Help with my data

[danylam]

I am new here. My AHI is always around 3, but 95% of my events are as shown in screenshot below. I have added epr (3) to control my flow limitation, which helped a lot. FL 95% went down from 0.25 to 0.08, but I still have this kind of events. Thanks if anyone can help.

[OpalRose]

Hi danylam,
Welcome to Apnea Board!

Good job bringing the FL down, but it's still a bit high. A little higher pressure might help.

Have you tried any other pressure combinations, besides fixed 7cm?

If you're willing, move the pressure to 8cm and keep EPR at 3 for now. That will give you an exhale pressure of 5cm.

What I'm looking at is the Obstructives, which we should try to lower first. A higher EPAP may help. EPAP is what sprints the airway open.

We can look at the CA's after we see the affect on the Obstructives. We may have to lower the EPR, but we like to try one change at a time.

[danylam]

Great. Thanks for the advice. I will try to move the pressure to 8 and see if it helps.

[Kathy14225]

I'm not sure if you are new to the message board, to Oscar or CPAP therapy but I will answer your question as being new to therapy with a recent sleep study. First wondering how high was your AHI? Now it is at an acceptable level. Do you have a copy of your sleep study? If so, look to see if you were diagnosed with OA or mixed? If it's mixed you should have a different machine. I am wondering why you are having all the centrals. Your AHI would be much, much lower being you have 10 OAs and 3 Hypos in almost 9 hours, so just over 1. A CPAP machine can not address centrals and can actually cause them but with a pressure of only 7 that should not be the case. The theory is that your brain isn't telling you to breathe because your lungs are being hit with all that air, but at 7, it isn't that much. Actually being higher than that may get rid of the OAs. If you did a home study you may need to be on a range to see what pressure is needed or did you do a titration at the lab? You may need to talk to your doctor or if you're doing your own settings you can do a small range and see what the 95% pressure is and start a little lower than that. Doctor's usually don't look at details but will at least look at the summary before an appt. or hopefully if you call and ask them to address it. They may just feel it is in the acceptable range.

[danylam]

Thanks for your reply. In my sleep study, I had 39 AHI (only hypos and OA). No CA and no mixed. I moved my pressure up for a few times, but it makes no real changes. I always have these spikes while sleeping that, sometimes, are labeled as CA or OA. The only thing that recently made some difference was moving EPR from 0 to 3. That made flow limitation reduce from 0.25 (95%) to aroung 0.08.
Last night I tried APAP (4-12 of pressure). This is what my doctor prescribed. But to tell you the truth, where I live (Brazil). Nobody knows about OSCAR. They only talk about AHI and O2 Saturation.
I know my number are not bad and I have been sleeping much better. But I am the kind of person who is willing to reach the best result possible.
Thanks again.
Dany

[OpalRose]

If you didn't have CA's or mixed apnea on your sleep study, then the CA's you see now are what we call "treatment emergent". They will lessen in time. Even the use of EPR didn't raise the CA's, so that's good. You need some EPR to tame FL, Hypopnea and Reras.

Hang in there and keep watch on the Obstructives. I would have liked to see a chart with a minimum pressure of 8cm. You should give it more than a day and observe.
And only make one change at a time, otherwise it's hard to tell what helps and what doesn't.

[upsman]

Over half of your events are obstructive in your most recent charts. 
I would suggest raising your minimum pressure to at least 6 or 7 cm. This adjustment should clear the obstructive apnea and would make your therapy more comfortable.

[staceyburke]

Do you have your EPR set to 3?  If you do you are not getting any help because your min needs to be set to at least 7 for your EPR to work. 

The absolute lowest a pap machine can go is 4. EPR is exhale pressure relief.  What that means - your min is the exhale pressure.  EPR is subtracted from the min for your exhale pressure. So at min 4 minus EPR 3 still gives you 4 exhale pressure.  Move the min to 7 then min 7 minus EPR 3 you’re sick I’m= 4 exhale pressure. 

Move your min to 7

Also remove the calendar from the screenshot. It is taking up room that has important information we cannot see because of the calendar.

[Gideon]

As Stacey said, set your min pressure to 7 to fully enable your EPR to work.
Your CA is likely a combination if Treatment Emergent and you holding your breath when you toss/roll at night. The CA is not nearly enough to worry about.
Also the pressure chart is important because Obstructive events, including flow limitations, will cause pressure increases. You want to understand why your pressure increases. Replace the respiration Rate chart with pressure.

[danylam]

Guys,
Thanks for all your support. I will raise my min pressure to 7. I will also attache my chart here with the changes you advised me to do. In a few day I will post again with the results. Again, you guys are helping me a lot.
Thanks