[Diagnosis] Low AHI and Headache: Compare Stats Request

[haikuclue]

Long time lurker, first time poster. 

I admit I am very unskilled at interpreting my OSCAR data. 

To keep things short and sweet:
I have been having headaches all day on and off for a few months now. It feels like a dull blur behind my eyes and pressure at the sides of my temples. It lasts all day, the only thing that sometimes helps is taking a longer (45 minute) nap during my circadian slow time in the day. 

It's honestly pretty awful and is affecting my life significantly. I have been to a doctor about it ("you have headaches because you have headaches", thanks!)  I have good hygiene habits and clean my machine regularly. I have been attempting to adjust my pressure settings, and I have been reading lots of posts on here about headaches. 

So, at long last cutting to the chase, I was wondering if those of you who are good at interpreting sleep data see anything obvious since yesterday, same settings, same everything, I did not have a headache and felt mercifully good. Today I have a terrible "apnea headache" and it is making everything 50% harder lol. 

So, posting the data here, very curious, in part to help me learn, in part to help me troubleshoot. Please let me know if I did this post right, again, first timer here. 

Thank you SO MUCH!

Last night (headache today)
[attachment=51708]

Night before (no headache, felt fine, higher AHI)
[attachment=51709]

[Sleepy Quixote]

@haikuclue,


Congrats on using OSCAR, its one of the most important steps to getting a handle on your therapy.

For chart analysis folks here prefer to see a specific organization to base opinions on the best available data. You can find the organization instructions in the link below -

https://www.apneaboard.com/wiki/index.ph...ganization

Your charts indicate some work needed on flow limits, others coming along will give you more detailed analysis once you update the charts. Personally I cant speak to headache causes because I rarely get them, probably because there aint much up there to hurt.

[haikuclue]

Thank you so much! 

I've updated the charts (I hope) to the standard. Reading the guidelines was already helpful, particularly using the zoom to 3 minute level to see more what happens for events. 

[attachment=51713]

[attachment=51714]

[Sleepy Quixote]

@haikuclue,

Good job! and Welcome to the board.

Your charts look good, but you definitely need to work on managing those flow limits, there a folks around here much more knowledgeable than I who will come a long take a look and hopefully offer some suggestions on optimal settings. I don't feel comfortable as of yet making suggestions to that end, maybe later on helping with minor tweaks tho. 

Keep at it! The best is yet to come.

[Marillion]

As a starting point, I would suggest increasing your minimum pressure from 4.2 to say 6 or 7. I have never found 4 or 5 as a minimum to be anywhere near enough for me and was frequently feeling starved for air at that setting. It may end up helping your breathing and perhaps (no guarantees) your headaches. I would say try that for a few days and post again with your results.

[haikuclue]

As a starting point, I would suggest increasing your minimum pressure from 4.2 to say 6 or 7.    It may end up helping your breathing and perhaps (no guarantees) your headaches. 

I will definitely try this. I always wonder about the minimum pressure, if, in the middle of the night, all is "going well" so my machine's pressure goes down and then as you say I find myself maybe struggling to pull in oxygen. I have tweaked in past, and have not at all figured out my sweet spot. OSCAR is very helpful though in gathering data, even if for just a few nights at a time to get a sense. Cheers and thank you.

---

Your charts look good, but you definitely need to work on managing those flow limits, there a folks around here much more knowledgeable than I who will come a long take a look and hopefully offer some suggestions on optimal settings. 

I wonder if the flow limits, as @Marillion wrote, may be connected to my low minimum pressure. I would love if folks take a look and chime in. I'm happy to zoom in a bit, but again, just learning to understand how to even begin to read these numbers so this process is very helpful for me and hopefully others!



Thank you so much!!

[Crimson Nape]

My eye caught your statement about headaches. The Resmed uses a very fine membrane for the exhaust port to diffuse noise. In fact, it is so fine, the slightest moisture can clog the pores, thus blocking or reducing air flow. This can lead to rebreathing your CO₂. This can lead to headaches, at least when you first awake.

- Red

[Sleepy Quixote]

@haikuclue

Yes your early Flow Limits are probably related to the low starting pressure, Marillion has you on the right track for sure.
Generally EPR is used to manage the Flow Limits, yours is only enabled on ramp and you have ramp turned off so that means no EPR at all. I'd set EPR to Full Time. Since ramp is off, good to leave it that way, no therapy happens during ramp. Another thing to note as you tweak settings and work your way around. EPR doesn't kick in until 7, if a person has a minimum of 7 set and an EPR of three that gives you an effective pressure of 4 during exhalation and a pressure of 7 on inhalation. Yours is set to 2, so once you get to 7 you will be exhaling against a pressure of five and of course inhalation pressure of 7 at that time. Setting your minimum pressure to 6 actually gives you a pressure of 6 during exhalation until the machine bumps up to 7 or above. You actually will be starting out breathing against a higher pressure than later in sleep time depending on flow limits and pressure increases. Depending on your comfort level incoming pressure of 7 might be a bit stiff, so starting off at six may resolve that air starvation without overwhelming you til you get used to it.

[Marillion]

I wouldn't advise changing the EPR setting just yet. For many folks (such as myself) increasing the EPR setting results in many more CA events. While we are changing the pressure and he gets used to it, I would advise limiting the other changes we make otherwise it gets difficult to track what is making an improvement (or worsening) of the situation. EPR may end up helping his flow situation too, but first I would like to see what the bit of increased pressure does for him.