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low AHI, poor sleep, UARS/mild OSA
#1
low AHI, poor sleep, UARS/mild OSA
[attachment=29779]     [attachment=29779][attachment=29779]Good morning,

I started APAP (resmed 10 autoset) about 6 weeks ago. I consistently have 0 - 5 episodes per night, so my AHI is really low but I am still waking up often. My sleep test AHI was 7.53 but my RDI was 13.34. Besides mild OSA, I have also been diagnosed with UARS. I am wondering if my awakenings are airway related. I am attaching an image of my flow rate and flow limitation from 2 nights ago. As well as my flow rate zoomed in. Any advice would be greatly appreciated.

Sorry. Newby. I seemed to have posted the images repeatedly.
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#2
RE: low AHI, poor sleep, UARS/mild OSA
By the way, the data is from OSCAR.
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#3
RE: low AHI, poor sleep, UARS/mild OSA
Your profile shows very low pressure and no mention of EPR. The charts are not useful without the summary information and settings from the left column. Please read the link in my signature on Organizing your Oscar Charts. There just isn't much we can do with the ones you posted.
Sleeprider
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#4
RE: low AHI, poor sleep, UARS/mild OSA
I am unclear about EPR. But is this better for Oscar? 
Thanks!


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#5
RE: low AHI, poor sleep, UARS/mild OSA
Welcome the board. EPR IS exhale pressure relief. It lowers your min (exhale) pressure from 1to 3 depending on the setting. Now the problem with your setting is 4 is THE lowest a pap machine can go. You are set at 4 so your EPR setting of 3 does nothing because the machine can NOT
 Go lower than 4.  

EPR helps you breath more easily plus it helps with FLOW LIMTS. SO I would suggest a low of 7 and leaving the EPR at 3. You should sleep better.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#6
RE: low AHI, poor sleep, UARS/mild OSA
Welcome to the Apnea Board,

Yes Stacey is correct. EPR has no room to work with Min pressure of 4. Fully functioning EPR 3 needs Min pressure of 7 as he said.

Despite that, charts look good. So during and after therapy, good do you feel?
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: low AHI, poor sleep, UARS/mild OSA
Thanks Stacey and Dave! 

Dave -- I am exhausted. I am waking up a ton (which I always did) but it seems a bit worse. 

I will try switching my minimum to 7 and my EPR to 3. 

Really appreciate the help. My doc was just happy that my AHI is leaks are so low. And acknowledged that people with UARS sometimes fail PAP therapy but she had no solutions.
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#8
RE: low AHI, poor sleep, UARS/mild OSA
Now the next trick is to repeat that OSCAR data. See nothing apnea related is very easy.

OK I hear you on the exhausted status. How long, definite or guessing is fine, have you had the sleep issues that your CPAP is to help with? You mention UARS, so include that. Have you had sleep studies or titrations done? Get those reports, detailed copies of any recent ones and a copy of the script. You'll need them for your personal health folder. And you might want to post redacted versions of these here. And when the docs office tries to deny the request, mention HIPAA, it states you have a right to copies of your report.

The posting of the report may be optional as therapy data is excellent on that night.

Any other tests or actions you did to combat poor sleep that you'd like to include? Any data regarding your therapy and sleep is ammo for us to help make this PAP the best it can be.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
RE: low AHI, poor sleep, UARS/mild OSA
Just a note - you have a lot of flow limits. Flow limits are just a smaller apnea. You can see how they are defined in my signature. Flow limits stop you from going into deep sleep or even wake you up. Your other apnea look great but the FL is making you poorly rested. As you use the new settings compare the FL from last night to the next night - they should decrease with the new settings.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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