Optimising Treatment - Help interpreting OSCAR

[teaspoonofsugar]

Hi everyone -

New to the forum and already learning a lot. 

I've been under treatment for about six-ish months and been pretty successful so far, now just trying to see if I can "optimize" a bit. I finally downloaded OSCAR and am hoping for some input or suggestions on anything you see where I can improve my treatment.

The AHI is a bit above average for me, but I've "levelled out" around 11 or so and can't seem to get it consistently lower. My pressure is 12-20 and I'm using EPR.  Full-face mask that I'm pretty happy with and generally have low leaks.

Let me know if there are other charts I should post or information to provide!

[staceyburke]

What is your EPR set to?
How long is your ramp set?

[teaspoonofsugar]

EPR is at 3 right now, it was at 2 for most of the last six months.

Ramp starts at 4 and increases to full pressure over 20 minutes.

[staceyburke]

I do want to know the 2 questions I asked BUT I believe your main problem is positional apnea. Positional apnea is when you sleep in a position where you cut off your own airway. There are no settings that can help this, you must find out and stop getting in that position. 

The main reason you are in that position is what is called chin tucking. When your chin goes down to your sternum. Sometimes it is your sleeping on your back or sleeping on to high of a pillow. 

If it is not that simple you WILL need to get a collar. Please find the link I have at the bottom of the post. It shows people without a collar and the same people with a collar - the difference is huge.

[teaspoonofsugar]

This is incredibly helpful! That also tracks, I sleep on my back as a default AND I've lately been propped up on a couple pillows that I got used to while I had an ear infection earlier this year.

Can you help me understand what you saw in the charts to tease that out [I believe you! Just want a greater understanding of what's going on]

[staceyburke]

If you can shut off the ramp. You are getting NO therapy during ramp and if you need to get up at night the ramp starts again. If you get up 2 times that is one hour you are not getting any therapy. 

Move the EPR to 3. EPR is exhale pressure relief and lowers the exhale pressure to make it easier to breath out. It Also helps with flow limits and yours are higher than we would like to see.

[Gideon]

Welcome to the forum.
Let's start with the obvious, You have a positional apnea and no amount of pressure is going to fix it. Others with a similar issue have fixed it essentially overnight. What is most likely happening is t=-you are tucking your chin. Either change your pillows up, if using multiple try 1, or a flatter pillow. If that doesn't work try a soft cervical collar, Seet the link in my signature.
Fix that then we can really clean things up.

[SarcasticDave94]

Welcome to Apnea Board,

Agreed, there's a pattern of positional Apnea. If you look at this chart you posted, see the places where there's one Apnea flag followed by others very closely together? Look at the wiki on soft cervical collar and positional Apnea.

[teaspoonofsugar]

Thankfully once I'm in bed I'm pretty much out for the night, but I can experiment with turning off the ramp.

I'll have to read up on flow limits on the wiki - thank you @staceyburke, @Gideon, and @SarcasticDave94 for giving me somewhere to start - I'll give your suggestions a shot and let you know how the next few weeks go

-tsp

[SarcasticDave94]

Best wishes on your successful Apnea fight.