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05-15-2024, 01:57 AM (This post was last modified: 05-15-2024, 01:58 AM by llambotte.)
Interpreting Oscar Data ?
I have been using a CPAP for a short time, but I am worried that the number of AHI events doesn't seem to be improving. After reading up on the topic, I installed OSCAR to try and learn more.
It's very complicated, but I am someone who likes to learn. You will find attached a screenshot of my analysis from last night, as well as another one from a few days ago.
I was diagnosed with an AHI of 28, and even with the CPAP, I never go below 15, with spikes up to 31!
I have a nasal mask, but I frequently suffer from a blocked nose. I have ordered a full-face mask. Could this explain the issue?
Thank you in advance,
PS: Sorry for my English, I am a French speaker...
I am not familiar with DreamStation 2, the DreamStation I am familiar with has a setting for Ramp Pressure. Most adults feel starved for air at pressures less than 7cmH2O. Try setting your Ramp pressure at 7cmH2O, or that is so close to your CPAP pressure of 8cmH2O, just turn off Ramp.
You have clusters of Obstructive Apnea (OA) and Hypopnea (H) events flagged at the top of your OSCAR Report, This could be indicative of what we call Positional Apnea specifically "Chin Tuck" very common in beginning CPAP users.
I suspect you may need your pressure adjusted higher, but it is important to correct positional apnea with pillows or Soft cervical collars before increasing pressure.
I will try to improve my position. I often sleep on my side, so I will see if it is possible to find a smaller cushion inspired by the notes in the wiki. Thanks ;-)
I used a much smaller pillow and made sure my neck wasn't "bent." I also followed the tutorials to adjust my mask (I also feel like I was less bothered by leaks).
The results remain "high." Do you think I should call my pulmonologist?
How does the mask fit feel? How rested were you after waking up? Did you feel starved for air or did you feel if too much air was coming at you? These are important questions to consider after you wake up in the morning, before you look at the OSCAR Report or the information the DreamStation 2 provides.
Are you able to find the French language version of the Wiki pages I send links to?
Here is a link to entering the provider mode for DreamStation 2 "
Were you able to find the information for Soft Cervical Collar ? It is possible to go into positional Apnea "Chin Tuck" while side sleeping. A Soft Cervical Collar can help minimize or eliminate positional Apnea. Your OSCAR Report shows what appears to be many indicators of positional apnea.
At the bottom of the left hand panel under the "Session Information" you can turn off the sessions where you practice fitting your mask or wearing the mask to acclimate your body to the fit and feel of the mask under therapy pressure. Try un-selecting the session 16:22:34 to 16:27:49 to see how it changes the OSCAR appearance.
I do encourage new CPAP users to wear their mask at therapy pressures earlier in the day while doing something distractive like reading the Apneaboard wiki, watching YouTube or TV. to acclimate their body to the fit and feel of the mask at pressure.
Did you try a nasal saline rinse and FloNase? Even with a Full Face Mask (FFM) we encourage nose breathing, often times myself included, We will tape our mouth to encourage breathing through our nose.
Did you get a copy of your Sleep Study Report? If so could you post a copy of it, after you redact all personal information?
You could possibly benefit from a slight increase in pressure to reduce the obstructive apnea and the introduction of Flex to control Hypopnea and RERA . After reviewing the Clinicians manual, if you feel comfortable adjusting your own machine you should be able to make some adjustments. we can guide you.
I would suggest: Auto mode
Pressure 8 to 16 cmH2O
Flex 2 cmH2O
Pressure will not correct for Positional Apnea, therefore I strongly suggest the use of Soft Cervical Collar (SCC) and low profile or CPAP pillow.
This morning I was very tired upon waking up, I haven't yet felt that the CPAP improved that... I suppose it will come with time...
I am getting used to the mask, and I think I could even be satisfied with a nasal mask because last night I felt "free." I admit I was woken up once or twice by a "whistling" sound because the mask was no longer perfectly centered on my nose (especially when I sleep on my side).
I ordered a Soft Cervical Collar and received it this morning, so I will wear it tonight.
I thoroughly cleaned my nose, and then put in drops before going to sleep.
I didn't receive a copy, only a letter from the doctor stating that my AHI was 30 and that I was having 19 micro-awakenings per hour. He concluded by saying that I would need to be treated with CPAP.
I contacted the pulmonologist and have an appointment on June 5th. I also see my general practitioner tomorrow, and I will talk to him about this recurring hypopnea issue.
In Belgium, it is the health insurance that provides us with the CPAP, with orders not to modify it ourselves. I will wait a little longer, otherwise I might defy this order :-D I am a computer scientist, so it shouldn't be a problem.
Thank you very much for taking the time to respond to me. I will get back to you as soon as I see some improvement (maybe tomorrow if the collar was useful).
Please do keep us informed of how your CPAP progresses, everything you can do external of the CPAP setting to reduce AHI is important. Correcting for Positional apnea, Sinus cleaning and drops, even room temperature is important.
I am not familiar with Belgium health insurance, I suspect it is universal health care similar to other countries in Europe, if you are able to try a Full Face Mask (FFM) or a Hybrid FFM it would be wise to have a different style mask on hand and fit tested so that if you have a difficult allergy season or other sinus problem.
I am lucky to have a Sleep Doctor that is very knowledgeable and willing to work with difficult patients. His whole team is knowledgeable of OSCAR, they use it in their clinic and encourages patients to become active in their therapy. I had a very difficult time meeting compliance after radiation and chemotherapy for cancer treatments, he coordinated with my primary physician, Dermatologist, as well as my Oncologists. My first two years of CPAP I had a doctor that was not responsive to patients needs, and I suspect his knowledge was lacking, plus he put me on a cheap machine that was not OSCAR compatible.
I believe you will do well on CPAP, you will probably find it interesting and challenging, after you get some more experience.
I also just received a short letter from the pneumologue without any real details.
This was quite disgraceful, but I had insufficient knowledge at the time to know that it was really important to have the full report, called "Rapport de polygraphie ventilatoire"
05-16-2024, 07:15 PM (This post was last modified: 05-16-2024, 07:28 PM by Narcil.)
RE: Interpreting Oscar Data ?
(05-16-2024, 07:57 AM)llambotte Wrote: I didn't receive a copy, only a letter from the doctor stating that my AHI was 30 and that I was having 19 micro-awakenings per hour. He concluded by saying that I would need to be treated with CPAP.
I contacted the pulmonologist and have an appointment on June 5th. I also see my general practitioner tomorrow, and I will talk to him about this recurring hypopnea issue.
In Belgium, it is the health insurance that provides us with the CPAP, with orders not to modify it ourselves. I will wait a little longer, otherwise I might defy this order :-D I am a computer scientist, so it shouldn't be a problem.
You can get your sleep study report yourself. It should be available in your e-health portal (myhealth.belgium.be) there you can access all your patient files ("dossier médical global"), mine was there with all the pulmonologist reports, ...
for me my GP recommended me to a pulmonologist, who ordered a sleep study after a 5 min talk, who prescribed the cpap machine when she saw the results.
I never received those orders not to change anything. Been using a loaner from a the hospital paid by mutuelle for a month. they wanted me to get used to the machine for 3 months before actually setting up the pressures with a titration study, well i didn't feel like waiting 3 months.
Yesterday I went to see my general practitioner (who also uses a CPAP) and he explained a few interesting things to me. He especially told me that I could adjust the settings myself and that I just needed to explain to the pulmonologist that I did it to feel better...
So I applied a mix between your suggestions and his.
In summary, I switched to automatic mode, with a pressure set between 6 and 12.
To be thorough, he also asked me to restart allergy treatment with Bellozal, which I started yesterday afternoon. And since I had something to celebrate, I drank 3 beers with friends in the evening... I think the combination worked very well :-D
The result speaks for itself... I will see how it goes tonight, but it looks promising.
In your opinion, should I stick with these settings or do you recommend increasing them?
