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CPAP Therapy / Settings Review (OSCAR)
#1
CPAP Therapy / Settings Review (OSCAR)
Hi everyone!

I'm hoping that someone could review my recent OSCAR charts and seeing if I'm on the right track to proper therapy and getting a good nights sleep.  I've only recently found a mask and setting that I am comfortable with enough to fall asleep.

I do notice that I still wake up occasionally early in the morning and will sometimes remove my mask.  Thankfully it seems like I'm able to stay asleep longer with my mask as time goes on and I'm averaging 5+ hours a night now.

I'm currently using the following:
- Philips Respironics DreamStation Auto CPAP
- ResMed Swift FX Nano mask
- Min Pressure:  8.5
- Max Pressure:  13 (Increased this from 11 to 13 today)
- C-FLEX 3
*The DME had originally set a range of 6 - 20cm2 when I first got the machine, but I've since been adjusting it manually.  

AHI with current settings seems to fluctuate between 2 - 5 some nights.  I'm not sure if this ideal or if I should be upping the min. pressure higher to try and reduce my OAs and Hypopneas further.  In terms of sleeping and feeling better, I don't notice too much difference in general tiredness throughout the day.  Although it may be too early to notice a difference yet.

I've attached the OSCAR reports for April 14 - 16.  If you need to see further information in OSCAR or prior days please let me know and I will upload.

I really appreciate the help!


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#2
RE: CPAP Therapy / Settings Review (OSCAR)
I would suggest moving the min up 1 cm and decrease the flex down 1. I think that will help the H totals. With a dreamstation the only way to cut back obstructive apnea is through raising pressure.
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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#3
RE: CPAP Therapy / Settings Review (OSCAR)
(04-17-2021, 03:04 PM)staceyburke Wrote: I would suggest moving the min up 1 cm and decrease the flex down 1. I think that will help the H totals. With a dreamstation the only way to cut back obstructive apnea is through raising pressure.


Thanks Stacey, I will give that a try.  Is there a functional difference between lowering Flex vs increasing the min. pressure?  I believe that would accomplish the same goal by increasing expiratory pressure but I could be missing something.
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#4
RE: CPAP Therapy / Settings Review (OSCAR)
I don’t own a dreamstation but I am on the site much of the time. many users report flex 3 is Disruptive for them and they use 1 or 2. Use the search on this site and read their comments. Again, I have used a ResMed and do not have personal experience with Phillips.
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: CPAP Therapy / Settings Review (OSCAR)
Flex 3 has been noted by some users to increase discomfort or something like that. This can restore some comfort for you. Also it's known Respironics has a fatal flaw in that they're too slow in responding to events unless Min pressure is near your needed minimum.

I don't always suggest 2 edits at once but this time it makes sense to do both.
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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#6
RE: CPAP Therapy / Settings Review (OSCAR)
Hi everyone!

So as per the advice in this thread I decreased Flex from 3 to 2 and upped the min pressure from 8.0 to 9.0.

I've been using these settings for about a week and a half now and I can't say that I'm feeling much better or different.  My main problem the past 2 weeks has been getting more than 4 hours of sleep with the CPAP machine.  It seem that I wake up without fail after 4 hours of sleep and at that point I'm wide awake.  It'll take me some time to fall back asleep and I usually have to remove my mask to settle down.

I feel that I got longer sleep without waking up at Flex 3 and 8.0.  I'm not sure if this because of the settings change or just happens to be a bad week.

AHI doesn't seem much lower either.  Sub-5 still but never below 1.

I've attached OSCAR screenshots for the last few days.


Should I increase the min pressure again or stay at this setting my sleep time gets better?  Any ideas why I'm waking up after 4 hours of sleep?

Appreciate your help!


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#7
RE: CPAP Therapy / Settings Review (OSCAR)
Bumping this up
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#8
RE: CPAP Therapy / Settings Review (OSCAR)
I don't see anything specific to indicate issues. If you liked pressure of 8 and flex 3 better you can change it back. It's more about comfort than numbers at this stage of therapy.
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: CPAP Therapy / Settings Review (OSCAR)
First and most important is how you are feeling and if you were better with the other settings - go back to them. 

But you really are doing better number wise. Look at the first posts and the new ones. Many of your new events are centrals which are not controlled by this type of pap machine. Centrals come and go they are very inconsistent. Your pap machine controls O, H and flow limits and all of those were better. 

Again, your numbers are ok and what you want is what feels better to you. How do you feel the next day is what you want.
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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#10
RE: CPAP Therapy / Settings Review (OSCAR)
(05-05-2021, 09:14 PM)SarcasticDave94 Wrote: I don't see anything specific to indicate issues. If you liked pressure of 8 and flex 3 better you can change it back. It's more about comfort than numbers at this stage of therapy.


I didn't notice much (if any difference) in my daytime fatigue with 8.0 and Flex 3.  I know that an AHI of 5 and under is considered treated sleep apnea / normal but I've also seen other CPAPers mention that some folks need a much lower number to feel better.

I may go back to the lower settings for now though.  I'd rather sleep more comfortably with consistent CPAP hours, at least until I get more accustomed to it.

Appreciate your help!

(05-05-2021, 09:54 PM)staceyburke Wrote: First and most important is how you are feeling and if you were better with the other settings - go back to them. 

But you really are doing better number wise. Look at the first posts and the new ones. Many of your new events are centrals which are not controlled by this type of pap machine. Centrals come and go they are very inconsistent. Your pap machine controls O, H and flow limits and all of those were better. 

Again, your numbers are ok and what you want is what feels better to you. How do you feel the next day is what you want.


Thanks for the advice Stacey!  I'm trying to find out if I'm in that group of CPAPers that needs an AHI score much lower than 5 to feel less fatigued during the day.  I didn't feel that 8.0 / Flex 3 made me feel much better, but admittedly I haven't been using my CPAP for that long.
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