Help Please, with Oscar Data

[MikeE3]

So for the 1st 2 weeks it was looking like moving from a DS to the AS10 lowered my AHI a bit. With the DS I was seeing an AHI of +/- 1. The AS10 seemed to lower it to AHI .6 with the EPR=2.

One of the suggestions to me was to raise the EPR to 3. I did that for a week starting July 20th. And now it looks like my AHI went back up.

Do you think I should keep EPR=3 and collect more data or lower it back to 2 and see if my AHI drops?

Here's a summary of my AHI. My next post will be the OSCAR reports for last night.

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And these are the OSCAR screenshots from last night.

(I haven't tried increasing my min pressure yet, which was another suggestion, just trying one change at a time)

[Sleeprider]

Increasing EPR to 3 without an increase in minimum pressure left you more vulnerable to obstructive events. It makes sense that if you lower the minimum EPAP by increasing the amount of exhale pressure relief by 1-cm, that any increase in events should be in obstructive events. I don't see much in the way of CA so, I think you can either go back to EPR 2, or follow the original advise which was EPR 3 with minimum pressure 9.0. The obstructive events seem to occur mostly in clusters over a short period of time. This may be minor positional apnea or chin-tucking. Not suggesting a soft cervical collar, but be aware that a thicker, higher pillow and head/neck position can account for this. http://www.apneaboard.com/wiki/index.php...onal_Apnea

[MikeE3]

Thanks,

I'll stay at EPR=3 and increase min pressure to 9 (already done for tonight) and watch that over the coming days. I don't use a high pillow, it's fairly low, so I'd guess it's more head/neck position than my pillow.

(Sorry about only making 1 of the 2 suggested changes. I guess it goes back to my working days, a techie environment, where we only liked to make 1 change at a time to see the effects of just 'that' change.)

[Geer1]

In a way increasing EPR and pressure at the same time is only making one difference, it increases IPAP by 1 cm while holding EPAP constant. EPAP is a more critical variable than IPAP because it is the minimum pressure the machine uses and is what holds your airway open.

[MikeE3]

I think I get what you're trying to 'teach' me. 

With the min pressure at 8 and EPR=2 ... assuming the machine was delivering the min pressure during inhalation, then on exhalation the pressure would be 6. 

If I change both min pressure to 9 and EPR to 3 ... likewise assuming the machine was delivering the min pressure during inhalation, then on exhalation the pressure would still be 6. 

So even though two value were changed (min from 8 to 9 & EPR from 2 to 3), actually only 1 was changed the min pressure. 

So much to learn about to understand my CPAP therapy. For the last 3 1/2 years I just put the mask on and used the machine. Now I've finally trying to understand how the settings effect my therapy and what the OSCAR graphs are trying to tell me.

[Gideon]

You got it Mike.

[MikeE3]

Hi, time to stop back with updates and questions about my therapy since moving to a Resmed Airsense 10. I started with these settings.

1. Min=8, Max=16, EPR=2 which averaged an AHI=.63

Then after suggestioins from 'you folks' I changed to:

2. Min=8, Max=16, EPR=3 which averaged an AHI=1.17

oops, I didn't make the changed correctly as suggested because I left the Min=8. So I changed that to 9

3. Min=8, Max=16, EPR=3 which averaged an AHI=.83

My last month's average using the recalled Dreamstation 1: AHI=.92

So currently I am doing a bit better with the AS10 but I'm curious if I should go back and try the original settings where I was getting an average AHI=.63 or was that just my 1st week honeymoon with the new machine and everything was just going right for me that 1st week?

I attached my AHI summary and a daily statistics from one of my highest AHI's (1.54 on Aug. 3rd ) on the current settings. I'm still reading and re-reading the Wiki on OSCAR but still such a novice interpreting the graphs, I'm again asking for comments on the attached OSCAR graphs.

Thanks.

   
   
   

[MikeE3]

Crickets ... silence ... not one comment or observation offered? Did I forget to put on my deodorant before posting. 

[pholynyk]

If your highest AHI is just over 1.5, there really isn't anything to comment about. You are in excellent shape, and there is nothing to change.

[Sleeprider]

I'll have to agree with Phil. Once your results are under 2-AHI and you are using only a fraction of your pressure range, this looks pretty good without more input on how you feel. I think most of your residual obstructive events are chin-tucking, but not severe enough to warrant a soft cervical collar, and centrals are not an issue. What do you think?