New to CPAP and Oscar, UARS?
Hi Everyone!
Was sent here from reddit as they mentioned you're all a hugely valuable help so thank you in advance!
I was diagnosed with sleep apnea about a year about but have only just gotten around the getting a CPAP (Insurance issues, etc). I have the Airsense 10 Autoset and just downloaded the data for the first time into Oscar.
There were some thoughts on reddit based off my sleep study that I might actually have UARS. I'm 29, slim, healthy, non drinker and smoker.
I've noticed that since downloading the report most of my issues are coming back as CAs. I'd love some help interpreting this, and any thoughts on my sleep study.
Thank you in advance!
Have attached a screenshot from Oscar, and my sleep study
sleep study.pdf (Size: 716.35 KB / Downloads: 10)
RE: New to CPAP and Oscar, UARS?
Hi and welcome to Apnea Board.
OK here's a free starter pack of info. The sleep study info had 1 CA based event. This means you're getting some treatment emergent CA while on the AutoSet. These will normally clear up as your body gets accustomed to the APAP. Right now your PAP machine is making your breathing too good at venting CO2. Most cases of this will clear up within 3 months.
Here's a bit of homework. Get your CPAP Setup Manual in the link at the top for your exact machine if you've not done so yet. I want you to enter the clinical menu via holding Home and the dial in for about 5 seconds. Now look for a few items in Settings. Item 1 is pressure, you seem to be on default of 4. Let's bump that to 6 for now to see if it can take care of the few OA/obstructive apnea on the OSCAR. And part 2 is the EPR setting. If you're using it, drop it by one number value and try it a night to see if CA drops down. Try this and post results after next use.
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RE: New to CPAP and Oscar, UARS?
Welcome to the forum
Use F12 to take your screenshots, that will remove the calendar.
Your min pressure is improperly set, the min pressure should be
Min Pressure = 4 (machines min) + EPR (3) = 7 or greater. (This gives you the full therapeutic effect of the EPR)
Min adult pressure is typically 6-7 cmw because 4 and 5 are often too low and the user feels air starved.
Flow Limits are very important on ResMed machines as they are a major driver of pressure increases.
Your sleep study implies that you possibly have UARS, low OSA, All you have are mostly Hypopneas, also you have a RERA index of 14 and this too can point to UARS. Your AHI of 8 may be a little high for an actual diagnosis.
You had virtually no centrals in your study, that is good, that means that the central apneas you have are likely treatment-induced and as such, they are likely to go away in 2-3 months.
What happens is your CPAP has improved the efficiency of your breathing, so much so that you are purging more CO2 than you have previously, to below your apneic threshold resulting in central apnea.
To manage the central apnea I'm going to suggest that you set EPR=2, fulltime, less than the 3 you are currently using with a min pressure =6
This is looking at your sleep study and the RERAs (index 14) and hypopneas reported there, which indicate a need for a higher EPR, and your treatment-emergent central apnea. I don't want to eliminate your Central Apnea now, I would like to see your body adapt to the new lower amount of CO2 in your blood.
RE: New to CPAP and Oscar, UARS?
Thank you so much both for your detailed responses, really appreciate it and incredibly insightful and helpful.
Last night wasn't a good night for sleep (unable to fall back asleep when waking up) but I did update the settings to 7 for min pressure and 2 for EPR. The 4 was the setting the doctor had prescribed I start at.
I did notice the air felt quite 'different' through the mask, almost like there was less? I'm not sure how to explain it.
Here's last night, still a lot of centrals but I'll just continue to monitor that
RE: New to CPAP and Oscar, UARS?
OK,
you are at a point where you don't NEED to make changes and here is where how you feel makes all the difference.
Noting how EPR =2 feels and everything around it,
try EPR=1 and determine which 'feels' better. This could have an impact on your centrals, (decrease) and a possible increase in your obstructive events. We are looking for the sweet spot between them.
Depending on what we see you may want to repeat this with EPR=0
