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NEED HELP INTERPRETING OSCAR DATA
#1
NEED HELP INTERPRETING OSCAR DATA
Hello All. Brand new here and really need your help. 

In addition to OSA i also have pretty serious Coronary Artery Disease so getting myself fixed right and quickly is of the utmost importance. 
 
Complicating matters is a general lack of knowledge on this subject (which I am working as best as i can to reconcile) and a a general lack of tech savviness. So understanding what I am looking at on Oscar is a very challenging proposition for me at this time so please take it easy on me.  
 
Some quick background - I have had OSA for at probably 20-25 years. Undiagnosed and untreated until about two months ago. So this thing has wreaked havoc on my body for a very long time. Finally started CPAP two months ago and was hovering around 4 - 6 AHI and wanted to see if I could get that down to something closer to 1 or 2.  I use a Dream Station Auto with a Res Med Full Face Mask.
 
I had my Dr change the script to a minimum pressure of 7 on June 3rd. It looks to me like he also changed it from the Auto to a Fixed pressure. I did not ask him to do this. I could be misunderstanding what the data says and be totally wrong on that. Hopefully you all can let me know. But for sure there was a clear increase to my average AHI since the change in pressure setting occured on 6/3. So the it seems safe to assume the increase I have seen is probably connected to that?
 
So instead of seeing a decrease in AHi i saw an increase and here I am looking for answers bc my Doctor doesn't seem to have any even when I am able to get in touch with him. 
 
I really need to figure out what I can do to get these numbers back to where they were and even lower than that. I really want to be under 3 every night if possible. 
 
I am already having chest pain symptoms almost daily and the sleep apnea situation only causes more anxiety and worry that I just can't endure.

The 1st two screenshots I have provided is from my best night of sleep since I got the CPAP. This was on May 31 before the change in pressure occured. 

The last one is from last night which has been the worst night since I started CPAP. 
 
Any insights or suggestions that amy of you can offer would be profoundly appreciated.  
 
Thank you in advance!!!


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#2
RE: NEED HELP INTERPRETING OSCAR DATA
The set pressure is sometimes used to reduce centrals. Is this why your Dr went with a 7. Cm setting?  If not I would try a min 7 max at 15. 

I also believe I see some positional apnea. This happens whew you sleep in a position where you cut off your own airway. Many times sleeping on your back or with to high of a pillow can cause it. Any position when you tuck your chin down to your Sternum is causing it. 

Chin tucking can NOT be fixed with any pap machine - it must be corrected by changing the position that is cutting off your air. Some people can’t achieve this without a collar. I have a link in my signature at the bottom of the post.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: NEED HELP INTERPRETING OSCAR DATA
Thank you for your reply. 

I am the one who suggested the pressure change not my Dr. But I just wanted to move it to a minimum start point of 7.

It appears that in addition to changing the initial minimum pressure from 5 to 7 he also changed it from an "Auto" to a "Fixed" pressure setting.

Again it is very possible that I dont know what I am looking at but it looks to me like the pressure no longer adjusts with my breathing throughout the night. 

I only wanted him to increase the minimum pressure not change the setting type altogether.

Are you able to tell me if this is true from my June 11th screenshot? I am including a second screenshot from last night as part of this comment i hope it helps?

As far as there potentially being a positional component to my situation - Yes according to my sleep test results i had 31 AHI supine and about 7 AHI non supine. 

So sleeping on my side makes a huge difference for me. 

I do always wake up on my back despite usutally trying to fall asleep on my side. I have tried the Slumber Bump thing to try to stay on my side and it didn't work. I still wound up on my back and just dreamed about having back pain. 

And you are correct about sleeping "too high." I have an adjustable mattress that do I elevate bc i was of the belief that if it was elevated that would help prevent obstructions from occurring. But it seems you are saying the opposite because of the chin being more tucked down. I will make sure to flatten the mattress tonight.  

Perhaps you can let me know based on what you see in the screenshots if the setting is still set as an "Auto" pap where the pressure is adjusting throughout the night as it was when I first started or if the Doc did in fact change it to a "Fixed" setting. 

Also, what do you think is the reason for the increase in AHI that occured on June 3rd. Obviously it has to be related to the pressure setting modification that was made, no? The increase occured on the same day as the change so it has to connected. But what specifically about the change is the cause of the increase in your opinion?

Thank you again for your insights.


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#4
RE: NEED HELP INTERPRETING OSCAR DATA
It appears you did better with an auto range, likely as the DreamStation has a fatal flaw. It needs a real effort in optimizing settings, an area your doc is clueless at what's needed. It's typical though with most docs.

You can access the clinical menu yourself and change it to Auto mode with min 7 and Max 20. I'd also change flex to 2, 3 is too disruptive to most users.

Above is the button for CPAP setup manuals. Look for your exact DreamStation and start reading it. You'll need your PAP therapy to start helping now. You'll find that accessing the clinical menu is done by pushing and holding Ramp and the Dial in for about 5 seconds.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: NEED HELP INTERPRETING OSCAR DATA
In the left column under the AHI gives your pressure FIXED at 7.  With that setting your machine never changes pressure, it is always at 7. 

To change it you have to go to the Clinicians menu. You can see how to do that if you don’t know by going to YouTube and search for dreamstation and clinician menu.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#6
RE: NEED HELP INTERPRETING OSCAR DATA
FWIW fixed pressure is just that, a static non-adjustable pressure. So doc didn't help but hinder. A strong suggestion you'll learn PAP by members here. Almost all PAP users are strong proactive self advocates that control their own PAP. Your PAP edits don't need backed by a script edit, but the doc's does.

You can edit any setting in seconds where doc changing settings is hit or miss, emphasis on miss. And doc's edits are a week or more away typically. And will include a boat payment. We coach self advocacy, you turn the control for free with knowledge. It's the absolute best way.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: NEED HELP INTERPRETING OSCAR DATA
Your doctor did indeed set your machine to a straight pressure of 7cm.  I would change it back to the Auto mode and set a minimum pressure of 7.5 or 8cm and max of 15.  See how you do for a couple days and repost.  

Set AFlex to 1 or 2 (depending on comfort, as you will only get up to 2cm pressure drop on exhale regardless of setting.)

Ditch the ramp setting.  You shouldn't need it and you are not being treated during this time.

The reasoning for a higher minimum pressure is due to the fact that Respironics cpaps are slower to react to apnea's than a ResMed machine.  You need to give it a head start.
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy




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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#8
RE: NEED HELP INTERPRETING OSCAR DATA
Thank you all so much for offering these insights. I really do appreciate your time!!

Is there a link to a tutorial video on how to adjust the settings that someone can offer? 

This is going to difficult for someone as tech challenged as I am so wish me luck. Any other insights from anyone else who wishes to offer any are still sincerely appreciated! 

Thanks again!!
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#9
RE: NEED HELP INTERPRETING OSCAR DATA
I think I may have figured it out. Does this look correct? Changed it to AUTO with Minimum of 5 and max of 20 and changed FLEX to 2.


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#10
RE: NEED HELP INTERPRETING OSCAR DATA
Order the Clinicians manual for your machine. This will show you how to enter the provider menu and make changes.  

https://www.apneaboard.com/adjust-cpap-p...tup-manual

Try settings 7min - 15 max.
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy




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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