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[CPAP] UARS, data interpretation OSCAR, what to do?
#61
RE: UARS, data interpretation OSCAR, what to do?
The way your doc does, by the numbers
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#62
RE: UARS, data interpretation OSCAR, what to do?
(05-21-2021, 05:25 AM)Gideon Wrote: The way your doc does, by the numbers

it doesnt give me RERAs tho which is the most important number for me
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#63
RE: UARS, data interpretation OSCAR, what to do?
If I'm correct, other ResMed machines like AutoSet and VAuto do count RERAs. If it's that important, tell them you're in need to swap machines.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#64
RE: UARS, data interpretation OSCAR, what to do?
You have Flow Limits, and that is a major part of RERAs and UARS.
To get an accurate count of RERAs you have to count arousal that have Flow Limits leading up to them. This is with ANY machine. The flagging of RERAs as Events just say you need to look deeper.
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#65
RE: UARS, data interpretation OSCAR, what to do?
Kingkong,

You came here for help but largely are refusing to listen to the advice given. If you want help then listen to the following.

Your comment about difficulty uploading data is only because of how you are doing it posting multiple small views. Use the screenshot function in oscar (view, take screenshot) and then attach that image to your post (found in documents, oscar data, screenshots and named in a year, month, day, time format). It only takes a matter of seconds to do it this way.

Barry Krakow has an opinion. His theories are somewhat substantiated but only in some patients, not all. This is why his opinions have not become mainstream medical advice. UARS is controversial because imo there are two types of UARS, type 1 is patients that have obvious flow limited breathing that causes arousals which can usually be treated with PAP and type 2 where the underlying issue isn't the breathing but rather an over sensitized nervous system that causes the arousals when they shouldn't occur.

The reason Dr. Krakow is a proponent for ASV (in some cases) is because of the way it acts. It acts quickly and forcefully to fight even minor flow limitations. If you take 1-2 small breaths it increases pressure support to try and force you to take a bigger breath. Although this can be helpful for some people it can also cause issues in others (aerophagia, sensitivity to pressure swings etc). I think it and bilevel are only really successful in treating above type 1 UARS patients. Unlike Dr. Krakow mainstream medical opinion is that ASV is more intrusive because of the large pressure swings and that it should only be used if indicated. Based on my experience on this and other forums I would say I have seen as many people succeed with ASV as those that fail it so I actually lean more towards mainstream medial opinion to use minimal treatment necessary. Where I differ slightly from mainstream medical opinion is recognizing the rare cases ASV can be beneficial in these off label applications and if other treatments have been attempted I support its use.

You in short have skipped multiple steps. You skipped CPAP/APAP which very easily could have treated your RERA's. You also skipped fixed PS bilevel which would have treated most cases of RERA's that CPAP/APAP won't treat and you jumped straight to ASV. You also did so starting out at too high of a min PS which I guarantee is screwing up your sleep quality and that is why I personally have already told you to lower it twice as well as others...

The main advantage of ASV is that it increases PS when needed and it does so rapidly, this is a highly responsive and powerful machine. A high minimum PS is only needed in very rare cases. Your case does not appear to be anything rare or special and I see absolutely nothing in the information or data posted so far to make me think your high min PS is warranted. In fact your data shows signs of respiratory rate instability which makes me believe the high PS is negatively affecting your breathing/sleep.

As for settings.

EPAP fights obstructive apnea which you don't have so you can use min EPAP = 4 cm. You are already using this, that is good.

Min PS of 3 is enough in almost all patients. Change min PS to 3. If it isn't then a bit of detective work will help you figure out if flow limitations/RERA's are occurring.

High PS causes issues with aerophagia and more issues related to the large pressure swings. It is only needed to fight severe central apneas or very severe flow restrictions. There is no data supporting a need for high PS so you should limit it to the minimum (5 over min PS, so 8 in this case). I highly doubt this will have to be raised but again with some detective work in OSCAR data you will be able to see if changes are necessary.

To see RERA's in your flow data you look for stuff that looks similar to the left side of the following example. In this specific case it is flagged as an OA (due to length and amplitude) but RERA's are very similar (just lower amplitude so the don't trigger an apnea flag). They show up as gradually worsening flow limited breaths followed by large amplitude arousal breathing (caused by RERA).

http://www.apneaboard.com/wiki/index.php...tional.png

I would change your settings and run them like that for a couple weeks while trying to learn how to interpret OSCAR data further. Your body will take time to adjust so just let it do so unless there is an obvious issues in results (if so post it and we will confirm and offer advice to fix it).
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#66
RE: UARS, data interpretation OSCAR, what to do?
Thank you for putting everything out clearly and concisely in a manner that I can understand. I really appreciate that and will follow your advice!

BTW, I did try CPAP but it was very uncomfortable in a way that ASV hasn't been. It didn't make me feel better at all.
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#67
RE: UARS, data interpretation OSCAR, what to do?
FWIW if this was the CPAP mode on an ASV, take note that this would be straight CPAP with no pressure support or exhale pressure relief. In my opinion, this is drastically different than something like the CPAP/APAP on the AutoSet or bilevel on a VAuto. And this is like apples to oranges.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#68
RE: UARS, data interpretation OSCAR, what to do?
(05-23-2021, 09:31 PM)SarcasticDave94 Wrote: FWIW if this was the CPAP mode on an ASV, take note that this would be straight CPAP with no pressure support or exhale pressure relief. In my opinion, this is drastically different than something like the CPAP/APAP on the AutoSet or bilevel on a VAuto. And this is like apples to oranges.

It was APAP I believe. Totally different machine.
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#69
RE: UARS, data interpretation OSCAR, what to do?
OK I copy. How was it set up?
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#70
RE: UARS, data interpretation OSCAR, what to do?
I have been forming a theory based on my personal experience and noting similarities between not only SDB patients but also people with other sleep and health issues.

Before I divulge my theory I am interested if you have any of the following symptoms?

Nasal congestion, if so most nights or just occasionally?
Geographic tongue?
Tongue scalloping?
Bruxism?
Reflux, if so GERD or LPR?
Digestive complaints such as constipation, bloating, diarrhea, abdominal tenderness, foul gas etc?
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