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NEED HELP INTERPRETING OSCAR DATA
#21
RE: NEED HELP INTERPRETING OSCAR DATA
How you feel is more important than numbers, but it sounds like your headed in the right direction.  
Post a new chart tomorrow.

You're right to take it slow when making pressure changes.  Raise it .5cm at a time and watch.  
Keep AFlex at 2.
Remember that AFlex is more of a comfort feature and does not work the same as ResMed's EPR.

Flex is based on Flow and possibly how hard your exhale.  Not to confuse you, but here is a short description on how it works.

Flex settings 1, 2, and 3. for PR machines
You can receive up to 2cm pressure relief which is flow based. (Regardless of setting)

• C-Flex – Provides pressure relief upon exhalation.
• A-Flex/C-Flex+ – Provides pressure relief taking place at the end of inhalation and at the start of exhalation.
OpalRose
Apnea Board Administrator
http://www.ApneaBoard.com

_______________________
OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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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#22
RE: NEED HELP INTERPRETING OSCAR DATA
I've taken another look at the pressure data that you posted, and I think I've learned something important about the Flex algorithm. Thanks so much for posting it!

You had the following settings at the time:

1. Your flex level was 3. This means that you were asking your machine for 3 cmw of pressure relief to increase your breathing comfort.
2. Your pressure was fixed at 7.

Also, although there is no specific setting for this, I believe that your machine has a goal of keeping your AHI under 5.

So the way that I interpret your pressure graph is like this: The machine wants to accommodate your request for 3 cmw of pressure relief, but the machine knows that if it reduced your exhalation pressure by 3 cmw then your AHI would skyrocket. So the machine prioritizes reducing your AHI over your comfort – at least until the machine thinks it can keep your AHI under 5. Why 5? Probably because 5 is the threshold for mild sleep apnea. Once the machine thinks it can keep your AHI under 5, then it prioritizes your comfort request for pressure relief (and the machine provides as much pressure relief as it thinks it can while keeping your AHI under 5). Basically, the machine is providing you with as much pressure relief as it can (up to your requested level) while keeping your AHI under 5.

Caveat: I have not read the source code for the Flex algorithm. I do, however, have a degree in computer science from a well-respected university and a thorough understanding of computer algorithms. What I have described above is my educated guess as to what your machine is doing, and why it is doing it.

Also, what I take from this is that when you set your flex level to 1, you are asking your machine to give you 1 cmw of pressure relief. When you set the flex level to 2, you are asking your machine to give you 2 cmw of pressure relief. Finally, when you set the flex level to 3, you are asking your machine to give you 3 cmw of pressure relief.

So what does this mean for you:

After the pressure on your machine was changed to 7 (fixed), your stats show that the average EPAP was 6.25. This means that the machine, on average, was giving you 0.75 cmw of pressure relief. Since you found this level of pressure relief to be comfortable, I would suggest changing your settings to flex level 1. Doing so means that you are only asking your machine for 1 cmw of pressure relief. In my opinion, there is no point asking your machine to give you more pressure relief than you need to feel comfortable. Doing so will only interfere with your therapy.

That green line on your pressure graph is what is responsible for keeping your airway open. I think you need to move the green line higher if you are not happy with your AHI. What I think you need is a minimum pressure of 8.0, and a flex level of 1. This combination will result in the green line staying at or above 7 all night long, and it should help reduce the obstructive events that you are experiencing.

Thanks again for posting your data. I learned a lot from it.
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#23
RE: NEED HELP INTERPRETING OSCAR DATA
Again... read my post above. Flex is based on Flow.

Flex does not operate the same as EPR.

Flex will not give more than 2cm drop in pressure relief regardless of the setting. I used a Respironics Cpap for over 6 years and with a setting of 2, received aprox. 1.5cm of exhale relief, very seldom 2cm exhale relief. It's simply based on flow.

This is one reason most of us prefer ResMed, where you get a true drop in exhale relief corresponding to the number set.
OpalRose
Apnea Board Administrator
http://www.ApneaBoard.com

_______________________
OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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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#24
RE: NEED HELP INTERPRETING OSCAR DATA
(06-13-2021, 06:58 AM)OpalRose Wrote: How you feel is more important than numbers, but it sounds like your headed in the right direction.  
Post a new chart tomorrow.

You're right to take it slow when making pressure changes.  Raise it .5cm at a time and watch.  
Keep AFlex at 2.
Remember that AFlex is more of a comfort feature and does not work the same as ResMed's EPR.

Flex is based on Flow and possibly how hard your exhale.  Not to confuse you, but here is a short description on how it works.

Flex settings 1, 2, and 3. for PR machines
You can receive up to 2cm pressure relief which is flow based. (Regardless of setting)

• C-Flex – Provides pressure relief upon exhalation.
• A-Flex/C-Flex+ – Provides pressure relief taking place at the end of inhalation and at the start of exhalation.

To be honest I feel much worse today than yesterday. Despite yesterday’s higher AHI. Much more tired today. But much better AHI. Very confusing and frustrating. I need to get my SD card out of my machine and into much computer to see what went on last night. My best guess is in an effort to keep my chin from getting too close to my sternum I used only one flat pillow instead of the three or four that I usually use and I was very uncomfortable because I’m not used to sleeping with a totally flat head to the bed. This led to what felt like very disjointed sleep where I sort of woke up several times and I was just generally uncomfortable throughout the night. So I think this contributed to a somewhat unrestful sleep overall and why I feel so crappy today. I just woke up from a two hour nap now. Hoping I feel better. Thanks again for chiming in today!!

(06-13-2021, 10:03 AM)Yes notam2 Wrote: I've taken another look at the pressure data that you posted, and I think I've learned something important about the Flex algorithm.  Thanks so much for posting it!

You had the following settings at the time:

1. Your flex level was 3.  This means that you were asking your machine for 3 cmw of pressure relief to increase your breathing comfort.
2. Your pressure was fixed at 7.

Also, although there is no specific setting for this, I believe that your machine has a goal of keeping your AHI under 5.

So the way that I interpret your pressure graph is like this:  The machine wants to accommodate your request for 3 cmw of pressure relief, but the machine knows that if it reduced your exhalation pressure by 3 cmw then your AHI would skyrocket.  So the machine prioritizes reducing your AHI over your comfort – at least until the machine thinks it can keep your AHI under 5.  Why 5?  Probably because 5 is the threshold for mild sleep apnea.  Once the machine thinks it can keep your AHI under 5, then it prioritizes your comfort request for pressure relief (and the machine provides as much pressure relief as it thinks it can while keeping your AHI under 5).  Basically, the machine is providing you with as much pressure relief as it can (up to your requested level) while keeping your AHI under 5.

Caveat: I have not read the source code for the Flex algorithm.  I do, however, have a degree in computer science from a well-respected university and a thorough understanding of computer algorithms.  What I have described above is my educated guess as to what your machine is doing, and why it is doing it.

Also, what I take from this is that when you set your flex level to 1, you are asking your machine to give you 1 cmw of pressure relief.  When you set the flex level to 2, you are asking your machine to give you 2 cmw of pressure relief.  Finally, when you set the flex level to 3, you are asking your machine to give you 3 cmw of pressure relief.

So what does this mean for you:

After the pressure on your machine was changed to 7 (fixed), your stats show that the average EPAP was 6.25.  This means that the machine, on average, was giving you 0.75 cmw of pressure relief.  Since you found this level of pressure relief to be comfortable, I would suggest changing your settings to flex level 1.  Doing so means that you are only asking your machine for 1 cmw of pressure relief.  In my opinion, there is no point asking your machine to give you more pressure relief than you need to feel comfortable.  Doing so will only interfere with your therapy.

That green line on your pressure graph is what is responsible for keeping your airway open.  I think you need to move the green line higher if you are not happy with your AHI.  What I think you need is a minimum pressure of 8.0, and a flex level of 1.  This combination will result in the green line staying at or above 7 all night long, and it should help reduce the obstructive events that you are experiencing.

Thanks again for posting your data.  I learned a lot from it.
Thank you so much for taking the time to look over my numbers!! I sincerely appreciate your insights. I’m going to give this idea and these settings a go tonight and I’ll post results tomorrow morning. Thank you again!!
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#25
RE: NEED HELP INTERPRETING OSCAR DATA
Joey,
It's not necessary to use a real flat pillow. Sounds like you went from using 3 to 4 pillows down to 1.
Laying too flat in my opinion can't be great for the neck.

Just so your not using a pillow that is too high that it tends to push your neck forward. Try to find a pillow that gives support without going to either extreme.
OpalRose
Apnea Board Administrator
http://www.ApneaBoard.com

_______________________
OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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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#26
RE: NEED HELP INTERPRETING OSCAR DATA
(06-13-2021, 10:41 AM)OpalRose Wrote: Joey,
It's not necessary to use a real flat pillow.  Sounds like you went from using 3 to 4 pillows down to 1.  
Laying too flat in my opinion can't be great for the neck.

Just so your not using a pillow that is too high that it tends to push your neck forward.  Try to find a pillow that gives support without going to either extreme.

Yes this is what I figured to do as well. I also just purchased one of these collars that I believe Stacy recommended earlier to help keep my chin from tucking down too far. Hopefully it is comfortable enough for me to sleep in. Thank you again for your time and insights!!


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#27
RE: NEED HELP INTERPRETING OSCAR DATA
Let us know how the collar works out for you.
OpalRose
Apnea Board Administrator
http://www.ApneaBoard.com

_______________________
OSCAR Chart Organization
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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.
Post Reply Post Reply






Donate to Apnea Board  
#28
RE: NEED HELP INTERPRETING OSCAR DATA
(06-13-2021, 10:15 AM)OpalRose Wrote: Again... read my post above.  Flex is based on Flow.

Flex does not operate the same as EPR.  

Flex will not give more than 2cm drop in pressure relief regardless of the setting.  I used a Respironics Cpap for over 6 years and with a setting of 2, received aprox. 1.5cm of exhale relief, very seldom 2cm exhale relief.  It's simply based on flow.

This is one reason most of us prefer ResMed, where you get a true drop in exhale relief corresponding to the number set.



I was looking at the charts doug001 recently posted in his thread.  He had set flex to 3, and there were periods on his charts where he was getting more than 2 cmw of pressure relief.  This is why I believe setting flex to 3 is akin to requesting the machine to provide you with 3 cmw of pressure relief.

My understanding of the difference between flex and epr is that with epr, you are commanding the machine to provide you a certain amount of pressure relief.  With flex, you are not commanding but rather requesting a certain amount of pressure relief and the machine provides it on an "as able" basis.  Imo, the former is probably better for advanced users, while flex is better for inexperienced users since the machine tries to protect them from settings that aren't optimal.

Also, I fully believe that you rarely got 2 cmw of pressure relief during the 6 years you used your old machine, but I think the machine had a reason for not fulfilling your requested 3 cmw of pressure relief - it was likely trying to lower your AHI.
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#29
RE: NEED HELP INTERPRETING OSCAR DATA
(06-13-2021, 01:02 PM)OpalRose Wrote: Let us know how the collar works out for you.

I will definitely keep you updated with what happens from here. Thank you!!
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#30
RE: NEED HELP INTERPRETING OSCAR DATA
(06-13-2021, 01:15 PM)notam2 Wrote:
(06-13-2021, 10:15 AM)OpalRose Wrote: Again... read my post above.  Flex is based on Flow.

Flex does not operate the same as EPR.  

Flex will not give more than 2cm drop in pressure relief regardless of the setting.  I used a Respironics Cpap for over 6 years and with a setting of 2, received aprox. 1.5cm of exhale relief, very seldom 2cm exhale relief.  It's simply based on flow.

This is one reason most of us prefer ResMed, where you get a true drop in exhale relief corresponding to the number set.



I was looking at the charts doug001 recently posted in his thread.  He had set flex to 3, and there were periods on his charts where he was getting more than 2 cmw of pressure relief.  This is why I believe setting flex to 3 is akin to requesting the machine to provide you with 3 cmw of pressure relief.

My understanding of the difference between flex and epr is that with epr, you are commanding the machine to provide you a certain amount of pressure relief.  With flex, you are not commanding but rather requesting a certain amount of pressure relief and the machine provides it on an "as able" basis.  Imo, the former is probably better for advanced users, while flex is better for inexperienced users since the machine tries to protect them from settings that aren't optimal.

Also, I fully believe that you rarely got 2 cmw of pressure relief during the 6 years you used your old machine, but I think the machine had a reason for not fulfilling your requested 3 cmw of pressure relief - it was likely trying to lower your AHI.



SO WHAT SHOULD I DO HERE TEAM? SHOULD I LOWER THE FLEX TO 1 OR 2?

I AM  FOR SURE GOING TO INCREASE THE MIN PRESSURE TO 7.5 AND GIVE THAT A TRY.

JUST NEED SOME GUIDANCE ON THE FLEX SETTING.  

IS THERE A CONSENSUS OPINION ON THIS? 

Thanks  Thanks
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