Odd Oscar results

[JEDP]

I have been slowly raising my pressure with my doctor's blessing. While my AHI is low, I think I am still having UARS episodes. I also have stopped using a range as I think the changing of pressure was one of the (many) sources of my frequent awakening. I am presently at 8. I just looked at my OSCAR data and the pressure is weird from a few nights ago. Anyone have any thoughts on what happened?

[OpalRose]

Are you using the smart start feature?  That could be the cause of the pressure drop, although I can't say for sure.  I guess if it only happened once, you can safely ignore it.

I'm not sure why you are using a 8-8 pressure, but you would benefit from using EPR, as this will help with the Hypopneas, Reras and Flow Limitation.  

I usually recommend to start with EPR set at 2.  Watch for a couple days and report back.

[Sleeprider]

JEDP, we use pressure to treat apnea and hypopnea and pressure support or EPR which creates a lower exhale pressure and higher inhale pressure, to treat flow limitation from UARS. If you will turn on your exhale pressure relief (EPR) Full-Time to a setting of l1, 2 or 3, you will notice a remarkable difference in how easily you can breathe. EPR settings are equal to the pressure relief during exhale in cm-H2O, so if you keep your current setting of 8.0, you will have pressures of 8.0/5.0, 8.0/6.0 or 8.0/7.0 for settings 3, 2 or 1 respectively. I recommend you try a setting of 2. Try to include the flow limitation chart when you post your results so we can see the difference.

[GuyScharf]

I just looked at my OSCAR data and the pressure is weird from a few nights ago. Anyone have any thoughts on what happened?

That is a weird pressure graph. It looks like a data problem of some sort. Is your pressure graph normally a straight line at 8.0?

Please post the Mask Pressure graph for that day. It will offer a different view, and perhaps a clue.

[pholynyk]

It is a data problem, and I thought I had fixed the 'missing last data point' problem.

Please make a zip copy of your SD card and upload it to Guy's Dropbox at https://www.dropbox.com/request/REp6AH7LCGyeOcXfOokH

Be sure to put your user name in the file name so we know what to look for.

Thanks

[JEDP]

I'm happy to upload the data. But it has only happened the one time. Is it worth uploading?

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Can you explain why using EPR can help with flow limitations, etc... Thanks. This stuff is so interesting.

[pholynyk]

Yes, it is still an error in handling the missing data. Even special cases need attention.

As the un-named Prince said: "Perfection is usually good enough"

[JEDP]

I uploaded it. I think I did it correctly. Thanks!

[Dormeo]

EPR drops your pressure when you exhale. By the same token, it increases your pressure when you inhale. This "pressure support" helps you inhale more smoothly -- gives you a little boost to help overcome flow limitations (and sometimes hypopneas and RERAs).

Flow limitations are limitations within the airway. If they're in your nose, pressure support will probably not help, but often they're in the pharynx, where the tissues lining the airway can relax a little during sleep. With FLs, you need to exert more effort to breathe in. Pressure support means you may need to exert less effort to breathe in properly, because you get a little pressure boost at the critical time. That can increase your chances of having solid and restful sleep.

Using EPR may or may not make a difference for you, but it's an easy experiment to try. Lots of people -- including me -- really like the "feel" of having pressure support.

Often it is recommended to increase the minimum pressure to offset the EPR, but your AHI is so good I think it'd be fine to keep min = max = 8, at least at the outset of your experiment. If you like EPR but get a bunch of obstructive apneas, you can always raise your min pressure.

You can start with EPR of 1 and see how it goes, then increase to 2, then 3, if all is well.

[JEDP]

Thanks so much for the explanation!