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11-18-2023, 10:14 PM (This post was last modified: 11-18-2023, 10:15 PM by HannibalBarca.)
Help deciphering OSCAR reports?
Hey guys, was diagnosed pretty recently, only received my APAP machine in mid-October. I began recording data to an SD card on November 14th, however for some reason the 15th & 17th didn't record any detailed data. I've attached the two nights I do have data for; as a note, I began using a soft cervical collar (I'm a chronic mouth breather) on the 16th, and subjectively I feel like I woke up with more energy than I have previously since starting APAP. However, that could just be a one-off.
In these two charts, do you guys see anything that sticks out to you as egregiously bad? Things I could improve? I still feel fairly sleepy most of the day, however I'm also being treated for depression, anxiety, and ADHD currently so it could be a million different things playing into this. I'll keep recording data in OSCAR as time goes on to see if I notice any trends.
Machine: Lowenstein Luisa Mask Type: Full face mask Mask Make & Model: Resmed Quattro FX Humidifier: separate F&P humidifier CPAP Pressure: Epap 4-20 PS 4-20; "auto" rate CPAP Software: Not using software
Other Comments: Using 45 degree angle upper body wedge (36"x36") and 4.5"soft cervical collar; 500 assured tidal vol
Welcome to ApneaBoard. It seems using the soft cervical collar should have produced better results, but it didn't.
Your EPR is set to 1 full time. You a few flow limitations. You can try raising that to 2 (and possibly even 3) and see how it affects your therapy. The only downside of using EPR is that it can increase central apneas (CA). It is a balancing act. You have a few CA.
If you ever get clusters of OA's and maybe even H's, the soft cervical collar should help (in theory). There is a possibility the collar you have is incorrectly sized or some other problem when wearing it. Measure in inches and fractions of an inch from your chin to your chest to get a good estimate of the correct collar size.
Overall, pretty good therapy. A few tweaks could get improved therapy, but the wrong tweaks might hinder your therapy. OSCAR should show which tweaks to make to optimize (or if you shouldn't make any more tweaks - this is the best you can do).
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11-19-2023, 12:22 PM (This post was last modified: 11-19-2023, 12:23 PM by gainerfull.)
RE: Help deciphering OSCAR reports?
Overall, considering the prevalent events and snore it looks like you're not using enough pressure and are under-titrated.
1. Fix obstructive events - raise minimum pressure by 1cmH20
2. Fix hypopneas - once you see no more obstructive events (light blue) consistently, consider adding more EPR with the goal of using EPR @ 3 full-time
An example approach:
Tonight: Adjust minimum pressure, if your data has no obstructive events keep the settings for a couple nights.
Night of 11/21: Change EPR to "2", review data the following morning, if obstructive events reappear add another 1cmH20 to minimum pressure and test for another couple nights
Night of 11/24: Change EPR to "3", follow same process as above
Rinse & repeat - a week from now should consistently see no or one obstructive event per night, less hypopneas and more restful sleep
Make sure to zoom in on the obstructive events and determine if they are actual obstructions or just sleep / wake junk followed by a breath hold while you change positions. If you want to zoom in on a couple from the two nights you posted we can help you determine if they are real events or not.
Thank you for the replies! I've attached my results for the night of the 18th (no adjustments from previously) and the 19th (bumping minimum pressure to 13cm). I zoomed in on the chart for the 19th since it added part of the previous night's sleep to the chart.
Also, I realized last night that uh... I was wearing the cervical collar wrong. Woopsie. Would explain why it wasn't helping out as much as it should. Gonna record a couple more nights data and see what I can get.
Okay, here's the data for last night; I fixed the cervical collar, and bumped my minimum pressure to 15cm. My AHIs seem completely unchanged to my untrained eye, so I'm not really sure where to go from here.
One thing that stands out to me is when your pressure is around 15 things look really good. As soon as pressure goes above that things go wonky.
Both Jay51 and GainerFull suggested increasing EPR to 2 or 3 if needed. Makes sense to me. I would set pressure to 14-18 with EPR 3 full-time. You may find with more EPR you will be able to drop pressure a bit.
