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I have been diagnosed with sleep apnea following two at-home studies, one reported:
Philips Respironics:
AHI 5.1
OAI 2.4
CAI 0.9
(no RDI measurement)
the other (WatchPAT):
pRDI 49
pAHI 13.7
ODI 2.2
pAHIc 2.3
I have been using a Philips Dreamstation on auto, with min P 4.0 or 4.5 and max P 20. I have EZ-start turned on. I use a nasal pillow mask.
My first question is how can I use OSCAR to get the RDI down if it doesn't monitor RDI? Or should I focus on AHI? My AHI is not that high, but my symptoms are severe.
Also I have a story for what it's worth: when I first found out I had sleep apnea/UARS I tried sleeping with a Nozovent nasal device, the next day I had dramatically reduced symptoms. I have not been able replicate that on other nights, but it does give me confidence my symptoms are related to sleep disordered breathing.
Some recent OSCAR shots attached, thank you to anyone with advice on improving things!
RDI = AHI + RERAs, and RERAs are monitored and reported by your machine See the RE in the Events chart.
RERAS are Flow Limits followed by Arousal. RERAs and Flow Limits are typically under reported.
4.0 is too low of a min pressure, especially on a PR machine. They need a boost to be able to head off obstructive events.
You are not going over 7 so
Set Min Pressure = 7.
To best treat RDI/RERAs/Flow Limits you need Pressure Support but your machine does not provide Pressure Support, therefore your only option is to increase pressure.
Gideon - Project Manager Emeritus for OSCAR - Open Source CPAP Analysis Reporter
01-22-2021, 08:34 PM (This post was last modified: 01-22-2021, 08:36 PM by staceyburke.)
RE: New member with OSCAR charts
4 is to low for a normal adult. I feel like I’m air starved with anything under 8. With it set at 4 the machine has to take time to ramp up to therapeutic pressure. I would suggest you move the min pressure to at least 7.
Also there are clusters of events that show some positional apnea. Positional apnea can not be helped with any machine. You are literally cutting off your own airway. Maybe you are sleeping on your back or sleeping on to high of a pillow. You are most probably chin tucking and you need to find out why and stop it.
Many people use a collar to stop chin tucking and I have a link about using a collar if you want to read about it.
I hope these suggestions help. Post tomorrow with how it went tonight.
(01-22-2021, 08:34 PM)staceyburke Wrote: Post tomorrow with how it went tonight.
Thanks to you and Gideon.
I put the min pressure up to 7 last night, and also wore a soft cervical collar. The OSCAR results are attached, it looks like the higher pressure induced CA's. I woke up in the night with burning in my esophagus presumably also caused by the increased pressure.
I sorry there were more centrals. Centrals are very inconsistent- one day you have some the next day you don’t. BUT you had a lot. Centrals many times come on when first getting use to pap therapy and they slowly go away as the body becomes accustomed to therapy. Your body is use to the CO2 level you had and you are getting more O2 and less CO2 so the body does not breath as much.
Another cause of central is a large spread between the inhale pressure and exhale pressure. Some people do better with straight Cpap. In other words the same pressure both inhale and exhale. You have a flex turned. It is used to lower the exhale pressure by 2 so the 7 you had it set for goes down to 5. You could try turning off the aflex, that would make the difference between inhale and exhale less.
I thought I might add something. Take a look at you pressure chart Like I said most of the night your low was at 5. I think in my 1ss post I mentioned the dreamstation is slower in response. That means it has to ramp up the pressure when it Senses an event. Look at the top pressure and you see a flat top area in a couple places. That means it just did not get huh enough quick enough to stop the event (not centrals they can not be helped with increased pressure). So again turning off the a flex will make it easier for it to get up to the pressure to give therapy for OA, H, FL.
Thanks staceyburke and Gideon for the simple explanations regarding pressures and preventing events.
I tried turning off the A-flex, with a min pressure of 7. For 30mins things were okay, but then I started to get the burning sensation which I guess (as Gideon pointed out) is reflux/GERD, I tried for an hour to take the pain and constantly needing to sit upright to reduce the vomit feeling, but it was overwhelming and felt unsafe so I took the machine off.
I am guessing the body can get used to the CA's more easily than it can get used to reflux? In which case, would it make sense for me to go back to A-flex with a min pressure of 7, and just continue like that until the CA's come down?
I also have the option of trying a friend's Resmed Aircurve 10 Vauto.
you may not have to trade one for the other. the first improvement I noticed after starting pap and getting my settings somewhat dialed in, was a significant reduction, near elimination, of acid reflux/heartburn. I don't remember how long it took but I'd say within a month or two.
