[Treatment] Help With Understanding Oscar / Bipap Settings

[jhb910]

Hello - I have been trying to improve my settings with Oscar, watched a lot of videos on youtube and read up as much as I could but still am unsure how to use my data to adjust my settings. 

I have included screenshots below, but am not sure what other information is needed for some guidance. I am using a Resmed Aircurve 10 ST with a full face mask. Pressure is 12, EPAP is 8 and backup rate is 10.

Original diagnosis was an AHI in the 30s, now it is listed in the 6.5 range on average but I am still feeling very fatigued during the day and am hoping to get this lower. Apologies if this type of post is not allowed. thank you in advance for any help!

[pholynyk]

This is exactly the type of post we encourage on ApneaBoard. The board was created to help CPAP users get the best results from their therapy.

I'm a simple APAP user (simple APAP? simple user?) but what I lave learned is that OA are controlled with EPAP, and hypopnea are controlled with pressure support. (in the absense of centrals, of course.)

You have zero OA, but many UA. The one UA you have shown us doesn't look like it's an OA wannbe, rather an H hopeful. If the other UA are similar, I would suggest you reduce your EPAP by 1.0 cmw and try it for several days (one day is not a trend). If you don't get any OA and no more UA, and your hypopnea go down, your are on the right track, and could reduce EPAP by another 1.0 cmw. When you start getting OA, stop and increase your EPAP by 0.4 or 0.6 cmw.

The point here is that most people are more comfortable with a lower EPAP - as long as the OA are controlled - and lowering your epap while leaving IPAP untouched automatically gives you more pressure support to contolled the hypopnea.

That's how I would do it if I had a bilevel - perhaps someone more knowledgeable will come along to confirm or correct my ideas.

[jhb910]

Hello, thank you so much for your help! I was able to use your advice last night (or at least I think I made the necessary changes) and my AHI improved to below 1 for the first night since starting treatment. Screenshots included for details. Thank you again! Please let me know if I made the right adjustments or if I was mistaken.

[Dormeo]

Pholynyk gave you some great advice there. Remarkable improvement in the numbers. (You reduced your EPAP by more than he suggested, but given the outcome, I'd leave it alone for now.) I see you also slept longer, or at least used the machine longer.

Are you feeling better today? While optimizing settings is largely data-driven, how you feel is also a key part of what should guide optimization.

[jhb910]

Pholynyk gave you some great advice there.  Remarkable improvement in the numbers.  (You reduced your EPAP by more than he suggested, but given the outcome, I'd leave it alone for now.)  I see you also slept longer, or at least used the machine longer.  

Are you feeling better today?  While optimizing settings is largely data-driven, how you feel is also a key part of what should guide optimization.

I realized I made the EPAP lower after going through this morning, but like you said it seemed to have worked out well so I will leave for now.

I do think I feel better and more rested than normal today, so I will continue with these settings and monitor things as I use them more. Will update!

Any more advice would be greatly appreciated, I am very open to any and all suggestions. Thanks!

[pholynyk]

It looks like you made the changes correctly, and it looks like it helped. The UAs and Hs look like they seem to be more obstructive than central, and I'm not sure it could get much better. The flow pattern - both inhale and exhale - looks spiky to me rather than smooth, but I don't know what could be done. If you are sleeping well, it probalby doesn't matter.

[Dormeo]

Everything else looks good to me. I'm glad you're feeling better today; fingers crossed you'll see an improving trend.

The one thing I note is that you had rather different bedtimes and rising times for the two nights you posted. It might be worth reviewing these guidelines to better sleep. I thought they were vanilla and didn't take them seriously at first. Then out of desperation I did, and following them actually helped.

• Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
• Set a bedtime that is early enough for you to get at least 7 hours of sleep.
• Don’t go to bed unless you are sleepy.
• If you don’t fall asleep after 20 minutes, get out of bed.
• Establish a relaxing bedtime routine.
• Use your bed only for sleep and sex.
• Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
• Limit exposure to bright light in the evenings.
• Turn off electronic devices at least 30 minutes before bedtime.
• Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
• Exercise regularly and maintain a healthy diet.
• Avoid consuming caffeine in the late afternoon or evening.
• Avoid consuming alcohol before bedtime.
• Reduce your fluid intake before bedtime.