations. And a pressure of roughly around 9-11 is best? Both nights I still woke up to go to the bathroom, and I have yet to dream which are signs for me of sleep apnea. 

Any insights, suggestions, or comments would be much appreciated. 

And here is my sleephq data that allows you to really zoom in on things:
https://sleephq.com/public/teams/share_l.../dashboard

Here is from 01.13.2025 where I used a PS of 0.4 which showed no flow limitations.
   

Here is from 01.14.2025 where there was a PS of 0 which showed some flow limitations.
   

[Deborah K.]

I had suggested you raise your TRIGGER to high or very high, NOT your cycle.  Did you raise your trigger?  That helps lessen the CAs.  I think maybe you did because your CAs are much lower now.

I'm sure you could raise your PS higher if you start seeing more flow limits.  It was not the high PS that bothered you that one night, it was because you raised your cycle to high.

As to your pressure, if you raise your max to 11 and aerophagia does not reappear, keep it there for a while.  If it does, drop it to 10.  As time passes your body adjusts to changes, and we should soon be able to see what pressure limit works for you.

As to the dreams, don't worry about them.  We all dream at night but don't always remember the dreams.

The main question now is how you are sleeping.  Are you feeling better?  Is your sleep more comfortable?

[kalensk]

I had suggested you raise your TRIGGER to high or very high, NOT your cycle.  Did you raise your trigger?  That helps lessen the CAs.  I think maybe you did because your CAs are much lower now.

I'm sure you could raise your PS higher if you start seeing more flow limits.  It was not the high PS that bothered you that one night, it was because you raised your cycle to high.

As to your pressure, if you raise your max to 11 and aerophagia does not reappear, keep it there for a while.  If it does, drop it to 10.  As time passes your body adjusts to changes, and we should soon be able to see what pressure limit works for you.

As to the dreams, don't worry about them.  We all dream at night but don't always remember the dreams.

The main question now is how you are sleeping.  Are you feeling better?  Is your sleep more comfortable?

Thank you for your help! Looks like I tried cycle instead of trigger to high. Oops. I will try trigger tonight.


My max pressure is set for 13 at the moment, and the data shows I have not hit that yet. I will try keeping it 1cm higher than my max just to be sure.

So far no major aerophagia, looks like my body has adjusted to it.

In terms of sleeping I am waking up quite slow in the mornings and brain is not sharp at all. Feeling quite sluggish. Seems like the brain is not getting nearly enough restful sleep. Nighttime feels relatively fine, but I randomly wake up around 4:30-5:30am or so which still doesn't seem good based on my history and context. That is, I am relatively young and "healthy" and no real reason to wake up which for me personally is a major sleep apnea symtptom.

[Deborah K.]

Hmm. Do you wake up for bathroom breaks or for no known reason? If it's not for bathroom breaks, I suggest you stay in bed, using your machine, until you fall back to sleep. The hope is that your body will adjust and learn to stay asleep.

Looking at your recent charts, you should raise your minimum pressure to 9. That's where your median pressure is right now, so it would be good to set it there.