RE: Titration Study Results
We do a rough guess by looking at the FL 95% stat in OSCAR. it IMHO should be .1 or less.
RE: Titration Study Results
(04-21-2021, 03:52 PM)staceyburke Wrote: You just do it by comparing the different days graph. One easy way to look at more than one is go to the day you want and right click next to "flow Limit." and pick popout, then go to the next day and do the same thing, and the next. You can get 3 or 4 depending on your screens res and compare them for how many and size....
Thanks for the tip, didn't know you could do that!
RE: Titration Study Results
(04-21-2021, 05:17 PM)Geer1 Wrote: (04-21-2021, 03:30 PM)hookedonstitch Wrote: How can I understand the OSCAR data to know if my flow limitations are getting better? Is there a number I should be looking at or how do I read this on my chart? I am really curious!
The only number that has an iota of value is 95% flow limitation, lower is better. Learning what a flow limited breath looks like and reviewing your breathing in detail is more valuable. Look for worsening flow limitations that are followed by large deep breaths (arousal breathing), these are RERA's.
Some info available here. http://www.apneaboard.com/wiki/index.php...limitation
A lot of necessary sleep study/titration data is missing. How many arousals did you have? How many were related to PLM? How many were related to breathing (RERAs)? Did they even score RERA's (not all do)?
Your pressure is being maxed at 8 cm almost all the time and flow limitations are driving that pressure increase. Treating flow limitations can be tricky. Increased pressure sometimes helps, sometimes does nothing, and sometimes makes it worse. The easiest way to tell this is for you to increase max pressure and let the machine work (I would do first jump by setting max pressure to 12 cm if minor improvement could then try 15 cm). If flow limitations reduce the higher pressure is helping you, if pressure maxes at 12 cm like it currently does at 8 then it isn't helping you and it would be best to return back to 8 cm max (and at that point consideration of using a different machine may be warranted).
I will be calling the office and asking for copies of my sleep/titration study tomorrow. This information was not shared with me, I was only told the total # of PLM per hour.
I have set my pressure to 6.0-12.0 which was my pressure setting when I was first sent home with the machine. I will check to see what the maximum pressure is over the next week and report back.
I really appreciate all of these tips!
RE: Titration Study Results
(04-21-2021, 05:39 PM)Gideon Wrote: We do a rough guess by looking at the FL 95% stat in OSCAR. it IMHO should be .1 or less.
So if I'm looking in the right place my FL # for Apr 19 & Apr 20 is 0.18? If so I will keep my eye on this # over the next week with increasing my pressure settings.
RE: Titration Study Results
Yes it was 0.18.
If you have the OSCAR data from when you previously used 6-12 pressure can just look at it.
RE: Titration Study Results
That and RERAs should be zero.
This, coupled with your EPR=3 also tells me that you may be seeing a BiLevel such as the VAuto in your future as it can apply larger values of "EPR" or Pressure Support and thus better treatment for Flow Limits and RERAs.
RE: Titration Study Results
(04-21-2021, 06:40 PM)Geer1 Wrote: Yes it was 0.18.
If you have the OSCAR data from when you previously used 6-12 pressure can just look at it.
I actually deleted it this morning to make room on my SD card! I feel like a moron 
RE: Titration Study Results
(04-21-2021, 08:00 PM)Gideon Wrote: That and RERAs should be zero.
This, coupled with your EPR=3 also tells me that you may be seeing a BiLevel such as the VAuto in your future as it can apply larger values of "EPR" or Pressure Support and thus better treatment for Flow Limits and RERAs.
Probably getting ahead of myself here but how do I talk to my Dr. about this when it has never been mentioned? I will try for a few nights to a week to see what pressure the APAP wants to settle on.
Even if I set it to 12, if it's not needed for an event it shouldn't go that high? Am I understanding this the right way?
RE: Titration Study Results
The good, my Cardiac CT was normal. Calcium score is 0, no sign of any issues with my heart.
The bad, I'm still having issues with breathlessness, especially upon movement and slight wheezing in my chest. I have had lung tests that have ruled out COPD.
Cardiologist suggested weight loss, exercise and a follow up with an echo in 1 year to follow the enlarged heart.
Could this all be related to the sleep apnea? I strongly suspect I have probably had it for at least 10-20 years without knowing. I've had issues with insomnia and sleep dating back that far.
RE: Titration Study Results
(04-21-2021, 09:17 PM)hookedonstitch Wrote: Probably getting ahead of myself here but how do I talk to my Dr. about this when it has never been mentioned? I will try for a few nights to a week to see what pressure the APAP wants to settle on.
Even if I set it to 12, if it's not needed for an event it shouldn't go that high? Am I understanding this the right way?
You probably don't... Most doctors don't try to treat flow limitations and will think you are crazy if you ask for bilevel to treat them, especially when you have a titration study saying your apnea is treated. Most people end up buying machine out of pocket and self titrating. First step is seeing if higher pressure fixes the flow limitations as it might.
Resmed's algorithm increases pressure after apneas, hypopneas and flow limitations. When set on auto mode if the higher pressure helps it will reduce flow limitations until they are not an issue and then the machine will stop increasing pressure unless more apnea/hypopnea/flow limitations occur. If no flow limitations are occurring it will then try lowering pressure slowly until apnea/hypopnea or flow limitations cause it to increase again.
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