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[CPAP] Help understanding Oscar Data - Printable Version

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Help understanding Oscar Data - OnlyDans - 11-29-2024

First time poster here and hopeful to get some advice with what is going on with my sleep and CPAP machine. Recently diagnosed mild sleep apnea. Im using a ResMed 11 with a P30i Nasal Pillow. I’m having a lot of events happening and trying to understand what is happening and how to fix. My pressure is 7-14 cmH2O. Last night I taped my mouth and that did help bring down the events to around 6/hour but that’s still not great. Previous nights (prior to using Oscar, events ranged from 10-25/hour). Any advice/help/suggestions? The image is from last night’s sleep. Since starting, I constantly feel like garbage and very tired. I tend to start sleeping on my back and move to my sides throughout the night. Happy to provide more data if needed, like I said I'm very new to this. Thank you!

PS - Also not sure if this is helpful but my AHI gradually increases over time...


RE: Help understanding Oscar Data - OnlyDans - 11-29-2024

Updated Oscar Image to fit all


RE: Help understanding Oscar Data - Deborah K. - 11-29-2024

Welcome

I suggest you raise your minimum pressure to 8.  Your median pressure is slightly above that, so that's a good place to start.  Also, turn off ramp.  You don't need it.

Most of your apneas are CAs.  Did you have a lot of them in your sleep study?  If you don't know, please post a redacted copy of your sleep study.  If you don't have a copy, request your prescriber to give you a copy.  By US law, he must provide it.  If there were not many, your CAs are treatment-emergent and will lessen as time passes.

You also have a little Positional Apnea, at least on this one chart.  PA occurs when your chin is tipped toward your chest.  In the same way that a kinked hose reduces water flow, PA reduces airflow.  It shows on your chart where Os and/or Hs are clumped together.  No setting will fix these. Some people find that sleeping on a flatter pillow works.  More need to wear a soft cervical collar that is high enough to keep their chin up.  I use a low pillow that has a raised front edge that tips my head back slightly and has solved my PA altogether.

Again, welcome, and good luck with your new therapy!  Smile

P.S. The first chart is what we need to see unless someone asks you to provide more.


RE: Help understanding Oscar Data - OnlyDans - 11-29-2024

Thank you very much! I'll raise my minimum pressure tonight to 8. I do feel like I usually sleep with my chin closer to my chest. I can't stand having things around my neck so I'll save the cervical colar as a last resort. I so love my pillows but will try a flatter pillow first.

Here are the results from my sleep study as well in case that informs anything additional.


RE: Help understanding Oscar Data - Sleeprider - 11-29-2024

It may help to keep pressure to a lower range than your current 7-14 EPR 3, especially since most of your events seem to occur at higher pressures. Also you should try lower EPR to see if that helps with the CA events. Obstructive events show some clustering, so read the positional apnea wiki and see if anything there relates to you, for example, if pillows are tall or firm. https://www.apneaboard.com/wiki/index.php?title=Optimizing_therapy#Positional_Apnea

Try pressure 7.0 to 10.0 EPR 2, and provide a chart and your qualitative feedback tomorrow.


RE: Help understanding Oscar Data - OnlyDans - 11-29-2024

Thanks so much! Will give it a shot and report back


RE: Help understanding Oscar Data - Deborah K. - 11-29-2024

Your sleep study shows more CAs than either of the other two types. This means they are not treatment-emergent and will not go away. You may need a different machine to treat them.


RE: Help understanding Oscar Data - OnlyDans - 11-29-2024

What sort of equipment is there to treat CAs?


RE: Help understanding Oscar Data - Sleeprider - 11-29-2024

People with CA need the stimulation of pressure support to remind them to breathe or to actually cause the breath. Individuals diagnosed with central sleep apnea will generally need and "Adaptive Servo Ventilator" (ASV). This is a bilevel machine that maintains the rate and volume of respiration using pressure support, a difference in pressure between inhale (IPAP) and exhale (EPAP). The adaptive element is that the pressure support is delivered when it is needed and in the amount that is needed to create a normal breath. Typically, even with central apnea, patients are prescribed CPAP, and must fail to achieve efficacy with CPAP in order to be prescribed a more advanced device. This requirement is imposed by insurance due to the higher cost of bilevel and ASV. An overview of ASV is in this wiki https://www.apneaboard.com/wiki/index.php?title=Adaptive_servo-ventilation_(ASV). Your AHI is on the "mild" end of the scale, and you will need to demonstrate compliance in trying to use CPAP, and your doctor will need to make a determination that a bilevel of ASV device is medically necessary. It is possible your central apnea will resolve as you become accustomed to the therapy. One of the things that usually helps individuals with CA is to use lower settings of EPR. Higher EPR settings tends to increase ventilation resulting in a lower CO2 level in the blood stream. CO2 is a major simulator of respiration, so as you move along with therapy, we will probably evaluate how EPR and lower pressure affects you.


RE: Help understanding Oscar Data - OnlyDans - 11-30-2024

Here is my data from last night. I have no idea what is going on. This The CSR has never happened before. Could it be because I lowered my pressure last night?