Transitioning from APAP to CPAP using Oscar

[sleepadventurer]

@SarcasticDave94 - Thank you for clearing up the flow limit question. VERY helpful! Also, thanks for sharing and sorry to hear about your COPD. My grandmother has it and it is definitely a difficult disease. 

Also thank you for clearing up the "dial turning" question. I'm seeing huge benefits from CPAP from day one, and in the spirit of "making good OSCAR charts", 

Attached is my night last night with EPR turned on to 3 (Nov 28), as well as the previous night without EPR (Nov 27). No other settings were changed.

Questions about the new OSCAR data with EPR at 3:
- First, I feel great about the sleep I got (6hr53min) (yes!!) No leaks, one time getting up for the bathroom)
- The pressure seems to have done better during the night, not maxing out as much at 13, so would we say that the EPR was the right way to go, even if AHI is slightly higher?
- I am still seeking advice in terms of raising the min/max pressure because the flow rate does max out at certain points during the night...
- The flow rate has a red and green line this time - what are the meanings of each line?

You guys have been incredible, again thank you for listening and taking me seriously. Unfortunately I am dealing with some family and friends who are not supportive of my sleep apnea journey.

Thanks!!

[BoxcarPete]

Glad to hear it's working for you! Your obstructive events still look a little clustered, which might go away once you start using your collar.

The red and green lines aren't your flow rate, they're your pressure. If that pressure level is comfortable for you I would not touch it, if you are positionally kinking your airway there is no amount of pressure deliverable by your machine that will clear that up, you need to keep your neck straighter which means you gotta wait for your collar to come in and see how we do.

[SarcasticDave94]

If EPR 3 being added has brought better comfort and rest, keep it. Even if "bad" numbers like AHI go up a little, it can be OK. 2.xx AHI is perfectly fine if paired with better sleep.

As I recall, the red and green pressure trace lines are EPR reduced exhale as your lower green one and inhale upper red line, signifying the separate aspects. Example, you'll see at the beginning green isn't readily seen because it's at 8 and blended into the dark lower edge of the graph, while the upper red line is at 11. Typical of 11 reduced by EPR 3 when no event required increasing pressures.

With the flow rate not maxing, that's actually OK. This indicates you don't need whatever you've set as your max, but that includes a setting cushion just in case an event requires more. Your machine is smart enough it's not going to use more than required but it can't go further than your hard set numbers as well. A small cushion like this will be preferable as having it available but not needing versus needing extra and not having it available.

If you're gaining restful sleep, count this as a win. Run with this setup and make more good charts.

Congrats.

[sleepadventurer]

Ok everyone,

By a raise of hands, who is a perfectionist? Who gets greedy when trying to improve their health? 

Well, last night was one of those moments for me. I decided to experiment with high pressures and no EPR, trying to get those obstructive events down near 0. 

I set the machine to 13-14 pressure with no EPR (see image), no ramp.

I ended up having a big mask leak and pulled the mask off (don't remember that), only getting 3ish hours of CPAP sleep.

I feel awful today. And I think I learned my lesson? Without any advice from you all I will be going back to 11-12 pressure with EPR 3 which seemed to work well. 

Any thoughts/insights/learning from anyone today based on this crap night sleep?

Thanks

- Sleep Adventurer

[SarcasticDave94]

You feel awful today, so this counts as a fail in light of prior feeling better.

Don't melt your buttons and the dial. Alternatively maybe remove them so you don't fiddle.

Where I'm a perfectionist is my audio video desk at church, running the Livestream weekly on a Mac Mini M2 and Studio One 6 DAW. Not so when I had apnea therapy, make it close and consistent with sleeping well.

[BoxcarPete]

Yep, bit of a blunder there, but if you've learned your lesson it's all good. When do you get your cervical collar? That seems from my armchair here to be your best shot at going to zero. If you don't have it yet and want to be impatient, you can try sleeping with a shorter pillow (or even without one) or loosely rolling a hand towel to put under your neck to keep it straight or tipped back. This advice applies to you if you do the chin tuck test and find it harder to breathe, which I am going to guess it does because you ordered the collar.

[sleepadventurer]

Yep - the chin tuck definitely makes it harder to breathe.

I'm going to grab a collar at Walgreens or CVS this evening because the Amazon ones aren't coming until Sunday (and I am impatient).

The experiment tonight will be: Old Settings (11-13 pressure and EPR 3), along with a cervical collar.

Here's to a great night's sleep!

Thank you everyone and I'll post results tomorrow! It's exciting to be getting closer to have consistent, restful nights.

- Sleep Adventurer

[sleepadventurer]

Hello all!!
I'll cut to the chase - I had the best night sleep I've probably ever had in my life since developing sleep apnea last night 

Settings (See Oscar image attached): 11-13, EPR 3, No Ramp, Auto Climate, Mask F30i

PLUS Cervical Collar

8:55 total hrs

= AHI 1.68 

I had no problem keeping the cervical collar on last night, in fact it felt really good for some reason to have my neck secured. I often wake up with neck strains/pain and this prevented those.

My OSCAR data shows the most flat, consistent flow rate I think I've ever had (see attached image "6") 

Thank you all SO much for your thoughts and recommendations 


A few quick questions:

• I am now narrowing in on the events that occurred between 6:30 and 7:30 am (see attached image "6.5"). Oscar flagged 5 Obstructive Apneas and 1 central apnea during this time. 
  
• From what I've seen on LenkyLefty (what are yall's thoughts on him?), Oscar may have been misinterpreting these events, possibly because there was no breathing "slow down" before each breathing pause.
  
• Could someone help me interpret these events? (image "6.5" attached). Are they really obstructive events, central apneas, or something else? Whatever they are, the flow rate is definitely smoother than in the past, but I'm just wondering what might be causing these. 
  

Thank you to BoxcarPete for the cervical collar suggestion - invaluable! And thank you to everyone else!!


- Sleep Adventurer

[BoxcarPete]

Congrats on the good night! Hope you have many more.

 

As to the collar, I'm just passing along some advice that I got here from this community of fellow sleep sufferers.

[SarcasticDave94]

Looks like a win. Good job.