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I have UARS. Need help with analyzing OSCAR graph and titration
#1
I have UARS. Need help with analyzing OSCAR graph and titration
I am finally able to sleep using my ResMed AirCurve 10 VAuto and P10 mask after maxing out the humidity and changing a few settings. The problem is I am still waking up in the middle of the night and also feel more groggy waking up. Here is a link to my OSCAR graph - imgur.com/a/rM1DzuP and imgur.com/a/Or8f1ug. It seems like my breathing becomes erratic and the pressure/snoring increases before I wake up. I believe either my throat is closing at night and/or I am forgetting to exhale while asleep which causes me to wake up.

Here are the results for my WatchPAT test if they are helpful - i.imgur.com/IcxyTaq.png and i.imgur.com/yOdBfMe.png. My BiPAP settings were found using trial and error and is currently set at -

PS: 3
Min EPAP: 4.4
Max IPAP: 25
Ramp: 30mins
Mode: VAuto
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#2
RE: I have UARS. Need help with analyzing OSCAR graph and titration
I have posted complete links and some images below. As your post count increases you will be able to post your own links and images. In the third image below you provide a zoomed view of the flow rate ahead of a sleep disruption.  Over most of the night, your therapy is very good with steady pressure and occasional CA events. The event on 11/19 at 06:52 looks to start with flow restriction or limitation that may be positional from a change in body position, chin tucking or similar airway obstruction.  The fact it arises out of normal sleep rhythm tells us it is not related to pressure or settings, so we need to look elsewhere for the source of the problem.  Therapy settings appear good, and the number of events decreased slightly with PS 3.0 vs PS 4.0.   I think you can use either PS 3.0 or 4.0 as it has no effect on major respiratory statistics like tidal volume, minute vent and respiration rate, however you can increase the "trigger sensitivity" from medium to high to clear the CA events.  You can reduce maximum pressure to 12.0 if you wish. The machine only goes as high as needed, but there is nothing above 11.0 cm.

I can't identify the source of arousal, but it appears to be related to a change in body position rather than anything more sinister. Increasing trigger sensitivity should be more comfortable and reduce CA events. Other than that, let's monitor your progress and see if this makes a difference.

https://imgur.com/a/rM1DzuP

[Image: QAJ9CZ6.png]

https://imgur.com/a/Or8f1ug
[Image: 54FVbTR.png]

[Image: oST8aXs.png]
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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#3
RE: I have UARS. Need help with analyzing OSCAR graph and titration
Thank you. I will update my progress soon. I know I toss and turn a lot when I sleep so I might try a bungee cord strapped to the bed because I once used that to try and fix my acid reflux issue and it didn't work but it did help me stay on my back. I have also fixed my acid reflux issue recently by making sure to not lay down for an hour after eating and avoiding certain foods that trigger my reflux. 

I have also been able to fix my issue of waking up in the middle of the night in the past by two methods. The first way was when I went on triple therapy for h pylori but my acid reflux came back after about a month and thereby my sleeping issues. The second way was when I started using sudafed nasal spray but the rebound made this option unfeasible.
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#4
RE: I have UARS. Need help with analyzing OSCAR graph and titration
Here is my OSCAR graph from last night - imgur.com/a/8hcYxGg . I woke up in the middle of the night again but not sure when. Next time I will need to take my mask off so it's easier to spot on the graph. Also I felt like the PS was a bit too high after changing the trigger sensitivity to high so I might lower it to 2.6 or 2. But otherwise I felt like my sleep was much better with the new settings. Almost as good as what I consider to be "good sleep" but not quite there yet.


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#5
RE: I have UARS. Need help with analyzing OSCAR graph and titration
This appears to be a less restless night. The pressure increase is related to a cluster of flow limitation that is probably positional. Nothing wrong with your therapy, but suspending the tube above the bed so your mask moves with you, and possibly using side-pillows to restrict movement might be a better solution than a bungee cord.
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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#6
RE: I have UARS. Need help with analyzing OSCAR graph and titration
Thanks I will give those a try. I think my issue may also be allergy related as last night I was struggling to breathe through the mask so I had to take it off and I know I have dust mite allergy. But for the graphs I've already posted I had no such issues so it could be a combination of factors causing my sleeping issues.
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#7
RE: I have UARS. Need help with analyzing OSCAR graph and titration
Flonase! Seasonal allergies, congestion, nasal inflammation. It's a great solution.
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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