New and in Need OSCAR Analysis

[Well Marbled 1]

Hi everyone!

I've come across a ton of useful info on Apnea Board since I entered the world of CPAP a couple of weeks ago so I decided to join in on all the "fun" (please forgive the gentle sarcasm).

I've actually been doing remarkably well so far, but I'm a big believer in always trying to improve.  Even though my numbers look good (AHI under 3), I still don't feel well rested and I'm experiencing drowsiness most days.  I'm also getting morning headaches some days, which is something that has plagued me for as long as I can remember.  My PCP felt that my sleep apnea could be the cause so I was hoping for more improvement on that front.

Anyway, I am really hoping someone can take a look at my OSCAR data for the past 3 nights and let me know if there's anything that jumps out at you in terms of areas of concern.  It would also be fantastic if you have any suggestions as to how I could tweak my settings based on what you're seeing.

I'm excited to become part of this community and thank you SO much in advance!

Brad

   
   
   

[Old Steve]

I would first try raising your minimum pressure to at least 9 and perhaps 10 and see what happens.  If you are a back sleeper you may want to try sleeping on your side after you see if the higher pressure helped.

[Well Marbled 1]

Thanks for the input.  I do sleep on my side about 95% of the time.  Why do you think my pressure is too low?

[Well Marbled 1]

Wow, I must not be an exciting case because the replies are not exactly flowing at this point...

Can anybody with the requisite knowledge PLEASE take a look at my data??

[UnicornRider]

Welcome aboard Bradley,  Old Steve has some good advise there, 9 cmH2O for minimum pressure is a good starting point. 

Your AHI is sufficient to satisfy insurance and Medicare, Your leak rate is well controlled and your Flow Limits are fairly well controlled. those are each very important mile markers.

Now we have to get you some time under the mask to get sufficient data to assist you in achieving restorative sleep. It takes a while for your body to acclimate to the therapy pressure, so several days of Oscar Reports at a consistent setting would give us some information to go by.

 I notice you get to bed late in the evening and nap during the day, are you a shift worker, or some other family commitment to keep those hours. Or were the naps just you practicing with the CPAP to get acclimated to the fit and feel of the mask under pressure? For future reference, did you know that you can turn off those nap periods at the bottom of the left hand "Details" panel, so they will not detract from your main sleep session? It will also change the calculated AHI.

You will need to be able to navigate OSCAR and zoom in on selected events and times, for forum members to assist you in your quest for restorative sleep. Therefore I will suggest some YT videos and links for educational purposes.

From a forum member CPAPFriend.

https://www.youtube.com/watch?v=32JwMc6dphQ    OSCAR Introduction

https://www.youtube.com/watch?v=ujaoKvBnP00        OSCAR part 2

CPAPFriend has several videos worthy of watching.

• OSCAR - The Guide  always a good reference to fall back on.
  

Now back to your settings

Pressure Min    9.0 cmH2O    (starts you off closer to your median pressure)
Pressure Max  15.0 cmH2O    (allows room for therapy pressure)
EPR:   full time
EPR:   2 cmH2O


Give these settings a try for a few days and post back with further OSCAR reports, how the therapy pressure feels, the quality and quantity of sleep you are getting.

[Well Marbled 1]

Thank you so much for taking the time to provide all this helpful information!

To answer your question, I have been so drowsy that I often have to take a 30-45 minute nap during the early afternoon and also did some testing of new settings so those are the short sleep periods you were seeing.  I watched both videos at the links you provided and learned how to remove those sleep periods which I will do going forward.

Regarding your suggested settings, I had tried min 9.0 once and thought it was a bit uncomfortable so I backed it off down to 7.0.  Last night I moved it up slightly to 7.6 and slept REALLY well with even less AHI (1.77) so I'm going to keep inching it up higher each night until I get to the ideal minimum for me in terms of both comfort and effectiveness.  

I will also move the max pressure up to 14-15 to give some additional room for therapy pressure increases since I went as high as 12.71% last night.  I understand that this was just the peak (99.5%) and that 95% of the time I was under 11.76% with a median of 9.28%, but it probably makes sense to give some room at the top end just in case.

Attaching my data from last night in case you want to see it.  Please let me know if you want me to zoom in on anything.

In any event, I truly appreciate the input and I am very optimistic that I can get things really dialed in to achieve my best results possible!

Brad

   

[UnicornRider]

Take your time increasing pressure, you may hit a point where you need sit at a given pressure for several days before increasing by 0.6 cmH2O. It will take several days at pressure for your body to acclimate to the pressure and settle in it's response to that therapy pressure.

I am glad to find you are wearing the CPAP during naps. That is very important, your naps need *PAP support the same as regular sleep.

Being as how we know it will take you until the end of next week to reach the pressure min of 9 cmH2O, I really do not see any reason to zoom on these graphs.

I really suspect we may end up slightly above 9 cmH2O.

The important thing to remember is to really concentrate on how your body is feeling/responding with the therapy sessions. After you satisfy insurance and Medicare with AHI and usage reports the prime focus should be restorative sleep and how your body is responding to the therapy.

 More homework  http://www.apneaboard.com/wiki/index.php...ganization

 By standardizing the chart display it makes it easier for forum members to read the information they need to assist you. If we need a different arrangement we can ask at that time.

Enjoy your weekend.

[Old Steve]

You need to raise your pressure to eliminate as many Obstructive Apneas that you can.  If you do not want to raise your pressure all at once that is fine, it's up to you.   Although, if you look at your most recent chart you will notice that your median pressure, or the most frequently occurring value/pressure is already at 9.28cm.  That is the reasoning behind my suggestion of a min pressure of 9cm or 10cm.   Just having an AHI of less than 5 does not guarantee that you are getting quality sleep, you can still be having many arousals.  

[Well Marbled 1]

I've never heard that I need to take my time with pressure increases, but I'm definitely going to take that advice! I'm probably guilty of tinkering with the settings too much.

I already read that wiki on how to organize my OSCAR chart and believe that I have set it up correctly. That said, I will be happy to change it up or zoom in on anything as requested.

Thank you again so much for helping me along my journey. I hope you sleep well too and I will check back next week after a few nights at 8.0 min.

Brad

[Sleeprider]

With 7-12 pressure and EPR 2, you have clustered obstructive events that appear to be positional. You would benefit from higher minimum pressure and EPR a 3 to reduce flow limits more. Even with higher pressure, you will obstruct if you don't resolve the cervical misalignment that blocks your airway. This article may have some ideas for you. https://www.apneaboard.com/wiki/index.ph...onal_Apnea