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Bizarre OSCAR Charts!
#1
Bizarre OSCAR Charts!
First Post!

I have recorded some really strange OSCAR charts.

Respiratory Rate over 50 for 45 minutes! (shouldn't I be dead or at least be awake?).
Tidal Volume all over the place.
Large amount of Large Leaks.
And I am sure other charts are far from ideal.
Yet AHI seems reasonable at 5.12, under the circumstances.

RR as measured by Fitbit and WHOOP is 17.
Overall ODI as measured by finger oximeter is 5, SPO2 is 96, heart rate 55.

I have positional sleep apnea. On my side ODI is generally 5-10. On my back it is over 20.
I use a herbal nose spray just before going to bed, which makes my nose perfectly clear. My nose gradually stuffs up and after 7 hours it is very stuffy.
I do not at any time notice any mask leak.

I sleep straight through for six hours. I do not wake up at any time, other than normal brief periods. After six hours I get up to urinate and then return to bed after using nose spray. I leave CPAP mask off and sleep well for two more hours on my side with an ODI under 10. I sleep much better without the mask at this point.

I wake up feeling pretty good. I am not particularly tired or fatigued. Sometimes I take a nap at 5pm for 20 minutes and then continue on with a clear head until bed time. I would say overall I feel 80% sharp. Would like to get that last 20%. I am 77 years old.

I hope someone can shed some light on what is going on. If more information is needed I will be glad to provide it. I can post more charts, having used CPAP since November.


       
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#2
RE: Bizarre OSCAR Charts!
Hi GeorgeGus! - Welcome

Resmed determines the respiration rate by how many times your flow rate crosses the zero line. Any snoring will drive your numbers crazy. It would appear that you are either tucking your chin, or sleeping on your back.

- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
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Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
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Apnea Helpful Tips

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#3
RE: Bizarre OSCAR Charts!
Hi Red,

Thanks for the fast reply.

I go to sleep on my side. After a couple hours I find myself on my back and I switch back to side. I don't know a way of tracking my actual sleeping position to see how much time I spend on my back. Would back sleeping also cause the high Large Leak rate?

I have a snore app that records and ratres snoring but I stopped using it since OSCAR rarely recorded any snoring. There is some snoring on the charts I submitted but it does not seem to correlate with anything. I will reactivate the snore app.

Is there a way to control chin tucks? Not familiar with the concept at all. Is there a good source to learn from?

So basically are we saying the OSCAR charts are corrupted due to some non-apnea irregular breathing problems?

I also don't see any correlation (i.e., cause and effect) between the charts. They all seem to march to their own drum.
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#4
RE: Bizarre OSCAR Charts!
You have a couple of things going on here.  To start with you have your EPR (Exhale Pressure Relief) set to Full time 3.  That is what I would suggest.  BUT how you have your pressures makes this setup to EPR 1.   Let me explain how this works.  The min is the inhale pressure (5) your exhale pressure is with EPR 3 is 4 because 4 is the lowest any cpap can go.
Min 5 EPR 3 exhale is 4
Min 6 EPR 3 exhale is 4
Min 7 EPR 3 exhale is 4
Min 8  EPR 3 exhale is 5
And so on…
I would suggest you put your min to 7 That will help your flow limits.  Flow limits are apnea also just like O and H events.  The Resmed machine you have raises pressure when it finds flow limits to stop them from becoming bigger O and H events.  Look at your pressure graph and compare them to your flow limits.

The second problem you have are Positional apnea.  They can be found by looking at the O and H events.  When there are grouped events they are most probably Positional apnea.  Positional apnea can NOT be controlled by pressure changes.  You have to find out what position you are getting into and cutting off your own airway.  Have you changed your sleep position?  Sleeping on your back?  Using more (or new) pillows?  These things can cause positional apnea by chin dropping to your sternum and cutting your airway.  Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar.  I have a link to collars in my signature at the bottom of the page.  It shows people who are not wearing a collar and the SAME person wearing a collar.  There is a huge difference between the two.
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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#5
RE: Bizarre OSCAR Charts!
Thank you. Time for time for dinner. Will investigate tomorrow.
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#6
RE: Bizarre OSCAR Charts!
I changed minimum pressure to seven last night. Last night Oscar chart was a mess very similar but not identical to the one I already posted. The events seem so random. Let me know if you want me to post it.

I use a collar for reading and computer work, but it is not the right size for sleeping. I ordered two more collars from Amazon and hope they will fit better for sleeping. It would not surprise me if chin tuck was my problem.

Because of previous back problems, I am very careful to maintain the S curve in my lower back and neck. I tried over a dozen pillows until I finally found one that worked for me. It is a feather pillow and not very thick. It allows me to maintain my cervical and thoracic spines in a straight line while sleeping on my side.

I do not seem to snore. Oscar records 0.00 even though there are some small spikes in the graph. My other two apps also negligible snoring. In the past before using CPAP I did snore. I taped my mouth and continued to snore, indicating all the snoring was passing through my nose. Since using CPAP I have rarely seen any snoring recorded.

Will keep you posted. I really would like to resolve this.
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#7
RE: Bizarre OSCAR Charts!
I forgot to mention that I tried over a half dozen different backpacks from Amazon designed to keep you on your side while sleeping. They all worked for a while, but eventually, my body pushed through them and I ended up on my back.
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#8
RE: Bizarre OSCAR Charts!
Please post OSCAR from last night
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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#9
RE: Bizarre OSCAR Charts!
Let me know if you need anything else. I have oximeter chart showing ODI and SPO2 and heart rate.


Attached Files Thumbnail(s)
           
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#10
RE: Bizarre OSCAR Charts!
           

Attached are the charts from my May 31 sleep using a soft cervical collar. There was some improvement but so many of the metrics are still not looking right and I would certainly like to learn what is causing that.

Trying to break this down I looked at the Large Leak, as this should be an easy problem to solve. There is a big one lasting 34 minutes starting at 2:15PM. For this period, among othere metrics, the expiration flow rate is much greater than the inspiration flow rate and pressure goes down, but AHI stays steady at 2.0. How can this be? I am a rank beginner with Oscar so I really do not know what all the metrics mean.

Trying solve this 46L 95% LL I have done the following: switch my Resmed 10 to my bac up Resmed 10, changed air hose (both slim line and heated), changed nose piece, and changed to a completely new model, the Solo. None of these had any effect on LL or any other metric. I spend most of my time on my side and I think moving from my back to side and vice versa may be the problem. But there is no way I can sleep in one position all night. Would a full face mask be any better controlling leaks?

I slept straight through the 7 hours 23 minutes. Never gasped for breath, never woke up. My oximeter ODI was 2 and heart rate 54 and Sp02 96 with 99% greater than 93. I slept very well and woke up clear headed, but I think my head could be even clearer. How can I be feeling so well with such lousy metrics except for a decent AHI?

Help!
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