Need some help with OSCAR analysis

[OCJeriko]

Hi there, I've been on CPAP since about July, but have not been able to get a good nights sleep even still, and my doc has been pretty unhelpful in narrowing things down, and just leaving my pressure at 4-20.  I recently discovered this whole community and OSCAR, and could use some help to figure out what I can do to get some actual rest.

It looks like I am having flow limit issues, but I have no idea what's causing it.  It's like I have flow problems, my pressure picks up to compensate, then just starts going back down on its own for awhile, before starting back up again.  There are some leak issues in there too that I cannot seem to solve, but they don't appear correlated to anything with the flow rates or my pressure changes.
I also just picked up a Wellue Sleepu oximeter, which, despite low AHI, shows a good amount of o2 drops (current setting is 4% for 10 seconds), but several are not related to any hypopneas/apneas.

Any help would be appreciated!


   
   

[staceyburke]

Flow Limits are just apnea, you get them the same way you get all apnea, your airway is obstructed.  The flow limit events are not as large as O or H events but they are the SAME only smaller and are not counted in the AHI score.  They do stop a person from getting deep sleep and can wake them up.  Also, the machine raises pressure to stop the flow limits from becoming larger events - O or H.

To control flow limits we use EPR (Exhale Pressure Relief).  But to use it you must have a min pressure up to 7.

I would suggest the following changes in your settings.

Max 9
Min 7
EPR set to FULL TIME 3

Give it a try tonight and post tomorrow, you should see a difference in your sleep.

[OCJeriko]

I will give that a try, thanks.

[OCJeriko]

I saw a difference for sure, but it wasn't a good one.
Didn't fall asleep at all until after 4am and could not stay asleep at all.
I tried making changes to high and low pressure as the night went on, but it didn't really change much.  Also found the EPR very uncomfortable honestly.


Something weird I noticed is that when I am awake, the ramp eventually decides that I am asleep, and just flies up to whatever my max is very quickly, which made it even harder to fall asleep.


   

[OCJeriko]

Quick bump in case anyone has ideas

[fishfinderG]

Maybe try EPR=1 instead of 3? It'll make things more comfortable but won't be as dramatic as EPR=3. It should still help with flow limitation, just not as much as 3. Once you are used to EPR=1 you can give 2 a try and see if you like it even more.

As for ramp, after a while it will think you are asleep or give up on waiting. Ideally you turn ramp off, but if you still want it for comfort then leave it on.