I have UARS. Need help with analyzing OSCAR graph and titration - Printable Version +- Apnea Board Forum - CPAP | Sleep Apnea (https://www.apneaboard.com/forums) +-- Forum: Public Area (https://www.apneaboard.com/forums/Forum-Public-Area) +--- Forum: Main Apnea Board Forum (https://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum) +--- Thread: I have UARS. Need help with analyzing OSCAR graph and titration (/Thread-I-have-UARS-Need-help-with-analyzing-OSCAR-graph-and-titration)

I have UARS. Need help with analyzing OSCAR graph and titration - baskinghobo - 11-20-2022 I am finally able to sleep using my ResMed AirCurve 10 VAuto and P10 mask after maxing out the humidity and changing a few settings. The problem is I am still waking up in the middle of the night and also feel more groggy waking up. Here is a link to my OSCAR graph - imgur.com/a/rM1DzuP and imgur.com/a/Or8f1ug. It seems like my breathing becomes erratic and the pressure/snoring increases before I wake up. I believe either my throat is closing at night and/or I am forgetting to exhale while asleep which causes me to wake up. Here are the results for my WatchPAT test if they are helpful - i.imgur.com/IcxyTaq.png and i.imgur.com/yOdBfMe.png. My BiPAP settings were found using trial and error and is currently set at - PS: 3 Min EPAP: 4.4 Max IPAP: 25 Ramp: 30mins Mode: VAuto RE: I have UARS. Need help with analyzing OSCAR graph and titration - Sleeprider - 11-20-2022 I have posted complete links and some images below. As your post count increases you will be able to post your own links and images. In the third image below you provide a zoomed view of the flow rate ahead of a sleep disruption.  Over most of the night, your therapy is very good with steady pressure and occasional CA events. The event on 11/19 at 06:52 looks to start with flow restriction or limitation that may be positional from a change in body position, chin tucking or similar airway obstruction.  The fact it arises out of normal sleep rhythm tells us it is not related to pressure or settings, so we need to look elsewhere for the source of the problem.  Therapy settings appear good, and the number of events decreased slightly with PS 3.0 vs PS 4.0.   I think you can use either PS 3.0 or 4.0 as it has no effect on major respiratory statistics like tidal volume, minute vent and respiration rate, however you can increase the "trigger sensitivity" from medium to high to clear the CA events.  You can reduce maximum pressure to 12.0 if you wish. The machine only goes as high as needed, but there is nothing above 11.0 cm. I can't identify the source of arousal, but it appears to be related to a change in body position rather than anything more sinister. Increasing trigger sensitivity should be more comfortable and reduce CA events. Other than that, let's monitor your progress and see if this makes a difference. https://imgur.com/a/rM1DzuP https://imgur.com/a/Or8f1ug RE: I have UARS. Need help with analyzing OSCAR graph and titration - baskinghobo - 11-20-2022 Thank you. I will update my progress soon. I know I toss and turn a lot when I sleep so I might try a bungee cord strapped to the bed because I once used that to try and fix my acid reflux issue and it didn't work but it did help me stay on my back. I have also fixed my acid reflux issue recently by making sure to not lay down for an hour after eating and avoiding certain foods that trigger my reflux.  I have also been able to fix my issue of waking up in the middle of the night in the past by two methods. The first way was when I went on triple therapy for h pylori but my acid reflux came back after about a month and thereby my sleeping issues. The second way was when I started using sudafed nasal spray but the rebound made this option unfeasible. RE: I have UARS. Need help with analyzing OSCAR graph and titration - baskinghobo - 11-23-2022 Here is my OSCAR graph from last night - imgur.com/a/8hcYxGg . I woke up in the middle of the night again but not sure when. Next time I will need to take my mask off so it's easier to spot on the graph. Also I felt like the PS was a bit too high after changing the trigger sensitivity to high so I might lower it to 2.6 or 2. But otherwise I felt like my sleep was much better with the new settings. Almost as good as what I consider to be "good sleep" but not quite there yet. RE: I have UARS. Need help with analyzing OSCAR graph and titration - Sleeprider - 11-23-2022 This appears to be a less restless night. The pressure increase is related to a cluster of flow limitation that is probably positional. Nothing wrong with your therapy, but suspending the tube above the bed so your mask moves with you, and possibly using side-pillows to restrict movement might be a better solution than a bungee cord. RE: I have UARS. Need help with analyzing OSCAR graph and titration - baskinghobo - 11-23-2022 Thanks I will give those a try. I think my issue may also be allergy related as last night I was struggling to breathe through the mask so I had to take it off and I know I have dust mite allergy. But for the graphs I've already posted I had no such issues so it could be a combination of factors causing my sleeping issues. RE: I have UARS. Need help with analyzing OSCAR graph and titration - Sleeprider - 11-23-2022 Flonase! Seasonal allergies, congestion, nasal inflammation. It's a great solution. RE: I have UARS. Need help with analyzing OSCAR graph and titration - baskinghobo - 12-10-2022 I've slept with the BiPAP a few more nights and have been paying attention to any leaks and allergy related issues. I still wake up in the middle of the night and suspect it is caused by two reasons, specifically -  1. My nervous system is still on high alert and I never really enter deep sleep 2. My throat closes up and/or I stop breathing while asleep i.e. UARS and Central Apnea I noticed in my most recent OSCAR report I did not have any increase in leaks prior to having a CA event except for one so I do not think my issues are caused by it. Here is an overview of my sleep in OSCAR - Sleep overview - Album on Imgur Here is a zoomed overview of when I wake up in the middle of the night - Wake up middle of the night - Imgur Here is a zoomed overview of a CA event - Wake up middle of the night - Imgur Is there anything else I can do to solve my sleeping issues because it feels like I have tried everything and I am about to give up on the CPAP route as I am losing confidence in it. RE: I have UARS. Need help with analyzing OSCAR graph and titration - baskinghobo - 12-17-2022 I am not an expert but most of my issues seem to be CA events and some hypopnea as well. Would it be worth looking into getting a ASV machine or even a Remede system?