OSCAR Result Interpretation & Clear Airways

[Steven Alexandro]

Hi Everyone,

First off, I'm so glad I found this forum -  I've learned so many helpful insights over the weekend reviewing other apnea-related posts! Really appreciative that there are so many active helpful participants sharing their knowledge and experience.

I've come to ask for some assistance - both in the OSCAR results I'm getting, but also recommendations for adjustments.

A bit of background. I've had 2 sleep studies, one that was an overnight in a hospital, the other which was a Lofta study. The hospital study resulted in correcting a deviated septum (AHI was ~6), the Lofta study last year resulted in a ResMed Airsense 11 purchase (AHI ~8). Both studies indicated mostly OAs, but there were a few central apneas. Pressure recommendation from Lofta was 4 - 20, but I gave up after a month.

All that said, I'm giving it another go and getting mixed results. Last night, for example, all events were Clear Airway (which is surprising). The AHI scores are low, but I'm still very tired with brain fog. I've been waking up twice each night to use the bathroom. I'm hoping I'm tired just because sleep duration isn't long enough, but I'm also hoping these aren't really CAs but something else? Also, I use mouth tape, an intake nasal dilator, and mostly sleep on my side (I think).

I've attached two zoomed out screenshots and one zoomed in on CAs from last night. Of note, last night I adjust my min pressure to 7 with EPR to 2. The previous were min 4, EPR 3.

Any advice or recommendations? Thanks in advance for anyone that can provide insights on how to improve!

[PeaceLoveAndPizza]

First, do you take any medications? Did you do a sleep study and if so could you post the results or summary page (redact your personal data first).

Initial CA's are typically treatment emergent, so we do not worry too much about them unless you had true centrals show up during your sleep study.

I suggest starting with a basic configuration and using that for a few nights, then posting some OSCAR charts for review. Folks can help from there.

Mode APAP
Min pressure 7
Max pressure 15
EPR 2 full-time
No ramp

That should tell us quite a few things, in particular whether the CA's are pressure support driven or not.

[Steven Alexandro]

Thanks for your response! Regarding medications, 10mg of enalapril in the morning for high blood pressure. I also take a beta-blocker as needed for infrequent bouts of SVT (1 per ~2 months).

Sleep study results in the screenshots below. The first is a brief summary from 2018 - the study occurred in a sleep center in an academic hospital. The second is from Lofta in 2023.

I will increase the max pressure to 15 as recommended and maintain 7 as the minimum. EPR is set to 2.

[PeaceLoveAndPizza]

Nothing significant in the sleep studies as they indicate you have a mild case of SDB. I see what I would call RERA’s in the OSCAR charts with the arousal breaths, but there may be other factors causing that.

Give the suggested settings a go and let us see how it plays out.