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GeorgeGus - Therapy Analysis
#1
GeorgeGus - Therapy Analysis
   
   

I am new to PAPs and so have done a bit of experimenting.

I took a short test nap at 5PM to see how I would respond to my new Aircurve 10 VAuto. Around midnight I went to bed. Next morning I loaded the results into OSCAR. My problem seems to be that OSCAR is treating the separate events as one event, so there is large gap between 5PM and 12AM. I can zoom a chart to the full 12AM sleep period but the Events Flags chart does not follow along. This results in the vertical marker not showing up any more in the Event Flags chart. It is really useful to use the vertical marker.

Any suggestions on how to handle this?

Thanks again.
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#2
RE: OSCAR Multiple Recordins on same day
You can't really do much. A ResMed 24 hour day is noon to noon next day.
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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#3
RE: OSCAR Multiple Recordins on same day
George, on the Left Hand Panel of your OSCAR Report Daily view, scroll all the way to the bottom to "Session Information". There you can select or De-select sessions to display. Therefore you can test fit, nap, adjust mask head gear, just play around while acclimating your body to the fit and feel of the mask under pressure, yet only display the session you would like to discuss for evaluation. It will also change the calculated AHI score to that of the session(s) selected for display.

I noticed your leak rate is a little excessive. There's a Wiki for that!

https://www.apneaboard.com/wiki/index.ph...ask_Primer

Be sure to read all the way down to Jeffy 1958, he really puts all of the knowledge you learn up to that point into an easy to understand practical application of donning a mask for a leak free seal. It takes some time to acquire the fit and feel for a proper mask seal, you will not get it right off the bat, with practice it will come. Then one day you will get IT, and be leak free until, with the benefits of *PAP therapy you lose or gain weight and that mask no longer fits your face. So you get a new mask, but now you are armed with the knowledge of how to get a leak free mask seal. Remember tighter is not always better.

Your AirCurve 10 VAuto is one of the most powerful machines available (IMHO).

You can and should order a Clinicians Manual here.:

https://www.apneaboard.com/adjust-cpap-p...tup-manual 

Scroll about 1/3 the way down, you will see the ResMed A10 Series (AirSense 10 AutoSet, AutoSet for Her, Elite, CPAP, AirCurve 10 VAuto, S, ST, ASV, & CS PaceWave) quick link to a pictorial description of how to enter the Clinicians manual. But you should also go to the bottom of the page and request your very own digital copy of the Clinicians Manual via Email. That way you will know the parameters available for tweaking, tuning and timing your VAuto. As well as the various Modes available on your ResMed AirCurve 10 VAuto.

Then you will be able to change your Trigger setting to High or very high, that will help remove some of the CA Events you are experiencing.

From the left hand Panel under the Sessions Information your Median Pressure is 11.2 cmH2O, Your setting are still at factory I think you would be better served by increasing your Min. EPAP to 7.4 cmH2O

Your 99.5% Pressure in the same Sessions Information section shows you reached 15.8 cmH2O, therefore you, hopefully, will not need the upper range this machine is capable of, so I would recommend Max IPAP be set to 18 cmH2O. that will narrow the control band and limit the increase in pressure available. 

Your Pressure Support is set at 4.0 cmH2O, to knock down your Flow Limits, i would recommend you set Pressure Support to 4.4 cmH2O. That should help minimize the pressure excursions so in the future you may be able to tighten up the control range a little more.

To help forum members better assist you we have a standardized format for the OSCAR Report.

https://www.apneaboard.com/wiki/index.ph...ganization

It will take a little while for all of this information to sink in, do not be overwhelmed. It will come together and help us help you more efficiently.

To summarize    Mode:         VPAPauto
                        Min EPAP:   7.40 cmH2O
                        Max IPAP:   18.00 cmH2O
                        PS:              4.40 cmH2O
                        Trigger:        High or Very High

After you make these changes, post some more OSCAR Reports and we can fine tune from there.

If you have any questions, concerns or doubts please post back.

Welcome 

.
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#4
RE: OSCAR Multiple Recordins on same day
           

Greetings UnicornRider!

Thanks for the outstanding and exceptionally helpful reply. There is a lot to digest with this remarkable program.

That was my first day using the AirCurve with factory settings. I have revised several settings as you can see in the graphs below. Some quick history on me. I started using an AirSense 10 last September. I am 77 and positional sleep apnea. I took a quick look at OSCAR and was overwhelmed by the detail. My AHI was always much under 5 (confirmed by my ODI from oximeter), so I did not give matters further thought. Recently I started feeling less than fine. I reinvestigated OSCAR and saw some alarming metrics. LL over 40% which caused other metrics to be off the charts. A couple weeks ago I joined the forum and based on the charts I posted it was recommended to me to obtain a BiPap. I did that immediately. I have posted about a dozen times showing the old metrics if you want to check them out.

It turns out my mask was the cause of the massive leaks. I tried three different nasal masks and they all delivered the same poor results. I switched to a nasal pillow last Thursday and that more or less fixed the leak issue and brought the other metrics into reasonableness.

I would more than welcome your thoughts on suggested changes to my settings. It seems my Expiration Time, Minute Vent, and Tidal Volume are ragged.

Thanks for the recommendation for the Clinicians Manual. I have already received this from the source you recommended and am slowing digesting it.

Let me know if you need any other information whatsoever.
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#5
RE: OSCAR Multiple Recordins on same day
I would consider editing your Min pressure from 4 to 6 to help with a small amount higher base air. If you need Ramp still, consider bumping this pressure up from 4 also.
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: OSCAR Multiple Recordins on same day
As I stated above try the following settings, then post back and we will see how that works for you and tune from there.

                       Mode:         VPAPauto
                       Min EPAP:   7.40 cmH2O
                       Max IPAP:   18.00 cmH2O
                       PS:              4.40 cmH2O
                       Trigger:        High or Very High

After you get those plugged in and we get a day or two of OSCAR Reports, then we can fine tune for quality of sleep. Read through the previous post follow along as much as possible. My objective is to educate you so that you can provide additional information in detail so that forum members may assist your better.

 

Sleep-well


.
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#7
RE: GeorgeGus - Therapy Analysis
GeorgeGus - Your posts are more about your therapy. For this reason, I have moved your thread from the Software Support Forum to the Main Forum. To better describe the thread and to allow it to be more inclusive, I have renamed the title to, "GeorgeGus - Therapy Analysis". Please use this thread for all your therapy related posts.
- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: OSCAR Multiple Recordins on same day
(06-18-2024, 11:09 PM)SarcasticDave94 Wrote: I would consider editing your Min pressure from 4 to 6 to help with a small amount higher base air. If you need Ramp still, consider bumping this pressure up from 4 also.

Thanks for the recommendations. I changed Min pressure to 6. Have posted charts in my next post. I don't quite understand the Ramp sentence. Are you recommending I turn off Ramp, which I would be glad to do?
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#9
RE: GeorgeGus - Therapy Analysis
It's your choice whether Ramp is needed, I suppose I was trying to convey was likely make Ramp pressure same as your normal Min pressure.
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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#10
RE: GeorgeGus - Therapy Analysis
           
UnicornRider

Your reply arrived after I had shut things down, so I could not try your recommendations.

Please note that your recommendations were based on week old factory settings that I used only on the first day. During the following week a number of settings were changed which you were not aware of, for example, I changed Trigger to High on the second day.

Above are last night's charts. Do you still want me to use the your recommended settings, which I am glad to do? Change Trigger to Very High from High?

I just noticed that files chop off the last three settings. They are:

TiMax
1.70 Seconds
TiMin
0.90 Seconds
Trigger
High


Thanks
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