07-27-2024, 07:57 PM
New CPAP/APAP user looking for advice and OSCAR data interpretation
Hello,
Newbie CPAP/APAP user here requesting some help in interpreting OSCAR data.
I am unfortunately still experiencing wakeups in the middle of the night that disrupt my sleep quality while on CPAP (and this was my original motivation for getting treated).
I wanted to see what folks' thoughts are on what's going on and what the possible next steps would be (on any front, like tuning the CPAP, mask choice, medication, other medical issue I could be overlooking, would a BiPAP or other device have been more appropriate, etc.). I have some ideas of what's going on but want to be sure I'm not overlooking anything.
The first two pictures show my breathing patterns immediately prior to a wakeup event. I picked these because they seem quite distinct: one shows shallow breathing with a substantial drop in tidal volume (~400 -> ~200 mL) over a period of ~30 s while the other shows persistent double peaked breaths. I also attached an additional picture as a reference/"good" sampling of my breathing.
Appreciate your thoughts.
Thanks.
Additional items to consider:
-Mild apnea, home study with AHI marginally above 5. Have not gotten in-lab study - hoping that the CPAP data I have is sufficient to formulate thoughts/next steps.
-Concurrent nasal congestion and allergy problems (likely related to each other) - previously treated by ENT and currently being treated by allergist with immunotherapy, but progress is slow - one of my biggest fears is wasting months putting all my chips in this basket and overlooking something else. The congestion is almost exclusively inflammation, little/no mucus, and usually features one nostril having near complete blockage.
-Recently put in inline BV filter that seemed to improve congestion but only after I get out of bed - still experience congestion while in bed
-Device = ResMed AirSense 11
-F40 mask but recently also using mouth tape on top of it due to switching to mouth breathing creating complications (such as, triggering wake ups, dry mouth, drooling and puffed up cheeks)
-Arrived at Humidity and Tube Temp both at Auto as best climate settings.
-Use EPR = 3 or 2; subjectively cannot tolerate EPR = 1 and thus seems pointless to try 0.
-Using tighter pressure ranges (smaller Max minus Min) seems to feel more comfortable, but going above 12 cmH2O or so makes leaks/seal challenging. I'm open to exploring higher, but I'm not confident it'll be effective at overcoming my congestion, unless that's not the only issue.
-Tried just about every antihistamine and corticosteroid under the sun: Allegra, Zyrtec, Astepro, Claritin, Nasalcrom, Nasocort, Flonase, Rhinocort - level of improvement is small and inconsistent
CPAP data also shows (can provide additional screenshots if needed):
-After extensively looking at many days worth of plots, I noticed I can get into a periodic breathing pattern when EPAP is less than 8 cmH2O, though the vast majority of it occurs at less than 7 cmH2O. None of it is "severe" - highest AHI was about 7-8, but have used this to now set a lower bound for EPAP (i.e. if EPR = 2, use min pressure = 9; if EPR = 3, use min pressure = 10).
-OSCAR flow limit data does not seem to be modulated by EPR setting, in conflict with subjective feeling. I suspect the reported flow limit data is not very reliable considering there are periods where my breathing pattern looks flow limited but the "flow limit" reports at or close to zero - the screenshots in this post perhaps demonstrate that.
Shallow breathing prior to wake up example.
Double-peaked breaths prior to wake up.
Reference.
Newbie CPAP/APAP user here requesting some help in interpreting OSCAR data.
I am unfortunately still experiencing wakeups in the middle of the night that disrupt my sleep quality while on CPAP (and this was my original motivation for getting treated).
I wanted to see what folks' thoughts are on what's going on and what the possible next steps would be (on any front, like tuning the CPAP, mask choice, medication, other medical issue I could be overlooking, would a BiPAP or other device have been more appropriate, etc.). I have some ideas of what's going on but want to be sure I'm not overlooking anything.
The first two pictures show my breathing patterns immediately prior to a wakeup event. I picked these because they seem quite distinct: one shows shallow breathing with a substantial drop in tidal volume (~400 -> ~200 mL) over a period of ~30 s while the other shows persistent double peaked breaths. I also attached an additional picture as a reference/"good" sampling of my breathing.
Appreciate your thoughts.
Thanks.
Additional items to consider:
-Mild apnea, home study with AHI marginally above 5. Have not gotten in-lab study - hoping that the CPAP data I have is sufficient to formulate thoughts/next steps.
-Concurrent nasal congestion and allergy problems (likely related to each other) - previously treated by ENT and currently being treated by allergist with immunotherapy, but progress is slow - one of my biggest fears is wasting months putting all my chips in this basket and overlooking something else. The congestion is almost exclusively inflammation, little/no mucus, and usually features one nostril having near complete blockage.
-Recently put in inline BV filter that seemed to improve congestion but only after I get out of bed - still experience congestion while in bed
-Device = ResMed AirSense 11
-F40 mask but recently also using mouth tape on top of it due to switching to mouth breathing creating complications (such as, triggering wake ups, dry mouth, drooling and puffed up cheeks)
-Arrived at Humidity and Tube Temp both at Auto as best climate settings.
-Use EPR = 3 or 2; subjectively cannot tolerate EPR = 1 and thus seems pointless to try 0.
-Using tighter pressure ranges (smaller Max minus Min) seems to feel more comfortable, but going above 12 cmH2O or so makes leaks/seal challenging. I'm open to exploring higher, but I'm not confident it'll be effective at overcoming my congestion, unless that's not the only issue.
-Tried just about every antihistamine and corticosteroid under the sun: Allegra, Zyrtec, Astepro, Claritin, Nasalcrom, Nasocort, Flonase, Rhinocort - level of improvement is small and inconsistent
CPAP data also shows (can provide additional screenshots if needed):
-After extensively looking at many days worth of plots, I noticed I can get into a periodic breathing pattern when EPAP is less than 8 cmH2O, though the vast majority of it occurs at less than 7 cmH2O. None of it is "severe" - highest AHI was about 7-8, but have used this to now set a lower bound for EPAP (i.e. if EPR = 2, use min pressure = 9; if EPR = 3, use min pressure = 10).
-OSCAR flow limit data does not seem to be modulated by EPR setting, in conflict with subjective feeling. I suspect the reported flow limit data is not very reliable considering there are periods where my breathing pattern looks flow limited but the "flow limit" reports at or close to zero - the screenshots in this post perhaps demonstrate that.
Shallow breathing prior to wake up example.
Double-peaked breaths prior to wake up.
Reference.
