NEED HELP INTERPRETING OSCAR DATA

[SarcasticDave94]

See if this YouTube helps some, but it appears you've got it right on the screenshot.

[JoeyC]

Thank you again. I will check back after a few nights to let you all know how this worked.

[notam2]

From what I see, your 95% EPAP used to be 8.8, but after the doc's pressure change your new 95% EPAP dropped to 6.4. What's interesting is that the median EPAP is 6.3. The 95% mark and median shouldn't be that close. I interpret this as half of the time, your machine wants to increase the expiratory pressure, but it cannot do so because the settings have imposed a ceiling on how high the EPAP can go.

I'd be interested to see your pressure graph in oscar, if you can pin it to the screen.

I think you need to increase your min pressure to at least 8, but probably 9. These numbers assume you're using flex 2 or 3.

[JoeyC]

Thanks for the reply Notam. 

I apologize for my ignorance but i honestly don't really understand what EPAP is and bc of that I do not at all understand what you've said. 

i did a quick google search and see that it stands for Expiratory Positive Airway Pressure and that it has something to do with creating pressure while exhaling but I do not fully comprehend what it means in this context or the significance of the levels associated with this marker. Perhaps you can educate me a bit in real simple layman's terms?  

What your saying sounds important and I would like to fully comprehend your point and right now I don't at all 

i am including what I believe to be the "pressure graphs" from May 31 before the setting change when I had my best night at 3.3 AHI and also from last night after the switch with an AHI over 7.  I hope these screenshots provide the info you were looking for.  I apologize if they aren't!! I am still learning everything. Just downloaded Oscar today. 

Thanks again!!

[notam2]

Well, when you look at the pressure graphs, there are two lines. The top line is the air pressure when you breath in (called IPAP), and the bottom line is the air pressure when you breathe out (called EPAP). When you turn on flex, it lessens the air pressure when you breath out to make it easier for you to breathe. Its kind of a catch-22 though, because its the air pressure when you breathe out that is responsible for helping to keep your airway open.

Looking at the most recent pressure graph, that green line is hovering around 6.something, and its not enough to keep your airway open. That's why I think you need to try upping the min pressure to 9. By doing that, the minimum EPAP (the green pressure line) will stay above 7, and that should help with the obstructive events.

[JoeyC]

My only concern with increasing the minimum pressure that high is that it could cause my Clear Airway events to increase even more.

My understanding is that CAE are usually Central Apnea Events and those increase when you increase minimum pressure.

I could be totally off base with that as I did this research only today. But that is what I read a few times here today. 

To support that idea, I went from a six day CAE average of 4 before the setting adjustment to a six day average of 7. 

The primary difference between those two time periods is the minimum pressure increased from 5 - 7.  

FWIW, in addition to an increase in CAE there was also a pretty significant increase to the Obstructed Apnea Events as well. 

That could be related to the fact that he took me off Auto though and kept me fixed at 7.

By the way - are you recommending I turn the Flex on or off?

Right now I have it on and set at Level 2 per the recommendations of the others who have replied here.

[notam2]

You're right to watch your CA events, but from what you posted you're averaging 0.35 CA per hour. That's pretty low. Also, I didn't see a lot of CAs pop up when the machine increased your pressure over 10. I too recommend using flex level 2, but I think you need to try a min pressure of 9.

Edited to add: if you're worried about CA events, in the alternative you could try a min pressure of 8 with a flex setting at level 1. This should also keep your EPAP over 7 and results in a lower pressure setting.

[JoeyC]

I think for tonight I am going to give the current settings a shot based on previous recommendations here earlier.

If my situation is not optimized from that - and it likely wont be - then your suggestion is the next idea I will try!!

Thank you so much for your insights and time!!!

[notam2]

Curious, ever since the pressure was changed on your machine, how comfortable do you find the breathing experience? Any difficulty exhaling against the pressure?

[JoeyC]

Sorry for the delayed response. I fell asleep early last night. 

I did not really notice any difficulty when exhaling against the pressure after the setting change.

But I may not be entirely sure what feeling would feel like to know.

But i did not notice any obvious difficulties. 

FWIW after changing the settings back to AUTO with a minimum of 6 and a maximum of 15 my AHI was down to 4.5.

Tonight I will move the minimum to 7 or 7.5 and try that.