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08-08-2024, 11:10 AM (This post was last modified: 08-08-2024, 11:22 AM by alemon.
Edit Reason: Added original study info
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Help analyzing OSCAR data - CA's?
Hey folks,
Just wanting insight. I've been on this a week, a few ups and downs, but only got my SD card yesterday. I've been exhausted the past two years, really dragging - but this year especially I've just felt like I'm dying. So tired I've been unable to function. Finally saw a sleep doc, their sleep test said 7 AHI, 17 RDI, did not differentiate central apneas. Unfortunately I can't often breathe through my nose, so I have to do a full face mask - I don't actually mind it save for my nose currently looks like rudolph the reindeer, I think I'm sensitive to the silicone they use - I tried adding some cloth, and it helped, a little. Super high nose bridge, so masks are always an issue for me. I have a dreamwear on the way to try.
My machine wasn't set at all, 4-20, and I had no prescription numbers. My second day on default settings was fantastic, my 3rd and 4th were back to normal (bad). I tried bumping up minimum pressure to 5, then 6. This data is from that, last night, first day at higher pressure. Had more mask problems than usual, I was trying a larger size to give my nose a break. I'm really worried because I appear to have a ton of central apneas, which sounds really scary?!
I was really disheartened over having one day that was SO good, I had so much energy, and then several days that just weren't. If anyone is kind enough to help, I'd appreciate it.
You are sleeping a good number of hours, which is great for a beginner!
If I were you I would ask your doctor, or the sleep study people, to tell you the breakdown of your events, in particular, how many of them were CAs. If not many were CAs then your CAs are treatment-emergent and will lessen over time as you adjust to your therapy. If most were CAs, it's a different story and might need to be treated differently. If they have no answer, just continue on and see what happens as time passes.
Don't worry. We will help you as we can. Don't be surprised that each night feels different, especially so early on. We do breathe differently each night, but as you adjust your sleep will start to feel more and more normal.
As to masks, I too started with a full-face mask but switched to a pillows mask which I found much more comfortable because there is nothing much touching your face, so you don't end up with a sore nose bridge or face. Also, the air goes right up your nose, where you need it. If you mouth breathe, as I do, you can use mouth tape. I thought I would hate it, but once it's on I don't even feel it. Just something to think about.
Thank you so much for the encouragement! I haven't had tons of issues sleeping with the mask/machine tbqh, though surface-level sleep is a bit worse - my main issue is it just doesn't fit my nose bridge, presses too hard no matter how I adjust. But last night I followed through the recommended mask-fitting thread and it WAS a lot better. It definitely doesn't work for my nose, but between that and a hydrocolloid bandage I put over the pressure point no more skin-upset AND no leaks!
I also:
Used the correct-size mask after fitting (medium)
Bumped my minimum pressure to 6.4 (trying to get this a bit higher)
Set EPR down to 2
Saw a rec to try sleeping with a pillow beneath my chin/shoulder so I didn't chin tuck
AND I've gone from 6~9 AHI events to ~3!! (I think, OSCAR recorded me trying to fit the mask earlier in the day lol), but the CA count way dropped!
I was up at 4AM for a bit haha, and I still don't notice how well I've slept in the AM, I tend to drag, but I'm hoping today is a good one!
08-09-2024, 12:45 PM (This post was last modified: 08-09-2024, 12:47 PM by Deborah K..)
RE: Help analyzing OSCAR data - CA's?
I suggest that you raise your minimum pressure setting to 7. Most adults are more comfortable starting at least there.
You seem to have some positional apnea going on. With the CAs, they often show up that way, but you also have a few in your hypopneas. As you know, this is caused by chin tucking. Some people can change this by simply sleeping with a flatter pillow. You could try that. Others need to wear a soft cervical collar. If it's the right size it keeps your chin from tipping down in any sleeping position. I did that for quite a while, then tried something else that worked for me: I don't know of anyone else who does this, but I suppose it would work for others. I bought a child-size pillow (they are smaller and flatter than regular pillows). Mine has a raised front and back edge. This holds my head tipped slightly back and solves the problem completely for me. The pillow I use is no longer made, but I have seen some that I think should work the same way. Here's a link to one in case you are interested:
08-12-2024, 12:17 PM (This post was last modified: 08-12-2024, 12:21 PM by alemon.
Edit Reason: bad photo attachment!
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RE: Help analyzing OSCAR data - CA's?
Thank you! I've ordered a contoured pillow to try to help, it is clearly helping events to have mine stuffed under my face. A bit of a bumpy road with re: masks - I want to get used to a new one, and I was sent an Airtouch in what is the "correct" size, but I think it just doesn't fit as well, it leaks a little more - which leaves me feeling bad in the AM, probably from wakeups. I think it's less responsive than the silicone, so I'd have to press it way closer to my face for the fit, which makes it "too big" as it squishes.
Following represents by date, a mid-tier day, great day, bad day. Slowly increasing minimum - I'm still not sure where to set this? It's currently at 7, which feels a bit high, but I note it's close to the median pressure in the statistics, even when that value was set lower. Weirdly today I feel awful in spite of low AHI index.
Is the pillow you ordered like the one I showed you, small, contoured, and pretty flat? If so it should help. Well, your AHI has dropped a lot and that's good! For a lot of people, it simply takes some time to adjust to sleeping with a foreign object strapped to your face and head and to having air blowing up your nose through a tube. Hang in there. It will get better.
It is, thank you for the suggestion! It won't arrive til later this week unfortunately. I did confirm my home sleep study did not count central apneas, so we're really flying blind. I don't check in with them til another month, but they said to give it more time to adjust, which I totally get.
I wasn't positioned as well last night, so a slight uptick, but I tried to strap the mask on a little tighter - too tight, but it kept the leaks from waking me up haha. Tired again today unfortunately, clear head but sleepy - I'm split between increasing pressure a bit more and seeing how that does, or just trying to keep everything the same for a bit. Looks like my current average-median is 7.4, and I've got it set at 7 with EPR 2. I feel like I'm still chasing the high of that one incredible night of sleep a week ago, and I'm not sure how much to push vs how much to leave alone and see. If you had any advice or insight on that front, I'd appreciate it!
So I'm still dealing with a high number of CA's, though I can tell the other day it was due to sleeping position - I actually woke up choking, which has basically never happened before. I have a new contoured pillow and was going to look into cervical collar. I bumped my pressure to 7.4 (doesn't show one day because it started 7.0). Not sure if it's helping or not. I feel like I've evened out into what I'd call "moderately mediocre-sleep" - still not as restful as a couple of the good day but a better than the worst. Still chasing the "really good night", definitely sleepy during the day, BUT more clearheaded.
(Also, no idea what happened with the leak rate, it FELT totally the same as other nights! It must not have sealed around my nose.)
My EPR has been at 2 since I started logging data, trying to figure out if I should be trying to adjust this or not to try to help CA's?
My opinion the leak rate isn't terrible, unless it was a source of disturbance. You'll not want to accept much worse than this though.
Has the doctor's office given you the sleep study details yet? Keep bugging them. HIPAA laws say that you ask for the report, you'll get the report. Doctors can't legally withhold it, but they might charge you an admin fee.
If your request is denied, you'll contact your local or regional medical board. It's that important for you to have this. You're not yet sure you're getting the right treatment.
Go once more as is, unless the CA hinder. You'll probably have to try EPR 1 then.
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Oh yes, I must not have updated the text in my replies! I had added the original study to my first post - and I called them as well, for clarification. They didn't test for CA's in the sleep study (it was a home one) so unfortunately flying blind here. I have a follow-up in November, where I plan to press them more. Will keep on if things look all right, thank you!
