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+--- Thread: Help with reading Oscar Results. (/Thread-Help-with-reading-Oscar-Results)
Help with reading Oscar Results. - smokehouse502 - 01-30-2020
I am a 30yo male who has an extremely small airway with a tongue that falls back into my throat. I have had an in-lab sleep study that showed 3.6 RERAs per hour and an Arousal index of 5.6 per hour. I wake up every morning with clinching my teeth, hot, sweating, and breathing heavily. My sleep doctor recommended I use a APAP until I can get my jaw expanded through orthodontic means. I am using a new Dreamstation with a humidifier and Resmed Airfit N30I nasal mask. My settings are 6-16 with a flex of 3. I have 2 days of data with Oscar and my problems seems to come after 4 hours of sleep. I'm not sure what I'm looking at but it seems I have events during the night but at the end of the night when my tidal VOlume shoots up, my Resperatory rate dives and my flow rates change drastically. I'm so confused about what is happening to me.
Sorry if the pictures didn't load in, I have no idea what I'm doing on this forum. Here is a link to Imgur with all the screenshots.
https://Imgur.com/a/nZq1XEg
RE: Help with reading Oscar Results. - DeepBreathing - 01-30-2020
G'day smokehouse502. Welcome to Apnea Board.
At first glance your numbers don't look too bad, but it would help if you could re-format your Oscar output to maximise the most useful information. Please refer to this page for instructions. Some key points:
- Turn off the pie chart (File | Preferences | Appearance, and un-check the box for "Show Event Breakdown Pie Chart").
- Show the graphs in the following order: 1. Event flags; 2. Flow Rate; 3. Pressure (NOT mask pressure), 4. Leak rate; 5. Flow limit. We will likely ask to see other graphs later, but let's start with the basics.
- Turn off the afternoon nap sessions: See items 10 and 11 on this page
- For each night, let's see the full overnight chart (with afternoon sessions turned off), then zoom in on one area of concern. When you zoom in, please retain the ful page including the left side-bar.
Attach your chart to your post at Apnea Board: http://www.apneaboard.com/wiki/index.php/Attaching_Images_and_Files_on_Apnea_Board
Hope all that's clear.
If you format your charts like this, we will have a much better understanding of just what is happening.
RE: Help with reading Oscar Results. - smokehouse502 - 01-31-2020
Thank you for your help. I will do the instructions and repost. I am now having a problem where Oscar looks like it's zoomed in to 250%. Do you know what mist cause that?
RE: Help with reading Oscar Results. - Geer1 - 01-31-2020
Are you zoomed in a portion of the data or does the entire program seem to be larger?
Zooming in and out of graph area is done using left and right mouse clicks in the graph area. Once clicked there you can also use the up and down arrows (as well as left and right).
If the entire interface seems larger I am not sure how you would of done that and don't see anything obvious to change it. Some others might have ideas though.
RE: Help with reading Oscar Results. - smokehouse502 - 01-31-2020
The whole Oscar program seems zoomed in too 250%.
RE: Help with reading Oscar Results. - smokehouse502 - 01-31-2020
I figured it out. I just deleted the program and then re-downloaded it.
Help with findings - smokehouse502 - 01-31-2020
Here are my first 2 days on cpap, but I am concerned with what's happening in my sleep. I wake up every morning, after about 4-6 hours of sleep, clenching my teeth, hot, heart racing, and sometime breathings very hard. I have bad LPR reflux and it doesn't seem to be affected by what I eat or medications I take. I feel its related to breathing issues. My airway and jaw are very small (CBCT scan) and my tongue falls fall back into my throat. I have taken in an in-lab test which showed minimal AHI (.01), 3.9 RERAS per hour and an arousal index of 5.6 per hour. I just took a WatchPat test to see if anything is different at home. I am using a CPAP to try and correct my breathing issues. 6-16 pressure with 3 flex on Dreamstation APAP. I use Resmed Airfit n30I mask
My issues seem to come right at the end of the night. My respiratory rate will drop significantly, my pressure will change, and my flow rates start to do crazy up and down and flat lines. Can anyone help me work out why this is happening right around the 4-6 hour mark. I haven't been able to get a good nights sleep in 1.5 years and wake up the same way every day.
RE: Help with reading Oscar Results. - OpalRose - 02-01-2020
smokehouse502,
Your two therapy threads have been merged. We ask that you keep your therapy questions to one thread to get faster responses.
RE: Help with reading Oscar Results. - Geer1 - 02-01-2020
Were you awake for a while(~13 mins) before you got up and turned the machine off? Your respiration looks like you were awake and breathing seems similar at the beginning of the night which would agree with that idea.
Regarding LPR I have just been reading into this as I believe I suffer from it as well (appointment this week to try and confirm). In reading about it LPR can be caused by gastroparesis (stomach not emptying so builds pressure which then passes esophagus), something to get the doctors to look into if they haven't already. Elevating your upper body/head when you sleep seems to be a strong recommendation if you don't already do that. If nothing is helping you may need surgery to remedy it as well, something to push for if nothing else is working.
Did your sleep study comment on your sleep architecture (time spent in each sleep stage, onset time for rem sleep etc)?
Two days isn't much data and CPAP takes a while to adjust to, I think that might be part of the story here.
Do you take any medications? Some cause early morning awakenings.
RE: Help with reading Oscar Results. - Sleeprider - 02-01-2020
Smokehouse, you have a physical airway that is restricted, resulting in flow limitation and all the not-so-fun stuff that goes with it like sleep disturbance RERA and hypopnea. I know you can be treated without resorting to a mouthpiece that will do nothing. I am yet to see the person come here and solve a problem with a mandibular advancement device. They are uncomfortable, mess up your bite and don't work with CPAP.
Your answer is pressure support as in a bilevel machine. Let's talk about flow limitation and why bilevel works. Flow limitation is a restriction on the maximum flow that can pass through your airway. Like a narrow straw, you can only suck so much air per second because the airway collapses as the vacuum builds. You can see it in your flow rate charts in OSCAR as flat-topped inspiration waves. That flattening or even diminishing flow during inhale is flow limitation at work. It takes a lot of respiratory effort to pull the air in when that is going on, and it results in arousals to get more air.
Your doctor wants to try to open your airway, but if we use can just apply more pressure during inhale, and less pressure during exhale, the problem is easily and comfortably resolved Unfortunately you have a Philips Dreamstation which cannot help us. If you had a Resmed Airsense 10 Autoset, we would have 3-cm of pressure to work with. A bilevel like the Aircurve 10 Vauto would give us as much pressure support as you can use. We have seen lots worse problems with this than you have, and I could show you what pressure support can do, even with the limited 3-cm pressure support from a Resmed CPAP as in this Flow Limitation wiki http://www.apneaboard.com/wiki/index.php/Flow_limitation
Your answer is to get a machine with pressure support. You can buy one out of pocket or redirect your doctor to let you try bilevel. It solves a world of hurt.