Where to post Oscar screenshots for review?

[koopas]

Hi all,

Happy gobble gobble day.

Pardon the ignorance, but where can I post screenshots of Oscar for members to review? Is there a particular forum?  (I don't want to pollute the main board). I have been using my S9 Autoset for almost 7 years and only now downloaded the data. It's fascinating except I don't know how to interpret the data. I looked at Oscar - The Guide but the interpretation aspects still baffle me. Is there a plot I should focus on? My AHI is under 2. I have no complaints about my treatment and how I feel, but wondering if the data shows the same.

Thanks much!
Koopas

[staceyburke]

Welcome to the board, there are a lot of very knowledgeable people here that can help.  You can post here.  Do look at my last link on charts at the bottom of this post.  It shows the charts we need and if others are needed we will ask you to post them at that time.

[koopas]

Thanks Staceyburke for the warm welcome, and the support.

I have followed your instructions for chart organization and have attached my last 3 night's charts for members' feedback.

Anything concerning? Can tweaks be made to my treatment parameters?

I feel pretty good in the morning. I'm not sleepy during the day. I've been on APAP since 2013 and am very comfortable with the treatment.

Thanks a lot for any advice.
Koopas

[SarcasticDave94]

There's 2 things I'd change on the settings. Edit your pressure Min. to 7 to address Obstructive events. Then EPR needs to be turned on to 3, which you now have at 0, meaning it's doing nothing. Leave it at full time.

EPR is exhale pressure relief, and should make exhale a bit more comfortable, while working on FL too.

[Gideon]

I'd set min to 7
But EPR=1 full time and titrating up.
Why? Simply because your numbers are good.
It is important for you to notewhich settings feel better to you.

[Sleeprider]

Notice how your obstructive apnea are clustered and have no relationship to pressure?  We call that positional and it's actually chin-tucking that cuts off the airway. The image below is classic!  Read these two wiki articles and then consider if you might be using too tall or firm of a pillow. Your event rate is not so high that I would suggest a soft cervical collar, but that has been shown to really improve results:
Positional Apnea http://www.apneaboard.com/wiki/index.php...onal_Apnea
Soft Cervical Collar http://www.apneaboard.com/wiki/index.php...cal_Collar

EPR will stabilize your pressures and make therapy more comfortable. I would guess you will need setting 2 or 3 and a minimum pressure of 9.0.

[Dormeo]

As you will guess from the posts above, you can make changes gradually. For example, you can raise your minimum just to 7 for now, and set EPR just to 1. See how that goes, then possibly raise the minimum by 1 (or less -- you can change the pressure in increments of .2), and increase EPR to 2.

One key to successful experimentation is to stick with any changes for at least 3 or 4 days (preferably more) to see whether there's a trend. Another is to keep track of how you feel during the day. With generally good numbers like yours, that's a very important piece of the puzzle.

[koopas]

Hi,

Thanks for all for the feedback, it is much appreciated!!!

The two recommendations that have consistently been voiced have been upping the min pressure to 7 (roughly 2 below my Med pressure of ~ 9, consistent with the Wiki) and actually enabling EPR to something greater than 0.

Could someone please expand on the reasons behind these recommendations?  I'm not questioning but wish to learn the thought process (this stuff is really beyond me)

Regarding the first point, wouldn't the Autoset mechanism automatically up the pressure from my current min of 5 to whatever is necessary to prevent apneas?  I can see that given my current Med (median?) pressure of 9, the machine has less work to do to go from 7 to 9 rather than 5 to 9, but would that be the only reason to up the min from 5 to 7?  And wouldn't the increase in min pressure make me less comfortable?

Regarding the EPR, I read about it but don't quite grasp the impact of this on therapy numbers as I never really felt uncomfortable on exhalation. I think in the past I fiddled with EPR but didn't notice much of a difference in my sleep quality.

Another follow-up question: from the screenshots I provided, do they point to the treatment being effective?

Thanks!!
Koopas

[SarcasticDave94]

EPR must be given a suitable minimum pressure so that it actually has room to do its job. If your Min pressure was too low for this, it can explain why EPR didn't seem to help.

As for why you need to tune the pressure requirements to yourself: do your remember how spark plugs needed gapped to a certain spec for individual cars or trucks? It will run best with it adjusted/gapped to spec. Or how tire pressure needs set again for the individual car? Again, there's best pressure for tires on your Ford Mustang or F150. Or another, the Auto HVAC cars have now? This Auto HVAC needs set to your preferred temperature, where afterwards it automatically adjusted from there to give you the desired results.

The Auto part of CPAP is best used to allow it to adjust after bringing it up to your individual specs where it runs best. From there, it automatically adjusts for changing needs over the night's sleep session or if your therapy needs change some months later down the road.

[Dormeo]

Your machine will raise pressure only AFTER you've experienced an event (OA, H, FL, or snore), in order to head off more of the same. After a bit, it will revert to a lower pressure. By raising your minimum, you reduce the need for this kind of up-and-down, while heading off events before they have a chance to happen. I'm betting that the proposed increase in your minimum will feel just fine to you, but let's see.

EPR is partly a comfort feature and partly a therapeutic feature, especially for flow limitations. Flow limitations are a disorder of inhalation; the tissues in your airway relax a little while you sleep, which prevents you from inhaling smoothly and easily. This in turn may, in some people, result in somewhat fragmented sleep.

If your exhale pressure is lower than your inhale pressure, then by the same token your inhale pressure is higher than your exhale pressure. That gives you a boost to assist you in smoother inhalation, reducing the amount of work you have to do to breathe in.

All of that is assuming that the FLs are due to a limitation in the pharynx; if the limitation is in your nose, then EPR is less likely to help. But again, let's see.