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[Treatment] Understanding OSCAR data?
#1
Understanding OSCAR data?
Good afternoon all,

I apologize in advance for the rather lengthy post but I want to be as detailed as possible for anyone who is responding and willing to help. 

I had my initial in-lab sleep study done sometime in FEB of this year with a follow-up in-lab sleep study with CPAP equipment done around 06 MAR. I was diagnosed with mild sleep apnea with an AHI of 11.8. The doctor prescribed CPAP therapy for me and during the tele-consult to discuss the results of the sleep studies, he had said he had my pressure initially at 11 cmH2O but I complained that during the sleep studies, I had trouble falling back asleep after waking up sometime in the middle of the night. He decided to lower the prescription to 9 cmH2O. That being said I initially received Philips Respironics Dreamstation base model(non-auto, not even the Pro) with humidifier and heated tubing.

The first and only mask I have used is the Resmed AirFit N30i. I quickly found the mask itself to be comfortable but breathing through the mask was not comfortable. After about 3 days I requested a different mask which I am still waiting to arrive and I opted to try a full face mask in the Resmed Airfit F30i. I also requested a change in machine as I wanted a data capable machine and requested the Dreamstation Auto which promptly arrived in about two days.

I immediately changed settings around after doing some base research. I changed the mode from CPAP to auto and changed the pressure from 9 to 6(MIN) - 11(MAX) since 9 was roughly in the middle and 11 was where the doc wanted me initially anyways. I also changed C-FLEX to A-FLEX and changed the number from 2 to 3.

I have been on CPAP therapy for about 12 days now with the first 8-9 days being with the non-auto CPAP and the last 3 days with the auto CPAP. The first week or so, I was able to fall asleep relatively easily, but it would never fail that I would wake up 1.5-3 hours into therapy and not be able to fall back asleep. The only way I could actually get back to sleep was to completely remove the mask and forego the therapy for the rest of the night. Since switching to the auto CPAP, I have found it harder to fall asleep and I have found myself waking up sooner and not being able to go to sleep unless I remove the mask and forego therapy.

I downloaded OSCAR yesterday and have noticed that my AHI's have almost doubled in the past two days compared to my in-lab sleep study. That being said, I do not know really what any of the OSCAR data means or how to interpret it which is why I am coming here for help. Attached are three screenshots which represent the last three days worth of data. To me, it appears that I should either revert back to the doc prescribed setting of CPAP mode at 9 cmH2O or I should change the auto mode settings to 6 cmH2O(MIN) and 9 cmH2O(MAX) as my AHI appeared to be lower, albeit still too high, at a lower pressure setting. It particularly seemed higher at high pressure in regards to clear airway obstructions which would signify to me that I have developed Central Sleep Apnea due to the higher pressure settings?

At any rate, I have not gotten a single good night's sleep and have not worn the mask long enough for compliance purposes but I want to genuinely treat my sleep apnea. Any help and advice would be appreciated it, particularly if any of you also have advice on good full face masks aside from the F30i?



Moderator note: I have edited the post to make it more legible.


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#2
RE: Understanding OSCAR data?
G'day jabONE. Welcome to Apnea Board.

On your chart for 16 April, could I ask you to turn off the afternoon session to allow the rest of the data to spread out and be more legible? Use the blue and yellow bars just below Session Information - click any of these to turn the session off then back on.

Assuming you had no central apnea in the diagnostic sleep study, you are now seeing treatment-emergent central apnea. The first thing to do is turn Flex off. If you can't tolerate it off, then set it as low as you can. Although Flex is a comfort feature it has the side effect of making you breathe more efficiently, which reduces the percentage of CO2 in your blood stream. Although that sounds good, it tricks your brain into thinking "I don't need to breathe just now", and a central apnea occurs.

Also, could you post a copy of your study report? That will give us an insight into what's happening to provide more targeted advice. We need to see the full report with charts & tables. Make sure you erase all personal ID before uploading it.
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#3
RE: Understanding OSCAR data?
I will post the session from the 16th without the afternoon session tomorrow, that was more so just trying to use the mask during the day to get used to it. I will try turning the FLEX off and see how that goes, thank you for the response. As for the actual results form the sleep study, I will have to request those form the doc. Once I get them I will share.
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