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+--- Thread: Help interpreting non-obstructive events in OSCAR (/Thread-Help-interpreting-non-obstructive-events-in-OSCAR)
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Help interpreting non-obstructive events in OSCAR - needsleeps - 02-12-2024
I'm currently waiting the results of a lab sleep study but bought a CPAP as I was dealing with extreme fatigue. The CPAP (ResMed 10) has made a noticeable difference in terms of my energy so I'd assume I have some form of sleep apnea.
I just got an SD card and from last night's data, OSCAR is showing only CAs and Hs. I messed around a lot with settings for the last week but thought a more methodical approach with input from experienced people would be beneficial.
I have read some people saying in some circumstances CAs can be disregarded but I wanted to check this for myself and see if there's anything I can adjust to further reduce my AHI.
Many thanks.
[attachment=59497]
RE: Help interpreting non-obstructive events in OSCAR - dataq1 - 02-12-2024
Could you magnify the area around some of your typical clear airway events?
(Looking for periodic / CSR like waxing & waning)
RE: Help interpreting non-obstructive events in OSCAR - SarcasticDave94 - 02-12-2024
Since the Central aspect is this low when on an AutoSet, I would think they are going to remain low. However you don't have your test results yet, so that may reveal something to change the direction required. Given this OSCAR chart, I don't think there's going to be much regarding CA.
Hypopnea means you're at a bit too low pressure to keep your airway fully open. Obstructive Apnea means airway is mostly to fully closed. Hypopnea means about half to three quarters closed. Then least of those is flow limits. Any of these three will need Min pressure to increase, and/or adding in EPR. Yes, the CPAP does increase automatically, however getting a minimum pressure to prevent most is likely going to give best results.
I would try this, Min to 7 and then begin EPR at 1 full time. Take a look at the chart, post it along with how you feel. Probably repeat this while editing EPR to 2. Another repeat with editing EPR to 3. This is to give any treatment emergent Central Apnea time to reveal themselves and what their character actions will be.
What we're looking for from the above will be reduced Hypopnea, hopefully little CA action, and a bonus of increasing comfort and rest.
RE: Help interpreting non-obstructive events in OSCAR - needsleeps - 02-12-2024
Thanks for the replies. I've attached a zoomed in view of one of the CA events.
I've also attached a less granular view of some of the attempts I made before I got OSCAR. The worst night for CA events seemed to be when I raised the min pressure to ~8 and EPR up to 3 (this was before I really knew what I was doing).
Just to clarify with making changes, I'm assuming that I should only do a single change at a time and see what it's like for a few days before then adding EPR?
[attachment=59501] [attachment=59502] [attachment=59500]
RE: Help interpreting non-obstructive events in OSCAR - SarcasticDave94 - 02-12-2024
Normally, yes. 1 change at a time is the best answer in most cases. However here you can choose to do both by editing to Min 7 with EPR 1 full time.
It's your choice really. If you choose to only edit pressure, try it maybe 1-2 nights before deciding on adding EPR 1 full time.
PS: so there is some of the info about CA and pressure along with EPR, in what you just mentioned. This possibly suggests adding EPR but somewhat slowly. Much like I mentioned earlier. This will likely need a few days between EPR 1 to 2 to 3 instead of one day only. It's an attempt to get your body used to the CPAP pressures and an increase in CO2 exhalation that's increased because of the CPAP. That's the root cause of your CA. This in no way means CPAP is bad for you, it's meaning the body needs a slight reprogram with breathing, as CPAP isn't standard operation.
RE: Help interpreting non-obstructive events in OSCAR - Sleeprider - 02-12-2024
A low incidence of CA events is normal, and in your case, both examples of CA you zoomed in on have an arousal or movement before the event is flagged. These events are more of a sleep disruption or breath-hold from sleep stage transition, movement, etc and can be put in the category of sleep-wake-junk that most of us experience. I think you would do better with minimum pressure 7.0, maximum pressure 10.0 EPR on Full-Time at setting 2. That should be more comfortable, resolve the flow limits we see and stabilize pressure.
RE: Help interpreting non-obstructive events in OSCAR - needsleeps - 02-12-2024
That's great, thanks both! I'll build up to those changes and then post the results.
RE: Help interpreting non-obstructive events in OSCAR - needsleeps - 02-13-2024
So I'm posting last night's data as there are a couple of things I wanted to check after looking at the OSCAR data.
It looks like a max pressure of 10 is probably too low as I'm bumping up against the pressure max at some points during the night so is this something that I should increase?
I also saw that flow limitations seem to coincide with the pressure beginning to increase. I see above that EPR of 2 would potentially have a positive impact on the flow limitations, so is this something that I should change again, having only been on EPR of 1 for a single night?
I did wake up several times during the night, which I'm going to make a note of the times to see if that shows up in the data in some way (although I would still describe my sleep as refreshing).
Many thanks again.
[attachment=59539]
RE: Help interpreting non-obstructive events in OSCAR - Sleeprider - 02-13-2024
I did suggest EPR at 2 which would have prevented the peak pressure. There is no harm in moving to max pressure 11.0. You should find the additional increment of EPR more comfortable.
RE: Help interpreting non-obstructive events in OSCAR - dataq1 - 02-13-2024
Two points to draw your attention:
The expanded flow charts you posted Seem to be pre-event arousals rather than arousals caused by respiratory flow disruption. The significance here is to recognize that many (if not most) of these short arousals occur without the benefit of our conscious awareness.
A simple example of non-awareness of changing positioning while asleep.
I hope that you don’t try to write down every time you shift position!
The second point is that flow limitations, largely driven by the shape of each breath, is the principle driver for pressure increases. Think of the flow limitation index as an attempt to predict that an airway closure is coming, the algorithm within the PAP calls for an increase in pressure to avoid a possible apnea.