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First time poster - Advice - Lukeh84 - 12-09-2024
Hi All!
New member here, This forum has been great so far for info but I am trying to dial in my resmed 10 using OSCAR. The data is great and im slowly getting used to reading it however I would love some advice on clinical settings for tonight to try and improve and optimise the machine. I know the leaks have to be sorted and I have a few things to try and work on there but aside from the leaks can i have suggestions for settings on pressure, epr on or off etc etc?
Screenshots attached
Thank so much in advance
Luke.
RE: First time poster - Advice - staceyburke - 12-10-2024
You are having positional apnea. You can see positional apnea where either H (yours are H events) or Oa events are clustered together. Getting rid of as many as you can will lower your AHI. Positional apnea can NOT be controlled by pressure changes. You have to find out what position you are getting into and cutting off your own airway. Have you changed your sleep position? Sleeping on your back? Using more (or new) pillows? These things can cause positional apnea by chin dropping to your sternum and cutting your airway. Think of it of a kinked hose – nothing can get through – you have to unkink the hose…
IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar. I have a link to collars in my signature at the bottom of the page. It shows people who are not wearing a collar and the SAME person wearing a collar. There is a huge difference between the two
RE: First time poster - Advice - Expat31 - 12-10-2024
Hi,
You seem to have made a good start.
Firstly at this stage, we need to see only these five essential graphs:-
Events, Flow Rate, Pressure, Leak Rate and Flow Limitations.
To take a screen shot, please use the F12 key. This will include the valuable information on the Daily Screen's left side, including statistics and settings. The snore graph is not really required.
To get everything on one page, you may have to go to File, Preferences, Appearance and Graph height. It could be necessary to reduce the default height setting to say 120 or less, depending on your screen resulation. See example attached.
Regarding the graphs you have posted, apart from the significant leaks, it looks like you have clusters of positional apneas , as clearly visible on your flow rate graph. (Did you have positional apnea indicated in your sleep report?)
Positional apnea can be caused by your head dropping forward on your chest during REM sleep thus distorting the trachea and consequenlly the air flow.
Sometimes just sleeping on your side resolve the problem, otherwise a soft cervical collar may be needed.
When we receive the full 5 graphs, we can make recommendations on your settings.
Thanks.
RE: First time poster - Advice - Expat31 - 12-10-2024
Screen settings attachements...
RE: First time poster - Advice - Lukeh84 - 12-10-2024
Thanks so much for your reply.
Thats great info!
I have changed settings as per screenshot and reduced graphs as you have suggested.
Screenshot attached.
Thanks alot again!
Thank you!
I believe its when I sleep on my side possibly with chin tucked...... Ill have a look at the collars!
Thanks alot for your reply
I attached a better screenshot below of the data if it helps further.....
Can i ask - how do you know its positional apnea? All I read is an air leak, unless I missed something terribly obvious....
Thanks again
RE: First time poster - Advice - Lukeh84 - 12-10-2024
Further to last, I can see the flow rate issues but it lines up with the leakage graphs.
I assumed that meant the machine detected the leak and ramped up flow to compensate but couldnt reach it due to mask not fitting correctly.
Any reason why it corrulates to positional apnea?
Keen to learn...... Luke
RE: First time poster - Advice - Expat31 - 12-10-2024
Correct, the flow limitations seem to have caused the groupings of hypopneas and also impacted your breathing patterns.
The flow limitation graph was not visible in your first graph posting. You see the importance!
So at the moment, it looks like positional apnea is not an issue.
To reduce your flow limitations set your EPR to 3.
You could also try APAP settings.
Minimum 8
Maximum 10
And as indicated EPR 3
This is probably best for initial titration.
For mask fittings, see mask primer
Note be aware also the possibility or mouth leaking.
RE: First time poster - Advice - Lukeh84 - 12-10-2024
Ok Great!
Thank alot for the advice
The machine does'nt have a minimum setting as far as I can tell so ill set it at 10 and turn epr to 3 and see how tonight goes!
Thanks again for the help!!!!
Luke
RE: First time poster - Advice - Expat31 - 12-10-2024
Hi,
I am probably stating the obvious, but just in case you don't have a manual for settings etc, see this link https://www.apneaboard.com/resmed-airsense-10-aircurve-10-setup-info.
Once you access the clinician's menu, go to options and select "Essentials Plus".
Hopefully this is available for your particular Elite model.
RE: First time poster - Advice - Lukeh84 - 12-10-2024
Thank you very much,
Unfortunately my machine is a bit older amd doesn't have those features. I got it at a bargain amd had it tested etc and it's still in good nick.
I'm going to get used to it and when I can purchase a new model with all the fruit!
Thank you heaps for your help ill see how nit goes tonight and post back results ???