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[Treatment] New to APNEA, new to OSCAR
#1
New to APNEA, new to OSCAR
In August of this year I was diagnosed with severe sleep apnea. (AHI 59)  Trying to decipher and digest all of this, it is clear I have a real problem, I am hoping someone with experience can make suggestions.  My APAP Dream Station 1 machine is factory set at 4 to 20cm on the low and high.  I use a WISP nasal mask, I seem to tolerate it ok.  I have seen AHI as high as 18+ and as low as 4+.  I want to better understand how my machine is reacting to my apnea and to understand if it is as effective as it could be.  I'm one of the people waiting on the Dream Station 2 machines as a replacement in Philips recall.  I'm reading a lot of bad reviews on the new machine as well.  Looking at my results in OSCAR, I'm shocked to see so many events.
Chris
52 years
Male


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#2
RE: New to APNEA, new to OSCAR
The factory default of 4:20 rarely does the job.

You are getting a lot of obstructive events and Hypopneas.

Your pressure immediately jumps to 8 and rrely dips below. I would suggest increasing your minimum pressure to 9 (to start) and then see how you do,
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#3
RE: New to APNEA, new to OSCAR
A minimum pressure of 4cm is too low.  Know that Respironics machines are slower to react to apneas than a ResMed.  

Your median pressure is at 9.2 and your 95% pressure is at 11.4.  This simply means that you are spending the night at a pressure of 11.4cm for 95% of the night and under.

I would set your minimum pressure at 10cm with a Flex setting at 2.  Leave the max at 20cm.  If you can tolerate it, work toward turning the ramp feature to off, or at least turn it down to 15-20 minutes.

Give this a couple days and repost.
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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#4
RE: New to APNEA, new to OSCAR
Thank you for the responses, I will try these things.  I just restarted use on Sep 3rd after replacing the air chamber with one that doesn't have foam. I used the ramp feature for the first few days, but I no longer turn that on when I start use.  I have had a few times in the middle of the night when it seems the pressure is too high and mask fit is off a bit.  I left the ramp feature on because in those situations, I've on a couple of occasions just hit the ramp button to stop the machine overpowering me.  I will set ramp down to 15, but prefer to have it in case of a wake through the night, easy way to back the machine off.  I'll try 10cm min. and change flex to 2.  I'll try this a few days and post the results.  Thanks again for the advice.
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#5
RE: New to APNEA, new to OSCAR
If you find that a minimum pressure of 10 is too high for you, back it down to 9cm and then you can work your way up if needed.
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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#6
RE: New to APNEA, new to OSCAR
PR machines NEED a higher Min pressure than other machines because of the slowness of the algorithm to respond. I was going to suggest 9 to start looking at 10 which I felt the above.might be needed. So I agree with e
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#7
RE: New to APNEA, new to OSCAR
Thank you for all the advice. I am at 9 on low side, ramp at 15 minutes. (ramp pressure @ 7). So far my incidents have not decreased much, but I know it can take a little while for me to adjust. I'll work on getting up to 10 on low side. I typically don't use the ramp when I first put the mask on, it is more of a relief valve when I wake up around 2Am to 4 AM with pressure at 15+ and mask is being lifted off my face and blowing air into my eyes. I hit ramp at this point because it is preferable to ripping the mask off out of frustration. I am wearing a WISP mask that covers my nose, but I'm considering trying the nasal pillow mask, hoping that would allow better side sleeping due to the top of head hose connection, and maybe avoid the pressure pushing my mask off my face.
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#8
RE: New to APNEA, new to OSCAR
(09-26-2022, 07:52 AM)steelepc70 Wrote: .......I  wake up around 2Am to 4 AM with pressure at 15+ and mask is being lifted off my face and blowing air into my eyes.


Is your max setting still at 20?  

The machine is reacting to either the leak rate and/or flow limitation, which raises the pressure to compensate.  So to keep you pressure from going higher than necessary, bring the max down a bit to 14. This will give you a narrower pressure range and may help with the run-away pressure waking you.

I also see some positional apnea. (Notice the clumps of apnea) Try to be aware of how you're sleeping. You may be on your back or tucking your chin to your chest.

Please show us an updated chart when you post again so we can "see" what's going on.
Thanks. Smile

And BTW, you may do better with a nasal pillow mask. It's worth trying.
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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