[Treatment] OSCAR adjustments recommendations

[leonardocolato]

Hi guys.

I've changed my CPAP machine settings, but I'm seeing an increase on the C and O events, while the H events and the flow limit decreased a little. 

For comparison, here is a print screen of December 17th, the last day with the old adjustments, and December 22nd, with the new adjustments. 

What do you think?

         

[Deborah K.]

I suggest you try a range of pressures to see how much you actually need.  Try 8 to 14.  Once you have done that we can advise you further.

Keep the EPR at 3 for now.

If you can tolerate it, please lessen your ramp time to 10 minutes and raise the ramp pressure to 7.

Did you have a lot of Central Apneas (CAs) in your sleep study?  If you don't know, please post a redacted copy of the study.  If you don't have it, ask your doctor for a copy.  If there were not a lot of CAs in your sleep study then yours are treatment-emergent and will lessen on their own as time passes.

Good luck at improving your therapy and comfort!  

[leonardocolato]

Hi Deborah, thank you for the answer!

I had zero CA on both of my sleep studies. Maybe I should focus on O events then, like my doctor was doing? I just don't know how, cause I had achieved less O events before, but since i started changing pressures and turned EPR on, it's getting bad again.

And there is another problem: I'm feeling dizzy since before changing pressures, and now the dizziness got a little worse. What do you think may be causing it?

View from last night when I lowered the pressure a little:
   

[Deborah K.]

It's great that you had no CAs on your sleep study.  They will lessen in time as you adapt more to therapy.

I did not realize that the Elite version allows single pressure only, so you cannot set a range of pressure.  Let's try 10.4 tonight and see if that's better.  

Move your EPR up to 3, as your flow limits are higher at 2.

You also have what we call Positional Apnea.  PA shows on your charts where Os and/or Hs are clustered together.  No setting can fix these, which are caused when your chin drops down toward your chest.  And somewhat like a kinked hose reduces water flow a dropped chin reduces airflow.  Sometimes these can be fixed by sleeping on a flatter pillow.  Most people find that wearing a soft cervical collar during sleep will work.  I bought a child-size pillow that has a raised front edge that keeps my head tipped slightly back.  That works for me.

Also, don't chase a 0.0 AHI. Most people never get those, although I sometimes do. They are nice but not needed.

I can't comment on dizziness.  Maybe your regular doctor can help you with that.

[leonardocolato]

Can I move the pressure to 10.4 directly from 9, where I was yesterday? I've seen that the recommended is 0.6 to 0.6 when making changes.

Also, the ramp time influence anything? Is it ok being 5-10 min at 7 cm? I don't see any differences if it is turned on or off, but I was used to it turned on for + 40 min in the beginning...

Oh, and about the positional apnea: I was recommended here by another user to try a collar and a flatter pillow. I'm waiting for the collar to arrive and searching for the best pillow 

[SarcasticDave94]

I would go ahead and change that setting to 10.4.

Ramp can cause two things, both against your specific needs. One, as it's lower than your minimum therapy pressure needs, you get less effective therapy the time duration of the Ramp. And this happens every time you start or restart therapy.

Second issue is Ramp may increase CA on the chart, and add a disruption.

[staceyburke]

You will have no problems with moving up more.  You probably will not even notice it.  As far as a 5 minute ramp, no 5 minutes is no big deal but if you wake up a couple times a night and use the bathroom, the ramp starts over and now it is 15 minutes of ramp.  While you are on ramp you are not getting therapy.

[Deborah K.]

Since you don't feel any difference, turn ramp off. You'll do better without it.