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(02-13-2020, 11:53 PM)deebob Wrote: That sounds good, the only problem is I'm doing a trial with the CPAP through a sleep clinic, and I'll have to go into the clinical menu and make changes to the settings, which I'm assuming they will see? Will they be notified that I'm messing with the settings? I'm not sure they'll be happy about that since they're probably used to dealing with patients who don't know what they're doing.
They will be able to see changes if they bother to look. That may or may not happen.
It's your health, so your choice. But we can't really help you if changing settings isn't an option.
I'd do it and be firm if they give you a hassle.
Caveats: I'm just a patient, with no medical training.
(02-14-2020, 05:46 AM)slowriter Wrote: I don't agree.
If OP changes min pressure to 7 (which as I said earlier, I recommend), pressure will stay pretty stable, unless they need more.
And at least on my machine, the fixed mode doesn't track FL (I can't remember if this is true on the autoset as well, but I suspect it is).
Auto mode effectively offers treatment benefits, and more useful information.
In short, my own view is one should always be on auto mode, and if necessary, adjust settings (typically raising min pressure or EPAP) to stabilize pressure.
Flow limitations are tracked, there is no less data in CPAP mode. I have been using my machine in CPAP mode because my situation is similar to the OP's.
He can try more days in auto but auto is only helpful if the pressure is adjusting to real events AND increasing the pressure helps overcome those events. A number of his pressure increases appear to have occurred either post arousal (due to SWJ/arousal breathing) or the combination of breathing issue/pressure increase caused arousal, in either situation these pressure increases likely were not helpful.
My thoughts were to switch to CPAP mode with full advantage of EPR as it will be easier for him to sleep like that early on in treatment. Then after a few days if he is seeing anything odd that looks like it could use more pressure then switch back to APAP mode and see if that helps resolve things. Can do the opposite and switch to CPAP mode if he can determine the extra pressure isn't helping but I feel that will take longer to determine.
I often advocate fixed pressure. In my last post I suggested a minimum pressure of 7 with EPR at 3. I expect this will result in very stable pressure, and of course you won't experience the weird changing pressure support of 4/4, 5/4, 6/4, 7/4 and perhaps 8/5. Geer1 is correct, but simply changing the minimum pressure will get you to the same place. Once you try a minimum pressure of 7.0, a fixed pressure can be considered. All of us are saying the same thing. If you use EPR at 3, then you need a minimum pressure of 7, or as bonjour correctly says, minimum pressure = 4+EPR.
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02-14-2020, 01:15 PM (This post was last modified: 02-14-2020, 01:20 PM by deebob.)
RE: PSG Results: Could this be UARS?
So I just kept the pressure the same last night until I decide how I want to approach changing the clinic's settings lol
But interestingly OSCAR reported a RERA from last night, which I didn't even know it could do. There was also another awakening earlier in the night that seemed to be accompanied by some flow limitation and pressure increase. So this might be pointing to UARS?
My Oura ring awakenings match the OSCAR awakenings again, so it seems to be at least pretty accurate in measuring those, except for maybe missing 1 or 2 brief arousals. The sleep cycles are still probably much less accurate, it's really hard to tell. The last few nights with the CPAP my Deep Sleep has been way less according to the Oura ring, and REM is a bit on the low side. I was previously averaging like 2.5 hrs in Deep Sleep and now it's like 1.5. But again, there's no way of knowing how accurate that is, but whatever's happening, the Oura ring is reporting much less Deep Sleep on the CPAP for the first few days. I actually feel OK today other than waking up like 5 times.
Oura Ring.
I'm trying to attach a couple other Oscar Screenshots but it's saying I've reached my limit.
I don't trust those RERA flags, I have had obvious RERA's that weren't flagged and obviously non RERA's that have been flagged. To me that doesn't necessarily look like a RERA that it flagged in that instance.
I am curious to see some shorter duration views of your flow rate though. Some periods at lower pressure (around 5ish) and some at higher pressure (close to 7) would be good to see if there are differences in waveform with the increased EPR.
