[CPAP] Can you help with insights on OSCAR data

[zwansleep]

While waiting for my scheduled polysomnography, I got a Resmed AirSense to work on my UARS. The sleep doctor say I have narrow upper airways (retropalatal, retroglossal, even nasal resistance). I don't have the exact measurements but I have the scan on CD.
Here's the data of my first successful night with the device (after many attempts and tuning). Can you help analyze it?

   

Settings:
   

[zwansleep]

Hello just to add more data. 
I think I am close to finding great settings for my case with the help of ChatGPT but I would like hear more from you guys.
I am already using a soft cervical collar (Caldera Releaf Neck Rest after trying BETOVIN Neck Support which was not that soft...)
The min pressure was increased from 10 to 10.4 cmH2O and response changed from standard to soft)

   

[SarcasticDave94]

Welcome to Apnea Board,

By the numbers, it looks great. I think the one thing I'd edit would be going back to the standard response. In the long run, it might be better for therapy.

Your low level CA and small Hypopnea aren't bad. At this stage probably only edit things for comfort.

[ejbpesca]

The OSCAR report looks fantastic.  Look at Flow Limitations.  Research them to understand the figure.  To me, it is very low.  My FLs are 5 times that figure due to my clogged airways.  Your AHI is insignificant, below the normal range.

I would like to know how you learned to do the "tuning," of the machine.  Did you use the Med pressure under statistics to find the optimal minimum pressure?

[zwansleep]

Thank you. This is encouraging.
Basically I read a lot of resources. Everything I could find on the wiki here or in the different threads.
I also use ChatGPT for insights ( I give it my fitbit sleep data as well)
It pointed out that my moderate and severe FLGs are probably REM related (REM-predominant UARS).
It also suggested to increase my minimum pressure to 11.4-12 cmH2O to reduce flow limitations...

I also read somewhere that the min pressure should be set to the 95% pressure minus 2 which gives: 11.2 - 2 = 9.2

So I m pretty confused...

[OpalRose]

With the change from standard to soft, your FL rose from 0.04 to 0.07.  I agree with Dave on setting it back to standard mode.  

We don't always know what causes FL, but it can be disruptive to sleep, so we should try to keep the 95% FL number under 0.03 if possible.

Since you are already using EPR set at 3, the only thing left is to raise the minimum pressure.  It wouldn't hurt to raise it to 11cm. Try raising it in small increments and gauge the results.

There are two things you can play around with, the minimum pressure and the soft vs. standard mode.

[ejbpesca]

Zwan wrote:

"I also read somewhere that the min pressure should be set to the 95% pressure minus 2 which gives: 11.2 - 2 = 9.2"

What you found is an example of the many contradictory bits of information concerning PAP therapy.  The only solid statement about it all is the fact that there is no set formula for settings, and what settings may be working for an individual can change.

The 95% pressure is a ball park figure.  Looking at just one 95% reading does not give the correct Min pressure.  My 95% can be 11.5 one night and 16.2 the next.  Over time, I see mine ≈ 12.  My prescription Min. is 12.  I have set Min. to 12.6 and may go higher.  My FLs have gotten worse over the years, so higher pressure may help reduce them.  I hope to try a bi-level machine day.

I would like to see an explanation of how someone arrived at -2 of 95%.  Perhaps they figured the Max would take over to provide optimum pressure.  Min to Max does not work well for me.  I want to find a Min that produces the lowest AHIs and FLs to avoid unnecessary upticks in pressure.   I would keep raising my Min if it were not for aerophagia.