confinedmind therapy thread - 25M

[confinedmind]

@gainerfull I was looking for a daily chart including things like # O2 events, times spent below 90%/95%, median SPO2, etc. Like what exists in the "Overview" tab in OSCAR for other data. The Wellue/Viatom app (for my O2 sensor) UI is pretty bad for that.

[UnicornRider]

@gainerfull I was looking for a daily chart including things like # O2 events, times spent below 90%/95%, median SPO2, etc. Like what exists in the "Overview" tab in OSCAR for other data. The Wellue/Viatom app (for my O2 sensor) UI is pretty bad for that.

Do you have "O2 Insight Pro" for your PC or MAC, It has very detailed daily reporting that my Primary and my Sleep doctors like to see.

https://getwellue.com/pages/pc-software

[confinedmind]

EDIT: disregard this comment. I thought I forgot to respond to a previous reply, but it turns out I was looking at the first page of replies... IDK how to delete this reply.

Thanks for the suggestion about O2 insights program. I do have it, but I hadn't messed around with it much yet.

Also, I did find out how to add the spo2 stats to the overview tab in oscar, but I do prefer that ratio% chart shown in o2 insight pro for getting a high-level understanding without having to dig into each spo2 drop to see if it was caused by movement.

[UnicornRider]

The Pulse/Oximetry information you can get off of the O2 Insight Pro report  is in a different format than OSCAR provides, yet each has their value.

 On the OSCAR Daily page I will double click the title on the Flow Rate graph to "Pin" it to the top of the graphs, then scroll the other graphs up under it to see correlation between Flow Rate Events and O2 drops or Pulse excursions. At times I have to go granular at about a three to six minute graph zoom to see the waveshapes related to an O2 or Pulse deviation.

OSCAR Overview and Statistics pages also have value, sometimes it takes a while to gather enough Data to populate the fields and time to gain the practice and experience to understand the information, it's value and when/how to utilize the info.

The learning curve is only as steep and deep as you are willing to commit to, but very rewarding.

I'll take O2 Insight Pro "Sleep Report" prints and OSCAR prints to the Doctor's office and Sleep Center to share with the staff in support of my concerns. After that sparks their interest, I offer to show them additional information on the laptop. I have gotten several extended examinations because of the data collected in those two formatts accompanied by Apple Health data. 

  If your medical staff is not interested in the data you have collected and willing to guide you in what additional Health Data you could collect for health records, then it might be your Sign. Time to change medical professionals.

[confinedmind]

I've attached daliy charts of the last 3 days. The CAs have decreased. I still see some sequences of varying flow rate amplitude that was leading up the the centrals before, but it seems less, and so I'm going to table that (assuming it's treatment-emergent and will continue to decrease).


I have yet to add EPR because I'm trying to get a more robust baseline without it (though I did try changing my min pressure from 6 to 5 the last 2 nights). And, more importantly IMO, I still have yet to see any RERA events flagged. And my 95% flow limit has been between 0.02-0.03 since I started. So I wouldn’t know how to determine if EPR changes are useful. Could the CPAP just not be sensitive enough to provide data about the supposed RERAs that the WatchPat was detecting?


My main question is: What is concerning in my OSCAR data that I can work in improving?


My leak rate seems low (95% for the last week is 0). My therapy indices (CA/OA/UA/H) have all been under 1 since the CAs decreased.
From previous comments, it seems like my spo2 stats might be concerning, but I don’t believe nose blockage is an issue and, without other CPAP data being concerning, IDK how to target improving SPO2.


The most easily measured data I can think of right now is # wakings during the night and nocturia, but I’m at a loss on what could be causing the wakings. When I look at OSCAR, I just see what I believe is an arousal breath and then I get up (with often little/no accompanying flow limit/leak. I can share pics of this if requested).

Would an in-lab study help me determine what exactly my issue is (i.e. what could be causing the fragmented sleep and nocturia)?

For now, I’m working on improving my mask setup because it’s sometimes uncomfortable/itchy. I’m not convinced that’s the cause of the wakings because I was waking the same amount before I started CPAP, but I'm hoping it will help me not take it off as much when I wake during the night (@dormeo this answers your previous question. I sometimes forget to put the mask on before I fall back asleep).

[Dormeo]

Thanks for the additional information. Yes, it's important for you to keep your mask on for the whole time you're in bed. To the extent that CPAP can help you, you aren't yet giving it a fair trial with those long gaps.

Nocturia: If you haven't had your doctor check your prostate gland, now would be a good time to do that. It'd also be a good time to look honestly at what and how much you drink in the hours leading up to bed-time. Also, if you wake up with an urge to urinate, that's one thing; but if you wake up and figure that as long as you're awake you'll go to the bathroom, you can try to change your behavior.

Your O2 levels look good, with median values of 96 and minima never going below 90.

I'd suggest you start introducing EPR, which may help with your flow limitations. There's no way to know in advance whether the FLs are spoiling your sleep, but it's worth seeing what happens when you reduce them. I recommend raising your minimum to 7 and trying EPR of 2. This will give you a pressure on exhale of 5, similar to what you're used to. The EPR will give you a little boost when you inhale. A lot of people use this simply as a comfort feature; it just feels better to them. See what you think.

[Sleeprider]

A couple of recommendations for you. I note that your therapy time is both fractured and less than 5-hours in total duration and typically includes a long period of prime sleep time without therapy. This is clearly insufficient sleep time, or you're sleeping with out the mask. In addition you note that have nasal discomfort, and that you have avoided EPR until you get more baseline data. I think most with UARS do best with nasal therapy, and especially nasal pillows because it opens the nasal passages, allows better airflow and allows better breathing with less crap on your face. Your pressure is 6.0-16, EPR off and the pressure range is only 6-8 cm, so you don't have a lot of flow limits or other events. Your home sleep study shows normal sleep and event rates (AHI 1.3) and no need for PAP therapy.

CPAP therapy will not hurt, but you are using it primary to relieve respiratory disturbances. I recommend you turn EPR on full-time to setting 2, and consider changing to a nasal pillows mask. If, after a fair trial, you find CPAP therapy to be more disturbing to your sleep than without CPAP, there is no health risk to you in quitting.