Help analyzing OSCAR data - CA's?

[Phaleronic]

Hi alemon

I would suggest turning EPR off for 3 or 4 nights to see if it clears up those CAs.

[alemon]

Thank you so much for the suggestion! I gave it a try.

So unfortunately I turned off EPR for Friday-night, and while the night felt fine, I felt SO BAD in the AM. Hit-by-bus-sick-with-flu bad. Had to spend most of the day in bed bad. I know one data point does not make a pattern, but I couldn't risk not being able to function today, so I actually set it back, and in fact, set EPR higher to 3, like on my best day - I feel MUCH better today. Admittedly could have just been good rebound-sleep.

I know sometimes it takes time to get used to settings, but I'll have to give that change a try next day-off when I can afford to have a rough day.

Beginning to wonder if I'm sensitive to flow limits on 'normal' breaths? AHI-wise last night was bad, a real uptick from where I was, but at the moment I feel a mildly better than even the rest of the week. My flow charts look bad at lower EPRs when you zoom in - dented and flat-capped a lot of the time. I think they seem a little better on the higher EPR, for whatever reason - maybe I'm bad at breathing out? Maybe I need to try higher pressure still alongside higher EPR?

Don't mind the user flags, I went back through a random night to look at my flow rate graph, and saw *27* near-CA's/breathing stops/major slowdowns (well over that night's marked total of 24) that weren't flagged as they didn't quite hit the definition of apnea -- trying to get OSCAR to pick these up without double-counting them. I've got a pulse-ox that just arrived that I am going to start wearing as well.

https://sleephq.com/public/b858aaa1-6900...c7cdbbc4a6
https://sleephq.com/public/29c1997f-6983...f5dab02cf7

[alemon]

Hi all! Back with more data!

I didn't think it was worth posting til I had my cervical collar - I should have listened to Deborah from the very start and ordered one right away! None of the stores by me had one - but I'm now rocking the ReLeaf. I had a group of just awful days lately, but it was clearly due to positional issues, so I figured it wasn't worth even looking at. I should have figured out how to sleep with it BEFORE going to bed though, it took me awhile, and I definitely unfortunately was up in the middle of the night. 

There's a ton of junk data at the start of these - that was me trying to get comfy and well-positioned, and same after I woke up. I got a SPO2 monitor mostly working too! The past few days were extremely poor sleep, and I woke up feeling like my head was full of static today, but I'm not 100% if it was bad-night or sleep momentum yet, there's a positive edge that's making me think it might be a decent day! I'm feeling hopeful.

I'll be posting two nights of data, specifically because my O2 monitor was working - 18th/19th, in which case, I felt awful, and today, where I think I might be feeling decent! I'm really worried about the O2 drops though, they look a little frightening - I didn't even include them on the flow-rate chart because it made it tough to see.

https://sleephq.com/public/2ad95394-e87f...81a5d850b9
https://sleephq.com/public/9775a107-28de...66de23a265

Additionally, I got some info on sleep stages - looks like I had a ton of REM (28%) last night. Comparing to my fitbit (which I lost), my "normal" REM is ~15%!

[SarcasticDave94]

It's getting better according to the numbers. Reducing AHI by 2 into the 3.x range will become a great benefit. When I last had Apnea therapy in 2019, AHI 3 was just fine with me. I got zeros rather frequent, it was not my goal it just happened due to the higher level ASV I was on. And I actually felt better with a 2.5 to 3 AHI than lower.

[alemon]

That's great to know! I had a few low nights last week, but I didn't wind up feeling as good as I think I might today, and my 'best' day I had a relatively high AHI. Time will tell if it's rebound-sleep or here to stay, but I'm trying to stay positive!

[Deborah K.]

I notice that you are using soft response.  I suggest that you try standard response.  It might help things.

[alemon]

Thank you Deborah, I will try this!

Does anyone have experience with the Pulse Change metric? It being at 50 is very worrying to me, I'm wondering if I should be reaching out to my doctor sooner than scheduled.

[alemon]

Hi all! Quick update - in spite of my AHI #'s not changing too much, I had a FANTASTIC night last night and feel great today, at least through the morning! Two in a row! Thank you all, hoping this pattern continues!

I'm still seeing AHI and flow limits a bit high, but I'm gonna keep with what's working before pushing more changes - I suspect I'm sensitive to flow limits, so might try knocking those lower when I start adding in tweaks. I did take a look through the data, and I think the big change I noticed is I'm no longer seeing the sub-clinical events (where I stopped or slowed breathing for say, ~7 seconds than 10) - previously there were a ton of those, this time I've hardly spotted any. Hoping this sticks!

[alemon]

Hi all,

I spoke too soon. It's like every time I try something new, it works quite well for two days, then falls flat. Last night I had a CA that lasted almost a whole minute  And the night before, even longer. I don't even know if I can intentionally hold my breath that long! I know the correct thing to do is to change EPR, but I had such bad experiences with it I tried just raising pressure to try to help... it did, a bit, but still had a couple scary-long centrals  


Still wearing the soft cervical collar to try to help positional apneas and using the low pillow both these days, it definitely worked the first couple days! I just don't understand, every time I get a couple good nights and think I've figured it out, it's followed by bad ones. Is my best option to tough it out on the lower EPR and hope I adjust? Seeing that whole span of not-breathing at night is pretty scary.

[SarcasticDave94]

I suppose you can try static pressure 8 or 9. It does seem CA are going be a nagging issue.

If you decide these CA are too much, you'll want to call up the doctor about them. If you do decide to act, sooner than another few months.

You probably want the lab sleep study to monitor CA. From there, get the detailed study results. Depending on what that reveals, you might want the bilevel VAuto for comfort, also some CA avoidance by way of timing control called Trigger. If the CA are a real issue, only an ASV treats them, but let's go with test and results first to see what's really necessary.