Therapy Questions, EPR, CA, Low O2

[kingskid]

I Just loaded Oscar, so need to read up on how to attach files, but for now my question is how to know whether to have EPR on or off, and if on, what level?  I currently have EPR on full time, level 2, pressure 7 min, 11.6 max.  Am experimenting with tiny incremental increases, but because of CAs, do not want to go too high and may not even need to increase the max pressure at all, but my reports will tell that.  The report last night was 6 hrs with .7 AHI.  That was because I made a concerted effort to keep my P10 on as long as possible and no supine sleeping and used new P10 pillows.  I have been a Cpap user for 3-1/2 years with an average usage of only 2 hours/night, so decided I need to fall back and regroup to get longer mask time on. I had been titrated with 7cmH2O in 2015.  My SH charts ( now in Oscar) have a lot of RERAs and CAs, but good AHI numbers usually under 2, but am concerned about CAs because I live alone.  My O2sat untreated during my sleep test had a low rating of 70.  After being titrated, the low was 78, so getting enough air while sleeping is a high priority for me.  Not sure if that is what flow limitation refers to.  Anyway, for now I’d like to know if EPR of 2 is optimum?  Thanks for any insight if you have any without charts.

[Dormeo]

It’s great that you’re regrouping on your mask time and getting into Oscar. Once you get a chart posted, I’m sure you’ll get help from the forum experts about your settings.

Given your concern about oxygen levels, here’s some information you might like to have. If you click on “Oximetry Wizard” on the opening page of Oscar, you’ll see a list of oximeters whose data Oscar can import and display.

You may have no need at all for an oximeter, but I thought you might like to know about the Oscar option.

[kingskid]

Thanks Dormeo, that is something I will look into and have thought about it before.

[kingskid]

[attachment=12384][attachment=12385]
Okay, I took screenshots of the last two nights, so let's see if I can load them...

[Dormeo]

Hey, you posted charts! One thing I notice is that the screen shots may include some personal information, so you might want to replace them with full-screen shots.

[Gideon]

Welcome to the forum.

First, get rid of the Pie Chart. You can get the same info on the table. You are not showing a lot of RERAs and a lot of Central Apneas, very few in fact.

If I told you that I had 50% Centrals and 50% RERAs in one night, what does that mean? Misleading in this case because I only had 1 of each event over my entire night. Many would give a lot to have those numbers. That would be an AHI of 0.25.

Your numbers are great, awesome in fact, well most of them anyway. Time on CPAP, here you say you are keeping the mask on only about 2 hrs a night. Why? What is your perception of why you are taking the mask off?

The other piece of "data" we need, because your "numbers" are really good, is how do you feel? What are your issues with Apnea? and what are your symptoms?

and why can't you sleep on your back? Is that where you are the most comfortable?

I would get the Flow Limit chart in view, it is one of the important bits of info since it drives pressure increases.

[kingskid]

Hi Bonjour.  I need to work on my charts to fine tune them.  Will resubmit.  Have kept the mask on 4-6 hours the last three nights.  Was only doing 2 hrs or so because I'd get up to use the bathroom and not put the mask back on.  I feel rested upon arising; sometimes I get a little sleepy around 3:00PM or so, but live at around 8800' so it might contribute to that. I reread ny sleep report of 4 years ago and the doc recommended, "Positional therapy with avoidance of supine sleep." Would it help to submit my sleep report until I can get the charts up?

[kingskid]

Hi Bonjour.  I need to work on my charts to fine tune them.  Will resubmit.  Have kept the mask on 4-6 hours the last three nights.  Was only doing 2 hrs or so because I'd get up to use the bathroom and not put the mask back on.  I feel rested upon arising; sometimes I get a little sleepy around 3:00PM or so, but live at around 8800' so it might contribute to that.  From my sleep report of 4 yrs ago, the doc recommended, "Positional therapy with avoidance of supine sleep, and cardiopulmonary workup for nocturnal hypoxemia/hypventilation" with some other recommendations.  Would it help to submit my sleep report while I work on getting my charts up?

[Gideon]

Sleep reports help. What altitude was the sleep study performed at.

Supine sleep is always worse. If you like we could revisit that easily, it would likely involve readjusting your settings, but that is your choice.

[kingskid]

 Well, MAC has some differences with Microsoft software, but finally figured out that the only way to modify a chart was in screenshot mode.  Duh!  Attached is last night's chart with my attempted modifications to get in the info you all like to look at.  There was no MAC way to remove the piechart that I could find.  As you can see, my sleep attempt got off to a rocky start with my dogs barking, P10 adjustment, etc.  I had turned off the EPR because in my experimenting, it caused an increase in my AHI and I had not used it previously.  Tonight I will drop the max pressure back down to 10 instead of 10.6 last night (felt a lot stronger).  I was titrated at around 8500' altitude (live at 9075') four years ago at 7cmH2O straight CPAP.  I wanted to attached my sleep and titration tests (the tests were done separately), but have had a heck of a time trying to edit out the personal info.  Will make copies, use witeout, scan, then will be able to submit.  For now, if this chart is workable, I can continue to do the same thing with future charts.  Any comments would be appreciated.  The CAs are my biggest concern since I live alone and started CPAP because I sometimes stop breathing at night.  My attachment is 456.33KB so maybe it won't work....