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[Treatment] Reading Oscar Charts (newbie)
#61
RE: Reading Oscar Charts (newbie)
speaking of watchpat, here's a meta analysis from April 2022 saying

"The results of this meta-analysis suggest clinically significant discordance between WatchPAT and PSG measurements of AHI, significant sleep apnea severity misclassification by PAT studies, and poor diagnostic test performance."
https://pubmed.ncbi.nlm.nih.gov/34879903/

and the ONE journal article I found that showed it could detect centrals had 84 subjects and was funded by the company that makes it.

So I really don't know.
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#62
RE: Reading Oscar Charts (newbie)
Here is today's, went back to F20 mask that doesn't blow air everywhere like F30i, just replying to myself now Wink

AHI 5.28 CA 4.2


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#63
RE: Reading Oscar Charts (newbie)
Still can't help with those mask issues.  Have you read through the Mask Primer?

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

Most home studies don't report on CA's, so it's hard to determine if these are treatment emergent or not.  Try turning the EPR setting off for tonight.  Repost tomorrow.
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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#64
RE: Reading Oscar Charts (newbie)
Thanks I'll read the mask info - I am a mouth breather so the info is good on that.  I think the mask itself just has some problems based on another post.  Will try turning off EPR.  

Insurance is saying I can't have an in lab study because I had a home study so I have to appeal.  I think I need an in lab study.  I think the sleep doc is supposed to appeal it but they didn't seem to make much of a case.  Something about how I might have a 'second sleep disorder' without saying what it is.  Very hard to communicate with the doctors these days.
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#65
RE: Reading Oscar Charts (newbie)
Heres today with EPR turned off, much better at 2.2 about 1/2 centrals.  Why does turning EPR off help?  I also used a different cervical collar that is thicker and I think a bit higher, it's meant to have a heating pad or some magnetic thing put in back, but i just used without those.  Sometimes the collar will give me a bit of a headache when I first wake up but def seem to help the results. Also no 02 desats with perfect score of 10 on the wellue 02 ring. That never happens!


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#66
RE: Reading Oscar Charts (newbie)
Just wanted to say a big thank you to OpalRose for the turning off of EPR suggestion!!
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#67
RE: Reading Oscar Charts (newbie)
Sorry, I saw your post earlier, but had to go out for awhile.

I'm glad to see that it made a difference.  I hope the CA's stay lower, but CS's are "consistently inconsistent", so we'll just keep an eye on that.

Did you notice a difference in exhalation without EPR? Maybe it can be introduced back in after awhile.

I'm more concerned with OA's, but they're not too bad. You may need a bit higher pressure, but I think you should hold steady with current settings for a few days.

One day doesn't make a trend.
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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#68
RE: Reading Oscar Charts (newbie)
It didn’t seem harder to breathe really, or not that noticeable.  Although I did have a lot of awake time according to watch, or actually sleepscore app had the most awake time which uses sonar.  I don’t know how accurate any of it is.

I know it could be worse again tonight.  But one OA an hour is not too bad ?
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#69
RE: Reading Oscar Charts (newbie)
ECM5 you asked " Why does turning EPR off help?"

Why? because it increased your EPAP and the EPAP is the main thing the CPAP uses to splint your airways.

Rule #1 with the ResMed AutoSet: when you increase the EPR you need to increase the pressure by the same amount to keep the EPAP the same.

Conversely:
Rule #2 with the ResMed Autoset: when you lower the EPR you need to reduce the pressure by the same amount to keep the EPAP the same.

Kind of back to front ResMed logic to keep you confused and returning to the DME for "advice".

So what you did was lower/remove the EPR and in so doing you increased the EPAP hence you had less OSA.

From this chart you posted earlier you can see your EPAP (which is the Pressure minus the EPR) is too low. You set the EPAP at 6 cms (7 cmw minus EPR of 1 = 6 cmw). This is less than ideal to control your OSA. You can see that every time the EPAP falls you had some OSA and the machine responded accordingly. 
   

You can easily figure out a better starting EPAP for yourself: zoom into the OSA event and record each EPAP at which each OSA commenced, write this down/spreadsheet this and work out the average.

Or simply look at where the machine is keeping your EPAP for most of the night. On the chart you posted earlier: your Med EPAP was 7.2 and your 95 EPAP was 8.72, so, if you like, you should aim to keep your EPAP closer to the 7 or 8 cmw mark.

You could also consider the For Her mode:
The For Her "resets" the min EPAP after the 2nd OSA to prevent the EPAP falling too low for the rest of the night. 
Good read here: For Her McArdle

An extract from the article in case you don't have the time to read the whole thing: 

(Quote: )
Another novel feature of the AfH algorithm is a moving minimum AutoSet pressure (i.e., a minimum pressure is set to which pressure decreases during sleep periods devoid of respiratory events). If  apneas occur within a short time period the minimum AfH pressure will automatically increase and the pressure will not decline below this level for the remainder of the night’s therapy. The purpose of this is to minimize inappropriate pressure decreases during REM sleep that could occur with the standard AutoSet algorithm. It is possible, for example, that the standard AutoSet algorithm pressure could decay below the critical closing airway pressure during REM sleep, which can result in several apneas at the beginning of REM sleep until the device responds with appropriate pressure increases. This could be particularly important in women, who have been shown to have a predominance of REM-related OSA compared to men. During REM sleep CPAP pressures may need to be higher to maintain patency of the upper airway secondary to a REM-related reduction in the tone of upper airway muscles. It is also possible that this algorithm feature could reduce pressure variability, contribute to longer REM sleep, and reduce REM-related respiratory events.
(End Quote: )

Lots to digest I know, but hope this helps a little.
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#70
RE: Reading Oscar Charts (newbie)
Thanks SevereApnea, 
I did try the For Her setting once a week or so ago and just looked back at it - it did give me an AHI just above 2 and EPR was off and looked pretty good but then I switched it back to regular.  My min pressure now is 7 with EPR off, should I go up to 8?  I also turned off the ramp awhile back because I don't need it.  I'll have to look at each event.  I tend to have more centrals than obstructive and last night was a lot of leaks because I used mouth tape under full face mask and I kept lifting the mask to tug at it.  But still good AHI at 1.86 but the chart looks like a mess from leaks I guess.  So you are saying the For her setting would keep the pressures higher and more steady?  Thanks again for all the info!

Attached graph.


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