[Treatment] Advice on OSCAR report

[airoutlaw]

Yep in CPAP mode my typical AHI is 0.5 > 1.5 range. I actually find the constant pressure more comfortable/natural too as I just forget about it, as opposed to the BiLevel where its almost like forcing air in when you take a breath.

Ooooh, "Periodic Limb Movement" is an actual disorder?  I know I toss and turn and find myself readjusting my legs a lot. I have a knee pillow and often stretch my legs into weird positions to feel most comfortable.

Before I started CPAP (been on for 2 years now, but never really felt treated), I definitely had restless leg syndrome where I would get that weird tingle sensation and an urge to really stretch my legs in bed.


Picking through some more random CPAP days' data, my insp times seem to vary from being very flat, around 1.4s average, but then there are periods of "crazyness" where there are these clear spikes.





Also of note, I got an SPO2 device and recorded a few nights while on CPAP. I also had perfect saturation levels so I believe CPAP is doing what its supposed to. I'm just not getting restful sleep out of it.


My sleep hygiene is very good btw - I follow all the do's and don'ts around this.

[sheepless]

if you've experienced rls, you might well have sleeping plm as well.  I'm often aware of rls before falling asleep but am completely oblivious to plm.  fyi, the attachment is an example of what my respiratory response to plm looks like.  I'm a little less sure about another pattern I often see, which is also periodic and looks 'softer', with a csr-like sinusoidal waxing and waning of flow, sometimes punctuated by apnea or hypopnea and often accompanied by leaks.  both patterns include flow limited breaths between inspiratory peaks.  pap can't help this. in fact, the resmed machine response to flow limitations that the machine can't overcome can be as disturbing as the movements. on the one hand, it's nice to figure out what ails us, on the other, I hope plm isn't your problem.  it's hard to treat, at least in my case.

[jaswilliams]

Graphs from last time I tried BiLevel:





who configured that BiLevel I think every one would have ca’s if the pressure support was set at 9 like that....

[airoutlaw]

What do you think a more sensible range would be?

[jaswilliams]

Start with pressure support at 3 the same as the Autoset with EPR at 3 we can tweak from there

[airoutlaw]

So tried it last night using the "S" mode with "EasyBreath" as I'd read good things. Feel like I slept OK but not great. Felt like I woke up with anxiety so wondering if I was hyperventilating.

[airoutlaw]

I increased the pressure by 1cm last night, here's the results:










Not sure what to read into this really. Maybe I should try the VAuto mode instead of the "S" mode? Doesn't seem to really make any difference. I generally seem to be able to get good results according to the machine, but always wake up feeling tired :/

Arghhhhhhhhhhhh.


Would increasing the pressure support range likely have any positive impact?

[jaswilliams]

Increasing pressure support is likely to increase the CA’s. Not all tiredness is caused by Sleep Apnoea your numbers look good, are you on any medication that could be messing with your sleep ?

[airoutlaw]

Wondering if I should actually try lower pressures. With IPAP of 12 I barely got any obstructive events by the looks of things. Not sure if its worth going much lower but at this point I feel like I just need to try things and hope I find a magic combination that doesnt make me feel horrible

[SarcasticDave94]

If you decide to change up or down, take it slow as in by steps of 1 cmH₂O at the most. Remember you've got partial steps to use on the settings as well, AKA .2, .4, .6, .8. IMO you're probably closer than you think on having this right. Adjust 1 aspect and if it feels wrong and/or gives bad data results, then go back to the prior setting and try something different.