[Treatment] New user story + OSCAR analysis

[leonardocolato]

Hello people!

I'm new here and new to Oscar too  feeling a little nervous for sharing for the first time my story, but here we go!

I'm a 23 Brazilian male and not overweight, if this is relevant. My first sleep study was in June of the last year because (for years) I had been feeling super drowsy, sleepy during the day, and (for years) everybody said my sleep was super agitated. Well, I never thought my sleep nights were refreshing at all, actually. On this first exam, my AHI was 43.0 (4.3 OA/hour, 26 in total, and 38.7 hypoapnea/hour, 236 in total). In December 2023, recommended by my doctor who thought maybe this could help, I passed though a surgery to remove my giant tonsils (bad recovery experiencie, oh my...)

Sadly, my sleepiness and tiredness and all the symptoms during the day persisted. On May this year, I did a second sleep study in which my AHI was 26.4 (3.1 OA/hour, 17 in total, and 23.4 hypoapnea/hour, 130 in total), hypoxemia on 8.5% of total time sleep and snore present almost all the time too.

Then, I was recommended a CPAP machine by my doctor. I rented a machine for a month and a half and, after that, with the decrease of my OAs on using the machine, I bought myself the Resmed AirSense 10 and the Philips DreamWear nasal mask, which I found out was the more comfortable one for me.

With this new machine, we started with a fixed pressure of 9.0 cmH2O. One month after that, symptoms remaining the same, we raised the pressure to 9.6 cmH2O, just a little because I had experienced aerophagia in the beginning of the treatment with the rented machine. 

Now, one month after raising the pressure and more than three months using CPAP machines, I feel more exhausted and sleepy during the day than ever, with my usual headaches and dizziness. It looks like the more I think about it, the more I feel bad; the more I treat it, the more I feel tired. My doctor says it takes time to get better (I know) and we have to do things patiently (I know too), but I feel like my symptoms are getting worse each day. There's no day I do not wake up feeling like I didn't sleep at all. There's no day I do not need to sleep for at least one or two hours on the afternoon. There's no day I pass through that I do not feel like a zombie. It's incompatible for the things I want to achieve.

I had been reading the sleep apnea forum on Reddit forum, but never shared my experiences or said anything because I though I was still on the very beginning of my treatment. However, more than three months after starting my treatment with no noticeable improvements on my symptoms and only being able to go to the doctor and talk to her once a month or two drove me crazy. 

So, I finally found out about OSCAR and the online communities around sleep apnea and decided I had to do something on my own too – and with your help. I really want to get better with CPAP. My OAs and stuff already got a little better for the sake of my heart, but I don't want the benefits to stop here. I believe I can feel better too.

Yesterday, I reserved a time and downloaded OSCAR, read my CPAP machine's SD card on my computer and watched videos on YouTube to understand what I was looking at in the software. Today, I feel prepared to share some of my OSCAR sleep data with you so I have more opinions on what should I do next to finally sleep better and wake up rested...

Could you help me on this?

If you need more data or different print screens, please, let me know. I only attached here the daily reports of December 16th and 17th.



         

[staceyburke]

Welcome to the board...

You are having positional apnea.  You can see positional apnea where either H or Oa events are clustered together.  Getting rid of as many as you can will lower your AHI.  Positional apnea can NOT be controlled by pressure changes.  You have to find out what position you are getting into and cutting off your own airway.  Have you changed your sleep position?  Sleeping on your back?  Using more (or new) pillows?  These things can cause positional apnea by chin dropping to your sternum and cutting your airway.  Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar.  I have a link to collars in my signature at the bottom of the page.  It shows people who are not wearing a collar and the SAME person wearing a collar.  There is a huge difference between the two.

The second problem you have is high flow limits.  FL are apnea just like O and H events just not as long lasting (at least 10 seconds to be counted in the AHI and O or H events)  we help the FL using EPR.

So what I would set the machine at is

Autoset
Min 7
max 10
EPR Full time
EPR 3
turn off the ramp

Give that a try for a night and post OSCAR again for that night.

[leonardocolato]

Hi! 

Thanks for the answer. 

I didn't know until now the positional apnea.

I don't know exactly in which position I sleep, because I move a lot during the night. But the position I fall asleep is by side. Do you think I should try changing it and use more flatter pillows, besides setting the machine differently?

[staceyburke]

You have both problems you need to work on both. Have you looked at the link to collars at the bottom of both my posts. 

You need to see how the EPR works for you and we need to see the OSCAR of that night.

[leonardocolato]

I've opened the link, but didn't read it yet. Going to do it now. But since I live in Brazil, I think I probably won't find the same collars as you have in USA...

[staceyburke]

The same collar does not matter, what matters is that it keeps your chin from dropping down to your sternum.

[leonardocolato]

Ok! 

I've read it all. Going to buy a new pillow (mine is too high) and a neck collar to try testing things out. 

Do you think this one is fine for a first test? It's from a brand I know here from Brasil --> https://loja.mercur.com.br/colar-cervica...iption-row

[leonardocolato]

There's a problem: my machine is a fixed pressure one. Adjusting it now, I've seen I can't put it on autoset and neither the minimum pressure of 7. What should I do in this case? 

[staceyburke]

You need the one that is the correct height.  The height is the distance from your chin to your sternum.

[Expat31]

You need access to the "hidden" clinician's  menu, see Manual for Airsense 10