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[CPAP] UARS, data interpretation OSCAR, what to do?
#21
RE: UARS how to interpret data!!
(05-14-2021, 11:00 PM)cathyf Wrote:
(05-14-2021, 10:12 PM)KingKongBingBong Wrote: Could somebody comment if flow limitation is RERAs? Or explain how exactly to identify them if not? Low AHI is great and all but I already had low AHI in my sleep study - which was likely inflated due to sleeping on my back rather than my usual side sleeping. Hence I'm trying to eliminate RERAs right now.

Sorry I have a little trouble following along with what you're saying! I'm new to all this. Where did you learn how to interpret these graphs and what they mean?

So do you know if there's any way to determine the number of RERAs? Or figure out if they're happening with any regularity?
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#22
RE: UARS how to interpret data!!
Flow Limits are on individual breaths. No machine accurately interprets them.
RERAS are identified as A series of Flow Limits ending in arousal.
UARS show up in the flow rate chart as Flow Limits.
Look in the Wiki article OSCAR - The Guide (my signature) in the Flow Rate chat to see examples.

There is no machine that accurately and completely flags flow Limits and RERAS. To do that the flow rate chart must be examined in detail, a approximately 3 minute view To identify these.

Typically we use the Flow Limit and RERA stats and or events to know they exist and assume they are present in higher numbers. We normally focus on these numbers and bringing them in control. That means no more than a very occasional RERA and 95% flow Limit 0.10 or under.

!We must be careful to just ensure Apnea in managed to the point of restful sleep and we are not chasing numbers.
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#23
RE: UARS how to interpret data!!
(05-15-2021, 05:14 AM)Gideon Wrote: Flow Limits are on individual breaths.  No machine accurately interprets them.  
RERAS are identified as A series of Flow Limits ending in arousal.
UARS show up in the flow rate chart as Flow Limits.
Look in the Wiki article OSCAR - The Guide (my signature) in the Flow Rate chat to see examples.

There is no machine that accurately and completely flags flow Limits and RERAS.  To do that the flow rate chart must be examined in detail, a approximately 3 minute view To identify these.  

Typically we use the Flow Limit and RERA stats and or events to know they exist and assume they are present in higher numbers.  We normally focus on these numbers and bringing them in control.  That means no more than a very occasional RERA and 95% flow Limit 0.10 or under.  

!We must be careful to just ensure Apnea in managed to the point of restful sleep and we are not chasing numbers.

Yep I get your point! I personally just feel like I have no way to assess what is a restful sleep, as I have perhaps had the issue for a long time... so even if I say my sleep is good, how can I say that it's objectively good? Perhaps for somebody else that night of sleep might be poor. Reading your guide now!
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#24
RE: UARS how to interpret data!!
Are these RERAs? If I am getting RERAs, what can I do to alleviate them? Would it be to increase the inspiratory pressure maximum?


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#25
RE: UARS how to interpret data!!
(05-14-2021, 10:01 PM)KingKongBingBong Wrote: Yes it's somewhat of an experiment! I try out different machines until I find something that works. They didn't have a better version available at the moment so I am using this one until a later date. If I did purchase a machine this week for example, I would get the most recent version.

Here is my latest data - I felt better waking up this morning than usual, but I did not feel dramatically different to how I wake up sometimes. I have woken up like this many times in the last 6-9 months without any machine. I also tracked the night before this; the data looks quite similar, AHI index 0 but it was only 3 hours of sleep.

My data looks weird between 7-8 and I believe this is because I was awake trying to fall back to sleep (in the past I've just taken it off! Smile)

Can you tell us more about the third OSCAR screen capture that you posted: http://www.apneaboard.com/forums/attachm...?aid=32246

The picture in the lower-left shows flow limits and leaks -- and your leak graph shows many, many leaks. I'm not very familiar with the output that comes from the S9 machine, but if that means that your mask is not sealed properly against your face then that is really bad.

#1 -- trying to sleep with a leaky mask is really hard! It makes noise, might channel air into your eyes, etc.

#2 -- the machine measures the pressure back at the machine end of the hose. If the amount of air escaping from the system is too high, then the machine can't deliver enough pressure at your end of the hose to do you any good. AND it also makes the data that it is measuring much harder to measure accurately.

The problem with the word "leak" is that we are using it to mean two different things.

If the mask does not seal properly and air comes out WHERE it's not supposed to come out, this is simply bad for the whole system and it can't do what it's designed to do. This is a problem.

But "leak" in the "Leak Rate" graph is referring to any air escaping from the loop of air between you and the machine. The problem with that is that the fundamental process of breathing can be thought of as a continuous cycle of "leaking". When you breathe, oxygen "leaks" IN to your body while carbon dioxide "leaks" OUT of your body. When you are wearing a CPAP mask, the air from the room is supposed to "leak" into the machine by being sucked into the machine by the pump, and the air that you are exhaling is supposed to "leak" out of the vent holes.

The different machines report the data out differently. I am most familiar with how my machine (a ResMed A10) reports the data. It only reports "leak" when it sees MORE air escaping than what is designed to let out your exhales. Other machines report the total amount of air escaping, and you have to subtract out the normal amount to see if too much is leaking.

But anyway, tell us about what you are experiencing with leaks.
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#26
RE: UARS how to interpret data!!
(05-15-2021, 09:51 AM)cathyf Wrote:
(05-14-2021, 10:01 PM)KingKongBingBong Wrote: Yes it's somewhat of an experiment! I try out different machines until I find something that works. They didn't have a better version available at the moment so I am using this one until a later date. If I did purchase a machine this week for example, I would get the most recent version.

Here is my latest data - I felt better waking up this morning than usual, but I did not feel dramatically different to how I wake up sometimes. I have woken up like this many times in the last 6-9 months without any machine. I also tracked the night before this; the data looks quite similar, AHI index 0 but it was only 3 hours of sleep.

My data looks weird between 7-8 and I believe this is because I was awake trying to fall back to sleep (in the past I've just taken it off! Smile)

Can you tell us more about the third OSCAR screen capture that you posted: http://www.apneaboard.com/forums/attachm...?aid=32246

The picture in the lower-left shows flow limits and leaks -- and your leak graph shows many, many leaks. I'm not very familiar with the output that comes from the S9 machine, but if that means that your mask is not sealed properly against your face then that is really bad.

#1 -- trying to sleep with a leaky mask is really hard! It makes noise, might channel air into your eyes, etc.

#2 -- the machine measures the pressure back at the machine end of the hose. If the amount of air escaping from the system is too high, then the machine can't deliver enough pressure at your end of the hose to do you any good. AND it also makes the data that it is measuring much harder to measure accurately.

The problem with the word "leak" is that we are using it to mean two different things.

If the mask does not seal properly and air comes out WHERE it's not supposed to come out, this is simply bad for the whole system and it can't do what it's designed to do. This is a problem.

But "leak" in the "Leak Rate" graph is referring to any air escaping from the loop of air between you and the machine. The problem with that is that the fundamental process of breathing can be thought of as a continuous cycle of "leaking". When you breathe, oxygen "leaks" IN to your body while carbon dioxide "leaks" OUT of your body. When you are wearing a CPAP mask, the air from the room is supposed to "leak" into the machine by being sucked into the machine by the pump, and the air that you are exhaling is supposed to "leak" out of the vent holes.

The different machines report the data out differently. I am most familiar with how my machine (a ResMed A10) reports the data. It only reports "leak" when it sees MORE air escaping than what is designed to let out your exhales. Other machines report the total amount of air escaping, and you have to subtract out the normal amount to see if too much is leaking.

But anyway, tell us about what you are experiencing with leaks.

I have no idea how the system determines leaks. I read somewhere I think that S9 works similar to yours, though I may be wrong. I am not sure. I haven't noticed leakage myself unless I take the thing off, of course I can't say what's happening when I'm sleeping.
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#27
Eliminating RERAs
How can I eliminate RERAs from my sleep? Currently my AHI is low but I still seem to be experiencing arousals.
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#28
RE: Eliminating RERAs
Which exact PAP machine do you have? Your left panel has partial description of 2 different machines, a ResMed AirSense and a BPAP. If you have an AirSense AutoSet, you could try EPR if they had it in the 9 series.
Dave

OSCAR
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#29
RE: Eliminating RERAs
(05-15-2021, 11:29 PM)SarcasticDave94 Wrote: Which exact PAP machine do you have? Your left panel has partial description of 2 different machines, a ResMed AirSense and a BPAP. If you have an AirSense AutoSet, you could try EPR if they had it in the 9 series.

Uh I don't know. It's an ASV S9 auto i guess?

Can you tell me what EPR is?
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#30
RE: Eliminating RERAs
There are many reasons for arousal,. Here are the guesses
1. Habit.  It takes time. For example sleep lowers your urine production, so when you get up for a bathroom break your production is down.
2. You mentioned it RERAS. RERAS end in arousal by definition which are proceeded by a series flow limitations. Treatment is on several fronts. Use a ResMed machine which is sensitive to flow limitations. Increase pressure support(PS) the difference between inhale and exhale pressures, then if needed increase min pressure.
3. Arousals can also come from a pressure change, particularly a rapid change. These commonly occur on an ASV since that is what is used to maintain your breathing volume.
4. Positional issues that cause Apnea. You see a cluster of events and they stop because you stir/turn over/arouse
5. Any number of sleep hygiene issues.

Can you post your nightly chart so we can see what is happening and include your history please.  I know you have other threads.  This is why we recommend you maintain only one thread for your therapy.
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