SleepyDawg OSCAR Review (Self-Titrated)

[SleepyDawg]

Hi All and Happy Friday!

I raised the min to 9.0 and have attached last night's data.  Should I make any adjustments for tonight?

Thanks in advance.

[staceyburke]

Your flow limits are still high, so we would increase the min again...   How are you feeling?"  Was last night better or worse?  Are you having any problem with the increase in min?   If things are going ok I would rase the min by 1 again.

[SleepyDawg]

I am still getting used to the mask and the therapy.  This is the middle of week 2 for me.  Overall getting more sleep is good for me.  The pressures don’t seem to be affecting me. I’m still tired when I wake, but neurology wants me to be strict on my sleep and wake times, so being a little tired is ok.  I felt slightly more rested last night.

I also have sleep-maintenance insomnia where I wake up in the middle of the night then have trouble getting back to sleep, but that is getting shorter on the wake cycle since I started CPAP.

I will raise lower limit to 10.0 tonight.

Should I raise upper limit higher than 12.0?

[staceyburke]

No the flow limits will continue to drive up to the max pressure. If you move up it will not help therapy. We want to stop the rise with raising the min. 

Max would only be raised if you got H and Oa events. You are currently under 1 AHI.

[Sleeprider]

While I mostly agree with StacyBurke, your flow limits and snores are in clusters. That suggests that there is a positional aspect to your remaining events. https://www.apneaboard.com/wiki/index.ph...onal_Apnea

[SleepyDawg]

I raised the lower pressure to 10.0 last night.  I definitely felt a difference at start up, (I don't ramp), with that higher pressure.
I was able to sleep straight through the whole night without getting up.  
I felt like I had more energy upon waking.
Attached is the OSCAR chart.

[SleepyDawg]

FWIW, here were the original sleep study results should that affect any recommendations from the team.

[staceyburke]

Sleeprider is one of the very best at reading charts and helping on this site. If he believes it is positional then you should take a look at it. 

Basically positional apnea is sleeping in a position that is cutting off your own airway.  Many times back sleeping will cause it. Couple that with a high pillow makes it worse. 

Typical we look for positional apnea by looking at O and H events clustered together - you have none in any night. You do have periods of high flow limits and snoring. 

It is also known as chin tucking where your chin drops to your sternum cutting off your air.

[Sleeprider]

Your last chart clearly shows flow limitation going from zero to 100 for no reason. From 22:00 to 00;20 you have very high flow limits and RERA. If you can figure out what causes this, you will solve the problem. Maybe a night camera, but when we see this kind of contrast, it's positional.

[SleepyDawg]

I suspect it is the side-sleeping where I chin-tuck.  

I use a hose holder because I'm an active sleeper, (arthritis keeps me moving).
I think I don't position my head correctly on the Contour CPAP pillow.
Likely it is paranoia over hose length due to the hose holder being too high over the bed.
I will experiment and lower the hose holder to extend the hose length to the mask.

I had the deer camera on all night.  I need to check the footage to confirm.