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[Treatment] Cholraj's CPAP Therapy Thread + Oscar data review - Printable Version

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Cholraj's CPAP Therapy Thread + Oscar data review - aktmdn - 07-12-2023

Hi everyone, I'm Cholraj. I was diagnosed with OSA (Obstructive Sleep Apnea) about a year ago and have been trying different treatments. Recently, I got a CPAP machine, Resmed Airsense 10 Autoset, and after trying out different settings for two months, I feel good about the settings I have now. The main thing is that I don't use EPR.

To give you some background, I think I've had OSA for over ten years, and I've always felt tired. I've tried sleeping pills, therapy, medications for depression, different mattresses, adjusting room temperature, and noise levels. I've always been a light sleeper. I've probably had only five restful nights in the past ten years, and I felt amazing afterwards. Now, at 38 years old, I reached a point where I was gaining weight, feeling sleepy all the time, scared to drive, and lacking motivation to do anything. Thankfully, my doctor recommended a sleep study.

For a long time, I looked for shortcuts because I knew I couldn't keep up with hard work. I was devastated when I received this diagnosis, and my family was strongly against me using a "machine" to sleep, seeing it as something shameful. I'm still worried about traveling on flights or staying in hotels or outdoors, wondering how I'll manage all this equipment (even the smaller CPAPs are not very portable and need power). I am a heavy snorer as well and many people have pointed out the high volume and being disturbed by my snoring.

My plan for the next year is to use the CPAP machine to regain my energy during the day, dedicate time to exercise and reach a healthy weight. I want to see if getting back in shape helps eliminate my Sleep Apnea. I know that OSA isn't always related to weight, but I want to rule it out for myself. I'm hopeful that I'll start feeling better and I'm counting on the support of this forum.

I would greatly appreciate it if someone could review my Oscar data. I'm new to this and analyzing the data is unfamiliar to me. Any suggestions to improve my treatment would be highly appreciated. I'm happy to answer any questions and I'm looking forward to connecting with other people fighting OSA.


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RE: Cholraj's CPAP Therapy Thread + Oscar data review - Jay51 - 07-12-2023

Welcome to ApneaBoard Cholraj.  The only thing I see that looks suspicious is your tidal volume.  It is a bit low for a male (unless you are very short and very small person).  That brings your minute ventilation down also -  Respirtory rate (yours is fine) + tidal volume (the amount of air you breath with each individual breath) = minute ventilation ( how much air you take in during one minute's time). 

I am not sure what is causing it, but you should definitely show this to your sleep Dr., RT, etc.   Please post a 3 minute close up zoom of your flow chart for us to analyze.  Just click with your cursor on any area were you know that you are asleep, and drag cursor for only a 3 minute chart.  Upload that here please.  Your snoring may be the issue.  

You are not using EPR and might benefit from it, but please post a 3 minute close up chart first.

RE: Cholraj's CPAP Therapy Thread + Oscar data review - aktmdn - 07-12-2023

(07-12-2023, 10:26 AM)Jay51 Wrote: Welcome to ApneaBoard Cholraj.  The only thing I see that looks suspicious is your tidal volume.  It is a bit low for a male (unless you are very short and very small person).  That brings your minute ventilation down also -  Respirtory rate (yours is fine) + tidal volume (the amount of air you breath with each individual breath) = minute ventilation ( how much air you take in during one minute's time). 

I am not sure what is causing it, but you should definitely show this to your sleep Dr., RT, etc.   Please post a 3 minute close up zoom of your flow chart for us to analyze.  Just click with your cursor on any area were you know that you are asleep, and drag cursor for only a 3 minute chart.  Upload that here please.  Your snoring may be the issue.  

You are not using EPR and might benefit from it, but please post a 3 minute close up chart first.

Thank you so much Jay51!
I'm about 5'7 in height (171cm) and ~88Kgs. 

Allow me to post 2 readings, 1 without EPR and other with. These are about a week apart. I have been on CPAP for about 2 months now.

ScreenShots without EPR, 3 min interval. Tried taking an OSA incident view:
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ScreenShots with EPR, 3 min interval. Tried taking an OSA incident view:

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RE: Cholraj's CPAP Therapy Thread + Oscar data review - Jay51 - 07-12-2023

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Thank you for posting all of those charts.  In the 1st chart you posted, the tops of your flow rate chart look round - that is a good thing.  I nice round top indicates a good inhalation.  

Your therapy looks good both without EPR and with it. I would say go with whichever is more comfortable to you at night.  EPR should make breathing easier for most people (as long as it doesn't cause CA's).  

Here is a chart that shows what the top portion (the inhalation) should look like (#1) and some other tops that are abnormal.  

Everything looks good IMO, if anyone else sees anything please post.  You still have a good AHI even though your tidal volume median is a bit low in the 300's.  

Any other questions just ask.

RE: Cholraj's CPAP Therapy Thread + Oscar data review - aktmdn - 07-14-2023

(07-12-2023, 05:03 PM)Jay51 Wrote: Thank you for posting all of those charts.  In the 1st chart you posted, the tops of your flow rate chart look round - that is a good thing.  I nice round top indicates a good inhalation.  

Your therapy looks good both without EPR and with it. I would say go with whichever is more comfortable to you at night.  EPR should make breathing easier for most people (as long as it doesn't cause CA's).  

Here is a chart that shows what the top portion (the inhalation) should look like (#1) and some other tops that are abnormal.  

Everything looks good IMO, if anyone else sees anything please post.  You still have a good AHI even though your tidal volume median is a bit low in the 300's.  

Any other questions just ask.

Thank you. If you had to change any settings, what would they be?

Thing is I dont feel rested in the mornings, I feel like sleeping the entire day and that sleep is not very deep. What can I change to improve this?

RE: Cholraj's CPAP Therapy Thread + Oscar data review - Jay51 - 07-14-2023

Great questions.  You have excellent therapy IMO.  Most people would happily take a 0.5 AHI every night.  I really don't see any settings that I would change.  

The random and very few OA's could be when you change position or something at night.  The only other things that might get you to 0.0 AHI and possibly feeling better are moving from back sleeping to side sleeping; reducing your current pillow height a little bit; or even trying a soft cervical collar.  But, you really don't need the collar since your therapy is so good.  

Maybe just give it time. It took a lot of time for you to get to this stage in life.  You probably spent a lot of night with untreated sleep apnea.  It may take some time to recover from this and feel better.  Very few people (from the posts I have read here) feel better immediately after starting PAP therapy.  The majority have problems right from the start and need tweaks in pressure and/or possibly a different machine since they were prescribed the wrong one.  

You mentioned that you still snore.  That could be part of the problem.  Here is another chart that helps explain snoring.  See how the up and down very quick oscilating lines (dark black) show snoring.  It should be smooth.  You could try using EPR all the time to help this. 

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RE: Cholraj's CPAP Therapy Thread + Oscar data review - aktmdn - 07-14-2023

(07-14-2023, 10:59 AM)Jay51 Wrote: You mentioned that you still snore.  That could be part of the problem.  Here is another chart that helps explain snoring.  See how the up and down very quick oscilating lines (dark black) show snoring.  It should be smooth.  You could try using EPR all the time to help this. 

I dont snore now, atleast thats what I have been told. Let me give EPR a try though. Thanks a lot for your analysis.

RE: Cholraj's CPAP Therapy Thread + Oscar data review - aktmdn - 07-17-2023

(07-14-2023, 02:09 PM)aktmdn Wrote: I dont snore now, atleast thats what I have been told. Let me give EPR a try though. Thanks a lot for your analysis.
Tried EPR, while breathing was slightly relaxed, I am still not feeling rested at all. Today was particularly bad. Had to take the day off due to the fatigue. How can I make this work for me. All suggestions welcomed. 

MyAir app showed a perfect score of 100 but it doesnt matter.

Is it something to do with the machine? its a new machine with about 180 hrs clocked. Is it the setting? or is it me?

RE: Cholraj's CPAP Therapy Thread + Oscar data review - Jay51 - 07-17-2023

Thank you for posting again.  It can take some time to begin to feel better when using PAP therapy.  Most people has spent many years with untreated sleep apnea, and it takes some time reverse this trend and start feeling better.  Another possibility is other (possibly undiagnosed) health problems that could be draining your energy.  If you are very early in PAP therapy, give it some time to get better IMO.  Your therapy looks great right now, too, IMO.

RE: Cholraj's CPAP Therapy Thread + Oscar data review - aktmdn - 07-29-2023

How am I doing? 

Posting some screenshots for review.

Notes: 
  1. I am waking up in the night, to adjust mask, prevent mini leaks
  2. Tightened the P10 mask with clips provided, I think more tightening needed. The mask is about a month old
  3. Not waking up fresh or rested, but continuing CPAP with discipline
  4. I want to adjust pressure from 7-11, looking at the current numbers
For the data, Is there a way to tell where is the obstruction coming from?

PS - any better way to share Oscar data? the screen shots are fine but take a lot of time