Help Interpreting Oscar data

[HN2207]

Hello,

I am a new member of the site, though I have looked at some messages on here in the past. I am trying CPAP agin after having tried in the past but having had issues with blocked ears (due to TMJ?), tinnitus and not great results with how I feel (I have ME/CFS also, so not sure that this will be a panacea).

I recently restarted therapy and have been getting AHIs of c. 1.9 - 3.2 at the lowest setting of 4cm H2O, which seems to be pretty good but am wondering if I can do better. So I would like to titrate and, last night, tried a range of 4.0 - 8.6. As you can see from the results, there was no change.

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[staceyburke]

Welcome.   A cpap machine is made for children as well as adults.  4 is the setting for a child.  You are never near the min 4 you have set.  I would change both the min and max to help with your therapy.

Min 8 max 11

I would try at some point EPR (exhale pressure relief) but it does cause some people to have more central apnea.  Because of that I won't suggest that until we set your min and max correctly.

[HN2207]

Hi Stacey,

Thank you for the feedback. I see that the pressure did go below 5 during the night. Is that not valid?

I am a little concerned about putting the pressure higher than necessary because I had problems with blocked ears from CPAP in the past, and get it now also, since recommencing treatment.

Thanks

[Old Steve]

A setting of 8cm isn't higher than necessary, you are having Apneas and need to stop as many of them as possible.  I would feel as if i was suffocating at 4cm or 5cm, they are settings for a child.

[HN2207]

So I upped the min a max pressures last night. No change in OAs but big increase in Central Apneas.

Any further advice? Up the max again and see what happens to OAs tonight?

Thank you.

[HN2207]

Thanks Steve. Is 4cm H2O not more than the pressure at which a human being breathes without a CPAP machine though?

[Old Steve]

A setting of 4cm is not enough pressure to keep your airway open.  I would suggest that you take staceyburke's advice and to start, raise your pressure to 8cm and max to 11.   

 Also, you are having some leaks, they are not real bad but as your pressure increases so may your leaks.   Leaks can cause some arousals due to the pressure changes.  Looking at your last chart it appears that you might be having a little positional apnea. This is normally caused by chin tucking, sleeping on your back or any sleeping position where your neck gets in a position that it starts cutting off your air.  Imagine a water hose that you bend to cut off the water.  I have to sleep on my side to stop positional apnea some folks use a soft cervical collar to help stop the chin tucking.   As to the Clear Airways, how many did your sleep test show?  If not many they are most likely treatment related and most should go away in time.   Give the new settings a few days and post some more charts.

Good luck.