[CPAP] Requesting Help with OSCAR Analysis

[Gideon]

CA evens are showing, UARS may or may not be a problem, but you have flow limits. All you can do is increase PS/EPR to manage the flow limits/UARS at the expense of higher Centrals or reduce the PS/EPR to better manage the central apnea at the expense of increasing the flow limits/UARS.

The other option is the ASV which you do not qualify for because of you excellent numbers, but will treat both obstructive events and the central apnea.

[omariumprime]

I've been following your thread. Nice to see the improvement, numbers-wise. I'd hang in there for a few weeks at least to see if the symptoms get better. I also suffer from cognitive impairment and mood fluctuations. I'm switching from F30 to P10 (I noticed you wanted to do the opposite) and also planning to use Somniflex tape. I'm curious why you decided to wear a chin strap and the tape? Isn't one or the other sufficient?

EDIT: has anyone tried using an in-nose nasal dilator with a nasal pillow mask?

Thanks for following my thread and for your input! As for doing both the strap and tape, it was really a matter of “going with the flow” in terms of the issues I was having which led me naturally to this approach. Without the strap, I kept waking up even with the tape heavily sealed with air blowing one of the corners, so once I threw in the strap it either reduced it or eliminated the mouth leaks entirely. What I’ve noticed is that I tend to drool and my jaw drops so throughout the night the tape around my lips tends to loosen with the drool and condensation, throw in moving around during my sleep and it’s a recipe for an almost inevitable mouth leak. I’m still sticking to the P10 and the skin irritation has calmed down a bit but still get it back every few nights which I quickly manage using creams.

CA evens are showing, UARS may or may not be a problem, but you have flow limits.  All you can do is increase PS/EPR to manage the flow limits/UARS at the expense of higher Centrals or reduce the PS/EPR to better manage the central apnea at the expense of increasing the flow limits/UARS.

The other option is the ASV which you do not qualify for because of you excellent numbers, but will treat both obstructive events and the central apnea.

Thank you for confirming/clarifying! Seems like it’s a lose-lose whichever way I play it, I know for the first couple of weeks I played with EPR so might go back to that if symptoms stay the same or worsen by end of next week.

[omariumprime]

Back for a quick update!

Machine setting changes: none

Ongoing Negative Symptoms: waking up with a headache, daytime fatigue and sleepiness, nausea, lack of concentration, anxiety (severity of these symptoms fluctuate day to day, assuming dependent on how good the sleep is).

I did a test run the night prior to yesterday and went to sleep without the machine, and I did wake up more frequently than with the machine and throughout the day I felt just a bit worse, so nothing major of a difference enough to make me believe the machine has reached a point of being 100% effective but enough to make me consider that maybe it's doing something better than nothing.

Symptoms as described above are still quite debilitating, I'm soldiering through the day without damaging my exercise/diet too much but the exercise portion has been almost impossible to maintain (besides a quick jog and some mobility routines) as I run out of energy and the headache is amplified if I push myself which I have in the past.

I noticed last night's data shows quite a higher number of leaks than usual, and one pattern that still arises when I sleep is waking up frequently (not as frequently as when I'm not using the machine) and toss and turn, so something is still going on with my sleep position and/or brain connectivity. I've been very carefully tracking everything else (sleep hygiene, nutrition, exercise, external influences such as work or other stressors) and nothing else is raising potential red flags.

What I'm waiting on still:
- Follow-up in-lab sleep study (I'm also looking online for some thorough at-home tests that might provide something similar to an in-lab test specifically with an ability to check for UARS/RERA, such as AXG Sleep Diagnostics);
- Blood work to check for thyroid, diabetes, testosterone and vitamin D deficiencies
- Knightsbridge Dual Chin Strap to arrive (still using my make-due strap which is working fine with 3M tape to keep my mouth shut, not mouth leaks for the past few nights)

As always, any input on the attached charts below is greatly appreciated. See ya'll on the next update!

May 9...
   

May 10...
Did not use machine

May 11...
   

EDIT: one other thing I forgot to mention was that I've also been using an SpO2 and HR monitor that I wear on my wrist and finger when sleeping, my blood oxygen levels have been fluctuating from a high of 98% down to the lowest of 89%, although most nights the lowest have reached only 91%.

[SarcasticDave94]

Not sure how it's handled up North, but in the US if you drop to 89% you'd be a candidate for supplemental oxygen. That's an area I'd monitor a bit more often IMO.

[omariumprime]

Hey guys could use some insight into the attached charts. Symptoms have been worsening since my last post despite my trying every tip including the Knightsbridge Dual Band Chin Strap + mouth-taping + sleeping on my side + using ergonomic neck pillow. The only thing left for me to try at this point (other than changing settings/going for an entirely different machine such as BPAP/ASV) is to try a Soft Cervical Collar but at this point not sure if any of these charts are pointing at anything definitive.

I keep waking up throughout the night and then it's quite a crappy day when I "wake up" with debilitating symptoms. The first two charts nothing changed but the third chart I decided to activate EPR again as I did during my initial month of therapy but that seems to have done nothing as far as I can tell/feel. *Note: I didn't use the machine on May 23, needed to take a break.

May 21...
   

May 22...
   

May 24...
   

Thanks in advance for any input!

[kuacc912]

HEY OMARAIUMPRIME YOU ARE NOT ALONE!!

[Gideon]

Let's take all pressure change out

7.4 to 7.4 EpR off

Flow Limits are driving your pressure up. I would like to see if the pressure change itself is what's bothering you.

[Sleeprider]

Fixed pressure, I like it!

[omariumprime]

Let's take all pressure change out

7.4 to  7.4 EpR off

Flow Limits are driving your pressure up.  I would like to see if the pressure change itself is what's bothering you.

Thank you! I'll try that tonight and report back. FYI I read on this forum's wiki a bit more about EPR and decided to raise the minimum pressure once I activated the EPR to 1 to avoid an increased AHI, this seems to have worked a bit better in terms of how I felt when I woke up, but really only very slightly better. Chart attached below.

Another issue that might be causing the frequent awakenings and higher leak rate is my body's positioning, I tend to prefer my left side but my left arm gets numb if I don't position it with an exact science (shoulder blade needs to be positioned at the perfect angle and my forearm can't be too outward or inward) and I'm guessing my brain wakes me up from the pain of numbness to reposition. I've been considering changing sleeping behavior to my back eventually but that will likely mean either an increase in pressure or considering an elevated pillow.

May 25...
   

[Dormeo]

If you go to Amazon, try searching on "arm pillows for sleeping." I wonder whether any of the options there would help you.