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First (mostly) full nights sleep with data.
#31
RE: First (mostly) full nights sleep with data.
(12-07-2019, 12:49 PM)Dormeo Wrote: Hello 17 WRX.  It'd be very helpful to the experts if you would rearrange your daily chart and then repost it.  Here are the steps to take:

Show all of the left-hand panel, being sure you turn off the calendar (little triangle next to the date) and the pie chart (File..Preferences..Appearance).

Move your graphs around so you can get this stack into one screen shot:

Events
Flow rate
Pressure
Leaks
Flow limitations
Snores.

Click and drag to reorder the graphs, and grab the grey horizontal bar between the graphs to scrunch them a little if you need to.

I'm really glad you find the VAuto more comfortable, and when the experts can take a better look at what is going on I hope you will get some advice about tuning your settings.

And read the wiki page I linked to ;-)
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#32
RE: First (mostly) full nights sleep with data.
Thanks for the tips Dromeo. Here it is. Let me know if I missed anything.


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#33
RE: First (mostly) full nights sleep with data.
17WRX, that last chart is the one we need to see every time. Be sure to turn on the CA events on the lower left corner of the graphs.

Your settings are EPAP min 7.0, IPAP max 16.0 and PS 4.0, so the maximum pressure you will experience is 16/12. We can see you are having considerable OA events, even at the maximum pressure, and of course your flow limitations remain fairly high. We need to be sure you are not having a positional (chin-tucking) issue that is contributing to the problem, and I would like to give your therapy more time to settle; however it appears you are going to need higher pressure and pressure support.

I recommend you set the machine to Vauto mode, EPAP min 9.0, IPAP max 18.0 and PS 5.0. give it a few days and let's see where things are going. Notice that using ramp, the machine immediately goes to maximum pressure as soon as ramp ends. That is telling us that the ramp pressure is too low and the machine may be over-reacting to the extreme flow limits that is causing. Setting ramp at the highest pressure you can tolerate will help. Whatever you did in the first session at 01:30 was pretty good because the machine did not increase pressure. The other sessions are all very high pressure within a short time of ending ramp.
Sleeprider
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#34
RE: First (mostly) full nights sleep with data.
I'll move up to those settings tonight. I was wondering do you know if there is anyway to show the RERA in the graph like with my auto set for her? Or does the Aricurve vauto not show that?
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#35
RE: First (mostly) full nights sleep with data.
(12-07-2019, 01:52 PM)17WRX Wrote: I'll move up to those settings tonight. I was wondering do you know if there is anyway to show the RERA in the graph like with my auto set for her? Or does the Aricurve vauto not show that?

I don’t believe the VAuto flags RERAS
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#36
RE: First (mostly) full nights sleep with data.
(12-07-2019, 01:45 PM)Sleeprider Wrote: 17WRX, that last chart is the one we need to see every time.  Be sure to turn on the CA events on the lower left corner of the graphs.  

Your settings are EPAP min 7.0, IPAP max 16.0 and PS 4.0, so the maximum pressure you will experience is 16/12.  We can see you are having considerable OA events, even at the maximum pressure, and of course your flow limitations remain fairly high.  We need to be sure you are not having a positional (chin-tucking) issue that is contributing to the problem, and I would like to give your therapy more time to settle; however it appears you are going to need higher pressure and pressure support.

I recommend you set the machine to Vauto mode, EPAP min 9.0, IPAP max 18.0 and PS 5.0.  give it a few days and let's see where things are going.  Notice that using ramp, the machine immediately goes to maximum pressure as soon as ramp ends. That is telling us that the ramp pressure is too low and the machine may be over-reacting to the extreme flow limits that is causing. Setting ramp at the highest pressure you can tolerate will help.  Whatever you did in the first session at 01:30 was pretty good because the machine did not increase pressure. The other sessions are all very high pressure within a short time of ending ramp.

I moved up the pressure settings but my AHI went up. The flow limitations chart looks a little better I guess, but up close it still looks boxy. Once I actually get to sleep it is much more restful with the Aircurve vauto. The F20 mask feels more comfortable than the F30 as well. But I just don't get why my AHI is up with higher pressure. I messed around with the buttons at the bottom left but I messed up the pie chart and took away some data. When I first uploaded the data this morning the pie chart showed a clear airway stat that maybe was around 2 or 3 that had some data in it. Could it be the increase in pressure support is causing the increase in AHI?


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#37
RE: First (mostly) full nights sleep with data.
Two things.  First, I think maybe you are not seeing all of your "sessions" in your charts.  From the Oscar help wiki:

Buttons (bars) to turn sessions on and off. Clicking on these buttons will include or exclude sessions from display of the night's data. Each time you turn the machine on, then off again is referred to as a 'session'. If you sleep all night without turning the machine off, that will be one session. If you turn it off once for a toilet break, that will show two sessions. Clicking on the blue and yellow session buttons will include or exclude sessions from the display of the night's data. This can be useful if (for example) you had a very brief nap in the afternoon and want to exclude it from the night's results. Note that turning a session off will change the calculated AHI for the night. Note also that sessions can be turned on and off using the small green/black buttons in the section information panel. When a session is off the button changes to black / red.

Second, to see how you are doing with flow limitations, you don't want to be looking at the shapes of the FL marks on your graph.  They are by convention squared off.  Instead, you want to be looking at a zoomed-in view of the flow rate.  I'm attaching a screenshot from the bad old days before I started using a VAuto.  If you look at the portion of the flow rate that is above the zero line, that's showing inspiration.  The points and dents on the top show that the breathing is flow-limited.  (A flat top would also indicate flow limitation.)  The tops of those curves are what you want to see smoothed out.


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#38
RE: First (mostly) full nights sleep with data.
If trigger sensitivity is medium, go to high.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#39
RE: First (mostly) full nights sleep with data.
(12-08-2019, 07:17 PM)Sleeprider Wrote: If trigger sensitivity is medium, go to high.

I set it on high and it really drove down the AHI. But should I now set the sensitivity on very high to try to drive the AHI even lower? You were correct about the bilevel being more comfortable. This machine is way more comfortable than my apap. But I have knocked my mask off once each night in the past two nights. My wife woke me both times because I was snoring loudly. But when I wake up in the morning now I feel well rested. I can't remember when I felt so good in the morning. Thank you for all of your advice!!


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#40
RE: First (mostly) full nights sleep with data.
Make sure all your events are turned on. In the lower left of the charts is a dropdowm that currently says LL and it is red meaning off. click that dropdown, and the one in the lower right and make sure everything is turned on (green, not red)

Your flow limits are very high, I would like you to set your PS = 6 and see how much that knocks them down.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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