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Been having a lot of trouble tuning my therapy to be effective. I'm a pretty textbook UARS with ~15 RDI, ~4 AHI, and I've been working with an Aircurve Vauto as of mid December. Overall I have no problems with the comfort of the mask or the therapy itself (at least while I'm awake), but I have not been able to get any sort of good quality sleep, and I'm really not sure where to go from here.
I attached 3 pics of my chart from last night with ps 5.6, epap 5, max ipap 15. I started with ps at 4, but based on my limited knowledge, it looks like the flow rate waveforms could still benefit from higher ps? I am having a few very short unidentified hypopneas/apneas which presumably would benefit from higher epap, but overall I don't suspect that's where the bulk of my problem lay.
Wasn't sure exactly what to zoom in on in the flow rate, so I just picked a random spot that looks disturbed. Let me know if there's something else I should include! Thanks all!
The charts are not very helpful. please include the left column with the event, respiratory and setting statistics, and charts should include Events, Flow Rate, Pressure, Flow Limit, Leaks. Instructions are in my signature links for Organizing your Oscar Charts.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
01-11-2021, 11:35 AM (This post was last modified: 01-11-2021, 11:38 AM by slowriter.)
RE: UARS help with OSCAR data
Curious what sleeprider will have to say, but what I think:
The flow limitation statistics look good.
You could maybe bump your min EPAP to 6.
Beyond that, you might experiment with further raising your PS slowly and see if that has any impact. With the current PS setting, you had no central apneas (at least on that night), so you have some room to experiment there.
Finally, you might post a two-minute segment of your flow rate graph; say from around 2 AM or so, so we can see how your breathing looks under the machine.
Caveats: I'm just a patient, with no medical training.
With EPAP min 5.0, PS 5.4, your flow limitation is as close to zero as possible, and pressure is only changing by about 1-cm. AHI is very low and respiratory statistics look very healthy. Your settings seem to have addressed the symptoms of UARS very effectively, and if you are comfortable, I don't see any need at all to change settings. I don't think the waveforms suggest any need for increasing PS. There will always be some irregularities in sleep and of course arousals. I don't see how arousals are likely related to respiratory effort, and that was what we wanted to resolve. There is always a risk of over-analyzing this, and so far, I don't see any compelling reason for changes. How are you feeling with your Vauto therapy?
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
(01-11-2021, 11:53 AM)Sleeprider Wrote: With EPAP min 5.0, PS 5.4, your flow limitation is as close to zero as possible, and pressure is only changing by about 1-cm. AHI is very low and respiratory statistics look very healthy. Your settings seem to have addressed the symptoms of UARS very effectively, and if you are comfortable, I don't see any need at all to change settings. I don't think the waveforms suggest any need for increasing PS. There will always be some irregularities in sleep and of course arousals. I don't see how arousals are likely related to respiratory effort, and that was what we wanted to resolve. There is always a risk of over-analyzing this, and so far, I don't see any compelling reason for changes. How are you feeling with your Vauto therapy?
Yeah, that's the real crux of my problem: my sleep quality has been *terrible* - as in, way worse than just going maskless. Even though the charts all look relatively clean, I wake up feeling absolutely awful. For the record, while I've been using the vauto for about a month, I'm not new to pap therapy, so I don't suspect that this is just part of an adjustment period or anything like that. I mean I'm waking up with the standard apnea symptoms - dry & sore throat, headache, etc.
On the one hand, since the charts look okay I'm inclined to stop playing around with it. But on the other, the therapy is clearly not working at all, and honestly without some sort of indication that it's helping I'm likely enough to just give up.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
(01-11-2021, 11:35 AM)slowriter Wrote: Curious what sleeprider will have to say, but what I think:
The flow limitation statistics look good.
You could maybe bump your min EPAP to 6.
Beyond that, you might experiment with further raising your PS slowly and see if that has any impact. With the current PS setting, you had no central apneas (at least on that night), so you have some room to experiment there.
Finally, you might post a two-minute segment of your flow rate graph; say from around 2 AM or so, so we can see how your breathing looks under the machine.
I've attached a 3 min segment that shows some wonky waveforms around 2:10 AM. I seem to have things like this popping up roughly every 15 minutes or so, and I can't figure out what's going on.
