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Requesting help dialing in my settings using Oscar results
Hi everyone! I've been using the machine for about 3 weeks now and I'm doing my best to learn to read oscar but it's a bit slow going. I have a couple questions and hoping for some insight on any changes I can adjust. Early on I adjusted my minimum pressure to 5.6 because I felt like like breathing out was hard and I turned off auto-ramp because the increase in pressure as I fell asleep was jerking me back awake. I also lowered my max pressure to 15 bc I thought that was causing the really strong jets of air that were keeping me from falling asleep.
Generally, into the third week, I've been using it pretty consistently (only 1 or 2 nights I took it off in the past 3 weeks and I sleep pretty well). I try to sleep on my back because that upsets the nasal pillows the least. I get up still once or twice a night and early in the morning I sometimes sleep on my side and the nasal pillows move around and wake me up.
-My pressure graph doesn't show hardly any red - is that an issue? It's only a green line with a few dashes of red
-Should I increase my minimum pressure or decrease my maximum pressure?
-What are the blue and yellow bars at the very bottom of the left-hand side bar?
RE: Requesting help dialing in my settings using Oscar results
Generally speaking, things look good. Minimal flow limitations, a bit of pressure swings from those that remain, some clustering of obstructive's which could be caused by sleeping in a supine position, and some centrals which likely are treatment emergent. It may sound like a lot, but for a recent CPAP user you are doing smashingly well.
On the sleeping position, supine is actually a poor position as your tongue will drop as you enter REM, which is likely the cause of your problems late in the night. If you have issues with the nasal pillows whilst on your side, a flatter pillow or CPAP pillow should help. Hose management may help with that, so pay attention to how you route the hose to avoid tugging on it.
I suggest reducing the pressure range and trying a bit of EPR to handle the remaining FL's.
Try the following:
Min pressure 8 (or 7.8 if you prefer)
Max pressure 12
EPR 1 full-time
That should smooth things out and hopefully be comfortable. We will have to keep an eye on the CA's thought as EPR may affect you and increase them. Give it a go for a few nights and let us know how things progress.
RE: Requesting help dialing in my settings using Oscar results
Thanks so much for the detailed response - this is really helpful.
By "EPR 1 full-time" do you mean try turning this on in the clinical settings and try it for 1 night?
I'll try adjusting the pressure range to see how that goes and also look into a CPAP pillow.
I missed your original question about the left-hand side blue/yellow bars. Those show you the session times. On the first one there are three distinct sessions where you turn on and off the machine. You can select or deselect sessions for viewing in OSCAR. I’m colour-blind and never realised they were different colours. Funny that.
05-20-2024, 04:40 PM (This post was last modified: 05-20-2024, 04:43 PM by lolo23.)
RE: Requesting help dialing in my settings using Oscar results
Thank you again!! Funny you didn't know the session bars were colored! The magic of the internet haha
Can you let me know how these look? I have had lower AHI and fewer Centrals since adopting the setting recommendations from your last post! I think the EPR is helping. LMK if you see anything I should maybe adjust?
I've been trying to sleep on my side more but it is resulting on a bit more leaks. I am getting a better pillow set up soon - so hopefully the leaks will diminish.
I gotta work on sleeping more in general I think.
Also thanks for your positive attitude and encouragement!!! It's hard to adjust but I'm hoping I'll feel more alert and less foggy in a few months.
RE: Requesting help dialing in my settings using Oscar results
Things look quite grand to me. Good enough that I would leave it for a bit longer.
You are now entering the micro-tweaking portion of CPAP settings. If there was anything I would suggest changing, it would be to bump up the min pressure by 0.2 every few nights until you get to 9 cmH2O. I would like to see the arousals reduce a bit, but it is nothing dramatic as long as you feel good in the morning. If you want to give it a go and have a night where things go off the rails, stop it there and back off to the previous night setting.
If you want to leave it where it is that is fine as well. Things are looking much better, and it sounds like you feel you are sleeping well, which is the real goal of all this folderol.
Thanks for the update and very glad it is working out for you!
RE: Requesting help dialing in my settings using Oscar results
Your help is so invaluable - thank you again!! I'm so grateful for you all and the resources you've made available to help everyone along on their CPAP journey. If I had waited to talk to my doctor at my next appointment (after receiving my diagnosis the next appointment was set for 3 months out) I wouldn't have had any help dialing in my settings and I definitely would have quit therapy bc the max setting was waking me up!
Appreciate your advice! I'm all for bumping up the min pressure bit by bit and keeping an eye on it and how I am feeling over time.
How do you read the data for micro-arousals? Just so I can try to pinpoint on my own when I look at the data by myself. Is it the flow rate spikes?
Also to your point about hose management in the earlier posts, I'm sort of threading it through headboard which keeps it above my head, instead of alongside me which is where I had it previously. Anyway some tweaking there to help the leaking or I might get a hook
RE: Requesting help dialing in my settings using Oscar results
Nae, not my info. You can thank the moderators, admins, OSCAR developers, wiki editors, and more, for their incredible work. I spent a few years reading posts and the wiki pages before working up the courage to try to help. Donations are most welcome, but not required as we are all here to help others like those that came before us.
For the arousals, look at your flow rate. The spikes that are popping up are typically arousals if not marked as events, though we would need to see zoomed in sections to be sure. As the only way we can try to control them is pressure, we have to apply it carefully to not create more problems than we solve. I am sensitive to rapid pressure increases so I use a fixed pressure in APAP mode and bump it up if I feel things are off in the morning. Everyone is different so we have to find what works for each member. There is a trade-off for comfort vs trying for “perfect”. I accept some flow limitations, arousals, and events if I feel like I am having a good nights rest. More of an art than a science.
Use whatever works for hose management. You just don’t want something that will pull on the mask as you move around during sleep. It takes time to figure things out, so don’t stress as you will learn over time what works for you.
