Help analyzing Oscar data

[Rosebearjoey]

Hi all, 

I'm very newly diagnosed with sleep apnea (mild) but have been very symptomatic with morning headaches, TMJ/Bruxism and general fatigue, anxiety and tiredness no matter how much sleep I get. 

I feel like i'm still getting used to CPAP (have had it for a few weeks). Here is my last week of data. I don't even know what questions to ask as I am struggling to even understand the basics of all this. Explaining this to me like I am 5 would be helpful. 

My AHI pre-CPAP was not very high anyways (5.7) but opted to try CPAP to get some relief from symptoms. Part of me has been wondering if an AHI that low even indicates that I have sleep apnea. Based on this data do you feel it is sleep apnea and not a fluke?

Because my AHI wasn't too high to begin with, I'm hoping I can get relief if I can get that number down. I feel improvement some mornings but it feels very inconsistent and I can't pin down why. Are there any settings adjustments you would recommend based on this data? 

Any general advice or pointers is greatly appreciated, as all this data is quite overwhelming and I don't know what to focus on.

[Phaleronic]

Welcome to the forum Rosebearjoey

You have quite a few clear airway events and with your machine's settings you're not getting optimal therapy for those events, please turn EPR down to 1 fulltime and raise your minimum pressure to 7cm, and lower your maximum pressure to 12.4cm, this narrower band of pressure will help you sleep more soundly without the arousals and microarousals you're having in these charts. Also please sleep on a flat pillow on your sides as much as possible and use another one to wedge between your chin/chest and shoulder to prevent chin tucking. You're doing pretty well

These settings will also help your leak rate spikes if you can make sure your mouth is closed during sleep, you need to please tape or use a chin strap to keep those leaks under control, it will also help your flow limits-and disable ramp please.

[G. Szabo]

Are there any settings adjustments you would recommend based on this data? 

Any general advice or pointers is greatly appreciated, as all this data is quite overwhelming and I don't know what to focus on.

It would be nice to see your anonymized sleep report or at least know the number of CAs during the test. If CAs contributed only a small or zero amount to the AHI figure in your sleep report, then you can fine-tune the pressure and EPR settings of your current instrument, and you will be fine. 

Until we see your sleep report, I suggest the following settings: 
Pressure minimum 7 cm (suitable for adults) 
Presuure maximum 12 cm (you are not hitting it yet) 
EPR=2 (to reduce your CAs but still cope with the high flow limits) 
Ramp off (because you have no treatment during the ramp period)

In addition you should reduce the leaks with better strap adjustment, tighter straps are not unnecessarily better.

[staceyburke]

I would agree with G. Szabo Min 7 EPR full time set to 2 for now and we will see how the centrals react.  If you compare your pressure chart, the max continues to rise because of the flow limits.   EPR helps with flow limits.  

[Phaleronic]

EPR only helps with flow limits if you raise pressure, and your flow limit spikes do not warrant increasing EPR beyond 1. With EPR fulltime @ 3 (-3cm on a min rate of 5cm-the max minimum pressure is only 4cm-this is why they are having flow limits). Increasing EPR causes more CA events-you can't tell if they are valid CSR in these charts SB.


Do not turn EPR up please Rosebearjoey.

[Rosebearjoey]

Thank you all for the info. I will try those adjustments. I will attach the results of my at-home sleep study.

[G. Szabo]

According to your sleep report, your CAs were negligible. Hence,  the current CAs are treatment-emerging and will disappear. Consequently, you should use EPR=2 and minimum pressure 7. When the number of your CAs reduces, you can increase your EPR=3.

[Phaleronic]

Hello Rosebearjoey, there is no reason to use EPR with your current pressure settings unless you have exhalation pressure issues, you can mitigate this by lowering minimum pressure by 1cm of water, EPR will not facilitate anything and will cause issues with timed inspiration pressure return.