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Help interpreting OSCAR Data
#1
Question 
Help interpreting OSCAR Data
I'm about a month and a half into my therapy, and it's been a great help for me.  While I still sometimes feel tired, it's not the "I didn't breathe in my sleep at all last night" kind of tired.  I use a FFM (F20), as I've been a sleeping mouth-breather all my life.  Funnily enough, I breathe through my nose all day, but can't at night.  I tried the nasal pillows but that was a rough way to get into my CPAP journey so I quickly switched to the F20 and it's been a lot better.

I am active on the r/SleepApnea and r/CPAP subreddits, but wanted to connect here to help understand my OSCAR data and get expert recommendations on tweaks that may be useful for me.  I use sleep aids for sleep, if that matters at all.

I've attached a recent sleep and my overview; I hope it is good data to review.  That sleep was the highest AHI I've had in quite a while.

Thank you in advance for any help and guidance you may be able to offer.

Cheers Thanks

       
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#2
RE: Help interpreting OSCAR Data
I would try using EPR to cut down on flow limits. To do this try these settings -

EPR full time
EPR 3
min 7

Try it tonight and post again tomorrow with Oscar charts again.
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: Help interpreting OSCAR Data
The lion's share of your apneas are central, which is to be expected in patients new to PAP therapy. You are a month and a half in, as you say, which is a little far in on average, but we can see that they're graduallygoing down with time.

You could benefit from a higher pressure and / or higher pressure support (EPR, in your case). You're on APAP, but you could try increasing your minimum pressure. If you're interested and willing, I lightly suggest to most patients that there's a chance fixed pressure could work better for you. The APAP algorithms are imperfect and we can expect variable response between patients; for some they titrate well, for others not as much.

Your flow limitation is on the lower side, but this is another thing I gently suggest patients try to eliminate so long as it doesn't create more problems than it resolves, and of course to always avoid hyperfocusing on attaining zero.

tldr; your sleep is still mildly interrupted and some settings changes could improve your situation.
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#4
RE: Help interpreting OSCAR Data
Thank you both, I really appreciate it.  I will make the suggested changes and report back!
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#5
RE: Help interpreting OSCAR Data
I had a different [worse] sleep last night.  The initial grouping of CA's started just as I was finishing reading/falling asleep, I had put my mask on about 30 minutes beforehand.  Any thoughts? Not sure I'm a huge fan, but only the first night.

Thanks in advance!

   
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#6
RE: Help interpreting OSCAR Data
The way the apnoeic events cluster it looks like positional apnoea’s, likely chin-tucking. I get the same thing and use a soft cervical collar with a full-face mask to keep my neck straight. Well, at least straighter than without.

The cluster around 02:15 is a good (bad?) example of positional apnoea’s and what it looks like when tucking. The 22:45 series, while CA’s, are still likely tuck events from the look of them.

Consider giving a soft cervical collar a try and see how it improves. You can try using a pillow to help prop your neck into a good position, but it is hard to maintain due to movements.

Pressure seems good when you look at the time between events. Managing the closing of the airway with tucking would be my first priority, at least for now. Once that is handled we can see where pressure needs lead.
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#7
RE: Help interpreting OSCAR Data
Thank you, nice tip!  I appreciate it.
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