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Suspected UARS - new to CPAP and OSCAR. Help?
#1
Question 
Suspected UARS - new to CPAP and OSCAR. Help?
Hi everyone! This is my first post and my first few days using a CPAP machine. Last night was the first night I was able to sleep about 3.25 hours with the mask on, so I got a bit of data from OSCAR but am not sure how exactly to interpret it. Please let me know if I didn't do the screenshot right and/or if you want me to zoom in on certain sections in OSCAR and report back. 

I'm having a lot of trouble falling asleep with the mask on, so I took a bit of benadryl last night, which helped. I started out with the mask on, awake, then took it off to adjust/pee, then tried to sleep again but had some awakenings just as I'd drift off. So I took it off again, used the restroom one more time, and was able to fall asleep sometime after 21:40. But when I woke up around 1:00, I couldn't fall back asleep after using the restroom. I tried for an hour and then took it off, and fell asleep pretty quickly with it off. Based on my very little UARS/OSA knowledge, I'm thinking I may need to bump my min pressure up to 7? My EPR is at 3. What are your thoughts after looking at my report from last night?

My history: currently undiagnosed, but suspecting UARS. My primary care doc referred me to ENT for evaluation of sleep apnea because I've been so tired for years now and we can't find a cause. In the last year or so, my insomnia really started ramping up (sleep maintenance). And the last few weeks I had been barely sleeping at all due to this weird feeling just as I'd start to fall asleep. Kind of like a hypnic jerk without the jerk? I call it a "brain thump" because that's what it feels like. Anyway, that led me to get almost no sleep last week and I went to urgent care, who fast-tracked my ENT consultation. I now have a sleep study booked 3/31. My coworker was kind enough to lend me their old CPAP machine (which I know has been recalled, but this is a temporary experiment). The ENT suggested UARS due to my large tongue and small jaw (and symptoms). I am a normal weight female in my mid-30s. 

Thank you so much for your time!!


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#2
RE: Suspected UARS - new to CPAP and OSCAR. Help?
Hi manders513,
Your assessment may be correct in suspecting UARS, but it's best to get that sleep study  done.  

If you're going through insurance for a Pap machine, please request a ResMed AirSense 10 or 11 Auto Cpap.  I believe you would see better results as a ResMed will target Flow Limitations, Reras and Hypopnea much better by using EPR.  
Respironics uses Flex, which just doesn't give the same type relief.

With that said, I would like to see you adjust your pressure a bit.  Set your minimum pressure to 7.5cm and leave the max setting at 14.  Flex is currently on 3, but I'd like you to change it to 2.  If the Ramp setting is on, turn it off.  

I think you will be more comfortable and hopefully sleep more sound.  Give it a couple days and post an updated chart.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
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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#3
RE: Suspected UARS - new to CPAP and OSCAR. Help?
Great info, thank you! I will make those adjustments and let you know how it goes. I really appreciate this!
And yes, I fully intend to get my sleep study in March. This is just a stopgap measure in the interim because I couldn't let myself suffer until then. Also it'll be nice to know if I'm barking up the right tree here (regarding a sleep disordered breathing issue causing my symptoms)!
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#4
RE: Suspected UARS - new to CPAP and OSCAR. Help?
Hi there,

I made the recommended changes, but am having issues I wanted to ask about. The first night, I used 7.5 pressure and changed FLEX to 2. However, I would keep getting "chipmunk cheeks" from air puffs in my mouth, and I found it too difficult to exhale. I was unable to sleep at all with the mask on that night. The following night (last night), I set FLEX back at 3 and that resolved the suffocation feeling. However, I still get the air puffs each time I'm falling asleep, and they wake me up. I tried a cervical collar, but it was uncomfortable and didn't stop the puffing. It seems my tongue drops from the roof of my mouth as I relax into sleep. That said, I was able to get about an hour of sleep with the mask on by taking a Benadryl. I woke with really painful nasal passages on inhalation, so I had to take the mask off after that hour. I've attached the OSCAR graph zoomed to that one hour I slept last night. I noticed it recorded some variable breathing for the first time...not sure what that's about (second attachment). 

Two questions--should I put the humidifier on to stop the nasal pain? And would it make sense to try the full face mask to resolve the air puffing issue? Any other thoughts?

Thanks so much!


Attached Files Thumbnail(s)
       
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#5
RE: Suspected UARS - new to CPAP and OSCAR. Help?
(02-03-2023, 11:55 AM)manders513 Wrote: Two questions--should I put the humidifier on to stop the nasal pain? And would it make sense to try the full face mask to resolve the air puffing issue? Any other thoughts?

Yes, use the humidifier.  Experiment with it, start low with humidifier settings and move up as needed.  Too high of a setting can cause issues too.  
There are nasal sprays or nasal gels you can try that keep the nasal passages moist.

Although the nasal pillow mask is the easiest to adapt to, it isn't for everyone.  
If you can't control the air puffing, then you may want to try the full face mask.  

I see variable breathing on both charts that you posted. It more than likely happens along with Flow limitation. The Flex system isn't going to give the relief needed. It can't compare to EPR. But since you're currently using the Respironics machine, use the Flex setting that you feel comfortable with.

You really need a ResMed that offers EPR, as that normally helps with flow limitation and Hypopnea.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
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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#6
RE: Suspected UARS - new to CPAP and OSCAR. Help?
Hi there, 
Thanks again for all your help. I started using the humidifier and no problems there! I also tried the FFM, which just didn't work. I couldn't get it to seal--either the top part under my nose would leak, or the bottom near my chin. Anyway, I switched back to the nasal pillows as I find them to be the most comfortable. I was able to sleep for quite a few hours last night by rigging up a DIY chin strap using a fabric headband! I'm attaching last night's report because I just want to see if there are any other improvements that I could make. My untrained eye thinks this report looks pretty good, but honestly I have no idea. I also had a question about many of the jumps in pressure (up to 9)--how can I tell what causes those? I'm assuming leaks, or is it the machine preventing events for me?

Thank you!
   
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#7
RE: Suspected UARS - new to CPAP and OSCAR. Help?
Finding a mask that works for you is one of the hardest parts of therapy.  Read the Mask Primer, as you will find many good tips on how to adjust your mask.

http://www.apneaboard.com/wiki/index.php...ask_Primer

Other than that, your charts looks pretty good.  

In answer to your question about the "jumps in pressure".....  This is a built in feature
to the Respironics algorithm.  The algorithm raises and lowers the pressure approximately 1.5cm to check if a higher/lower pressure is needed and adjusts accordingly.  There is no way to turn that feature off.  It seems to bother some folk, but others don't notice.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
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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#8
RE: Suspected UARS - new to CPAP and OSCAR. Help?
Gotcha. Well, great! Again, thanks so much!
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#9
RE: Suspected UARS - new to CPAP and OSCAR. Help?
(Just a comment that you might want to stop using the machine a few days before your sleep study so that the study is accurate.)
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#10
RE: Suspected UARS - new to CPAP and OSCAR. Help?
I appreciate that, thank you! Is a week overkill, or is 3-4 days sufficient?
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