OSCAR Data Review

[bukinnutz]

I've had my CPAP for over a year now, but still waking up tired. Any suggestions on improving my CPAP settings?

[mesenteria]

I don't know why it might be, but as depicted, your chart looks confused or mal-configured.  However, your tombstone information in the table/index at left says your machine is set for a minimum pressure of 4.0 and a high of 8.  The high pressure isn't so bad, judging by the charts at right, but your low pressure is almost certain to be about two points too low.  With an EPR of 4, which I think is excessive....probably....  I'm not a health professional or an expert here...your high pressure should probably be closer to 9 or 10, or you should try reducing the EPR to 3 or even 2 and run with it for at least three nights to see if the pattern improves, but consistently across nights.

Your AHI is not bad at all, but I'm pretty sure we can improve on it.  I hope you can accept that, in order to improve it in a way that builds confidence in you, AND THAT makes you feel somewhat improved, it may require a draconian rethink of your therapy, even to the point of changing modes of delivery.  If you can be open-minded, others here will suggest altering some settings, and you should carefully consider what they say, and why they recommend what they do.

[sheepless]

epr of 4? excessive? maybe I'm not understanding but for clarity, I assume you're referring to the minimum pressure setting although I'd say it might be low rather than excessive. to my knowledge, pr machines have flex and resmed epr settings are 0-3. also, unless conventional wisdom has changed recently, minimum pressure without epr is still ipap, not epap. please correct me if I'm wrong. not challenging you; just thinking this might be confusing, especially to a newbie.

[Cpapian]

4 is pretty low for an adult.  From a comfort point of view I would try it at 6 minimum and leave the maximum where it is.  It might reduce pressure fluctuations and give you a more settled sleep, while even reducing your AHI  a smidge

[mesenteria]

You are right, I misread that.  To our OP, if they saw it, sorry.  

The setting is a low of 4 cm, and the high is set at 8, if the information in the top section is correct.  The machine seems to top out at just above 6 cm, at the 90%ile interval.  It is hard to make out, but I do see some clustering after all, and they happen usually with a constriction of the airway, or the pinching of it.  This is often the case when the sleeper's chin falls toward the chest as the body relaxes, folding over the airway partly.  Either figure out how to sleep differently, or do what so many of us resort to doing, and purchase a soft foam cervical collar.  Wear it only tightly enough to keep the chin up, not so tight that it disrupts circulation or seems very warm.

Thanks for riding shotgun, sheepless.

[bukinnutz]

Thanks for all the advice! I went ahead and changed my min and max to 6/10. That seemed to helped with lowering the AHI. We'll see after the next couple of nights. I took another screenshot of Oscar from last night.

[Cpapian]

Looks better.  You have the ramp on at 4.  Do you need it?  If not, you can eliminate it.