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[CPAP] Requesting Help with OSCAR Analysis
#1
Requesting Help with OSCAR Analysis
Hello!

I hope this is the correct forum to post in, I started CPAP therapy recently and have been actively referring to reddit and other similar apnea forums for assistance, and would love some help analyzing my OSCAR data. I followed the guides on the best way to setup the data visually to make it as easy as possible for those willing to shed some light.


Quick backstory: I took both an in-lab sleep study 1 year ago then another at-home study about 6 months ago; the in-lab study showed only 7 AHI (on back) and 5.x AHI (on sides) but I was on sleeping pills back then, which I discontinued approx. 2 months before the follow-up at-home test which showed an AHI of 11. I am still waiting (as of this post) on a follow-up in-lab sleep study for a thorough investigation without any medication, but since that's likely going to take forever given the pandemic, I decided to use my prescription and insurance to try an APAP. Current machine is a Redmed AirSense 10 Auto For Her (I'm a dude but my research pointed at "better" settings here). The data from OSCAR might be a bit off since I played with the machine on-and-off the first night, but consistently used it after fiddling a bit. I've left it on auto mode (min 4 and max 20 pressure, EPR 3, humidifier and heated hose settings on auto) till last night (April 6) at which point based on the average pressure I read from the machine (8.x) I changed the clinical settings to min 6 and max 12. Had a really bad sleep, so not sure if it's because I'm still just starting out and bound to experience the roller-coaster I was mentally prepared for or if the pressure settings have not yet been optimized. I did have a few mouth leaks the first few nights, and still get them mildly, so I ordered a Resmed F20 Full-Face Mask that I plan to try, although I do prefer to hopefully adapt to nose-breathing.

I would really appreciate any input and wisdom into what my OSCAR data shows, and what steps I can take to optimize my therapy especially the pressure; should I change it back to 4min and 20max or can I set it to something more "optimal and consistent"?

Thank you in advance for any input!

   
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#2
RE: Requesting Help with OSCAR Analysis
Welcome to the forum.

A question first, is there a reason that you are not showing from about 4:40 for the rest of the night?
You had a number of central apneas during that period.  

We need to see full redacted copies of your Sleep Studies.  We need to see if you had central apneas.  Centrals are known by a number of different names. Often the summaries don't mention even cebtral apneas even when they are high.  I even saw one study where the patient had only 1 obstructive event all night and many, many centrals and the diagnosis was OSA.  

Having centrals prior to CPAP will tell us a lot about the cause of your centrals and as such the treatment for them.

For now
Set EPR = 1, fulltime,  leave your min press = 6, set your Max pressure = 10.  min pressure should never be lower than EPR + 4
Turn Ramp off, your pressures are low and you shouldn't need it.
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#3
RE: Requesting Help with OSCAR Analysis
G'day omariumprime. Welcome to Apnea Board.

Can I request you post a copy of your sleep study report for us? We need to see the charts and tables, not just the written summary.

Looking at the chart you have posted, there is negligible obstructive apnea, but an excess of centrals, especially in the last part of the night. Could I ask you to zoom in on that area and select out about 3 minutes, so we can have a close look at those centrals? It's important to know if they are "true" central apneas and whether they were happening before you got your machine.
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#4
RE: Requesting Help with OSCAR Analysis
(04-07-2020, 10:06 PM)bonjour Wrote: Welcome to the forum.

A question first, is there a reason that you are not showing from about 4:40 for the rest of the night?
You had a number of central apneas during that period.  

We need to see full redacted copies of your Sleep Studies.  We need to see if you had central apneas.  Centrals are known by a number of different names. Often the summaries don't mention even cebtral apneas even when they are high.  I even saw one study where the patient had only 1 obstructive event all night and many, many centrals and the diagnosis was OSA.  

Having centrals prior to CPAP will tell us a lot about the cause of your centrals and as such the treatment for them.

For now
Set EPR = 1, fulltime,  leave your min press = 6, set your Max pressure = 10.  min pressure should never be lower than EPR + 4
Turn Ramp off, your pressures are low and you shouldn't need it.
Thank you very much for the prompt response and input, I will alter the settings as recommended. I think I just realized that I posted only last night's charts rather than each day, should I post each day's image separately for each night for the past 5 days of usage? Only last night I changed the min and max pressures, before that all days were 4min and 20max.

Unfortunately I couldn't locate my most-recent at-home test (AHI was 11.x for that and the Sleep Tech said he couldn't figure out anything else going on as the test wasn't as thorough as the in-lab). I did find the original in-lab test from last year (attached below split into 2 photos), note that I was on the specificed medication which according to my research and the doctors could have induced the OSA and/or CSA that I'm currently (potentially) suffering. Not taking those medications now but I am confident my sleep issues have something to do with the sleep report's "frequent awakenings". Maybe URAS if not OSA?

   
   




(04-07-2020, 10:06 PM)DeepBreathing Wrote: G'day omariumprime. Welcome to Apnea Board.

Can I request you post a copy of your sleep study report for us? We need to see the charts and tables, not just the written summary.

Looking at the chart you have posted, there is negligible obstructive apnea, but an excess of centrals, especially in the last part of the night. Could I ask you to zoom in on that area and select out about 3 minutes, so we can have a close look at those centrals? It's important to know if they are "true" central apneas and whether they were happening before you got your machine.
Thank you very much for the prompt response and input! Wasn't sure if this is the area you're referring to, I zoomed in close to the end of the night, let me know if this works or if you need a different section. In my previous reply I posted the original sleep report, but that report has only the written summary without graphs, not sure if the sleep clinic's admin team just didn't forward it to me when I asked.

   
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#5
RE: Requesting Help with OSCAR Analysis
That looks like Treatment Emergent Apnea, that's actually a good thing, let's see what results you get tonight. Post another 1 of your previous nights. I would like to see what the CAI was.

Also, that was not the full study, you want the arts and charts also. There was no mention of centrals in what you posted so we need to see the whole study to see if that was actually the case. FYI you want a copy of these full studies in your permanent personal records,
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#6
RE: Requesting Help with OSCAR Analysis
(04-08-2020, 08:34 AM)bonjour Wrote: That looks like Treatment Emergent Apnea, that's actually a good thing, let's see what results you get tonight.  Post another 1 of your previous nights.  I would like to see what the CAI was.

Also, that was not the full study, you want the arts and charts also.  There was no mention of centrals in what you posted so we need to see the whole study to see if that was actually the case.  FYI you want a copy of these full studies in your permanent personal records,

Thank you for the response! I've screenshotted every night since I started (April 1) but due to restriction of only 3 attachments, I included 2 of the nights prior to the original one I posted + last night's. I tried the 6min pressure as you recommended but my nostrils almost immediately started leaking, exactly what happened at this pressure months ago when I tried the CPAP trial, not sure if the pressure was too high from the get-go or it's something else. So I changed it back to 4min but stuck with the new max of 10 as recommended.

Night of April 3 (4min/20max/3 EPR)...
   

Night of April 4 (4min/20max/3 EPR)...
   

Night of April 7 (4min/10max/1 EPR)...
   
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#7
RE: Requesting Help with OSCAR Analysis
All three posted charts use a minimum pressure of 4.0 and EPR at 3. You can resolve this really fast using a minimum pressure of 6.0 maximum pressure of 8.0 and EPR at 1.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Requesting Help with OSCAR Analysis
(04-08-2020, 08:34 AM)bonjour Wrote: That looks like Treatment Emergent Apnea, that's actually a good thing, let's see what results you get tonight.  Post another 1 of your previous nights.  I would like to see what the CAI was.

Also, that was not the full study, you want the arts and charts also.  There was no mention of centrals in what you posted so we need to see the whole study to see if that was actually the case.  FYI you want a copy of these full studies in your permanent personal records,

I've successfully retrieved my full sleep report from last year (when I was on sleeping medication and still feeling crappy). Snapshots of relevant sections attached below (can attach other sections in another post if needed):

1 of 3...
   

2 of 3...
   

3 of 3...
   

(04-08-2020, 11:57 AM)Sleeprider Wrote: All three posted charts use a minimum pressure of 4.0 and EPR at 3.  You can resolve this really fast using a minimum pressure of 6.0 maximum pressure of 8.0 and EPR at 1.

Thank you! I'm concerned I'll get the same leakage from my nostrils if I start off at 6min as was the case last night, that's when I changed it back down to 4min to be able to get myself to dose off.
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#9
RE: Requesting Help with OSCAR Analysis
What model and size of nasal pillows are you using?
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Requesting Help with OSCAR Analysis
(04-08-2020, 08:03 PM)Sleeprider Wrote: What model and size of nasal pillows are you using?

AirFit P10 medium currently and waiting on an order for the F20 FFM also medium that I’m hoping would be better. The pillows do seem a bit tight against the nostrils but slowly getting used to them. I noticed when I change sleeping positions from back to side I have to fiddle with the mask a bit to avoid leakage which the whole repositioning experience tends to keep me awake longer.
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