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Hello all, I was hoping to get some help interpreting this OSCAR data. Briefly, I was recently diagnosed with moderate OSA/UARS based on an in-lab sleep study (see below). I have been on APAP for a couple of weeks. My sleep remains fragmented and I wake up early not feeling refreshed (so no improvement). Just wondering if there are any adjustments I can make to optimize therapy. Thanks in advance!
Apnea Hypopnea Index (AHI4%*): 0.3/hour Supine AHI4%: 0.3/hour; Non-supine AHI4%: 0.0/hour REM AHI4%: 0.0/hour; NREM AHI4%: 0.5/hour Respiratory Disturbance Index / Apnea Hypopnea Index (RDI / AHI3A*): 16.8/hour Supine RDI / AHI3A: 16.8/hour; Non-supine RDI / AHI3A: 0.0/hour REM AHI3A: 16.5/hour; NREM AHI3A: 17.0/hour
Welcome to the forum. Please post a copy of your sleep report with your info redacted.
On the 20th what was it that woke you up so early?
Your minimum pressure is a bit low for an adult, try 8 cm of pressure. that may help with the small amount of flow limitations that you have and also minimize the pressure swings which can cause arousals in many. Most of your pressure increases are from detected flow limitations that Resmed machines aggressively treat by raising the pressure.
Raise your ramp to 7 cm and change it to 5 or 10 minutes from auto. You get no therapy pressure increases during ramp. Try these setting for a few nights and see how you feel and then post a few charts. Good luck and i hope you get some rest. Keep in mind that it may take weeks or months to recovery from the time you had untreated apnea.
I don't recommend making more changes presently, you need to to get used to the suggested changes first, unless you are feeling much worse.
It might take weeks or months to feel like normal after having untreated apnea.
Update: I tried the new settings for a couple of nights and uploaded my OSCAR data from last night. Sleep remained the same subjectively--fragmented with early morning awakenings. There still seem to be flow limitations. Should I stay the course or make any further adjustments? Thanks!
Thanks for getting back to me. I will make those adjustments.
Here is my sleep study. It was an in-lab study done while wearing a mandibular advancement device.
Data Summary and Interpretation: SLEEP ANALYSIS: Total sleep time (TST) was 348.5 minutes, with a sleep efficiency of 78.1%. The latency to sleep onset was 50.0 minutes. The first REM period started 117.0 minutes after sleep onset. 91.0 minutes of REM sleep in the supine position were recorded. Sleep architecture demonstrated increased Stage N1, Stage N3 and Stage R and decreased Stage N2.. Sleep was fragmented. There were 179 sleep stage shifts and 25 awakenings. The total arousal index was 44.9/hr, of which 14.6/hr were respiratory and 26.5/hr were spontaneous. Sleep stage distribution:Stage N1: 52.0 min (14.9%) Stage N2: 104.5 min (30.0%) Stage N3: 101.0 min (29.0%) Stage REM: 91.0 min (26.1%) EEG/EMG remarks: No alpha-intrusion, epileptiform activity, parasomnias, REM without atonia, or rhythmic masticatory muscle activity observed. Periodic limb movements of sleep (PLMS) were observed but did not meet AASM criteria for PLM Disorder. Periodic Limb Movement Index: 4.5/hr. Limb Movement Index: 9.3/hr. Limb Movement Arousal Index: 1.5/hr RESPIRATORY ANALYSIS: There was no evidence of central sleep apnea or periodic breathing. Over the course of the study, the patient had 1 obstructive apnea(s); 1 central apnea(s); 0 hypopnea(s) with 4% O2 desaturation criteria; and 96 hypopnea(s) with 3% O2 desaturation and/or arousal criteria. The baseline O2 saturation was 98%. The mean O2 saturation during sleep was 97%. The lowest O2 saturation during sleep was 92%. Cumulative time O2 desaturation below 89% was 0 minutes. Apnea Hypopnea Index (AHI4%*): 0.3/hour Supine AHI4%: 0.3/hour; Non-supine AHI4%: 0.0/hour REM AHI4%: 0.0/hour; NREM AHI4%: 0.5/hour Respiratory Disturbance Index / Apnea Hypopnea Index (RDI / AHI3A*): 16.8/hour Supine RDI / AHI3A: 16.8/hour; Non-supine RDI / AHI3A: 0.0/hour REM AHI3A: 16.5/hour; NREM AHI3A: 17.0/hour CARDIAC ANALYSIS: Normal sinus rhythm with an average of 50 beats/min during sleep. No significant arrhythmias observed. SUMMARY & RECOMMENDATIONS: 1. This study is consistent with Moderate Obstructive Sleep Apnea (OSA) using the AASM Hypopnea rule. The patient should consider additional adjustment of the Oral Appliance versus alternative means of treatment for his OSA. 2. Follow up with referring Sleep Medicine physician.
Keep in mind that it may take weeks or months to feel great and rested as your body recovers for the time the apnea wasn't treated.
You are doing well in using the cpap machine the required 7 1/2 to 8 hours to get the required therapy.
Many struggle and take the mask off and sleep badly without any therapy.
Congratulations for doing a great job!
I appreciate it. I do wonder how much I should be adjusting CPAP settings based on the OSCAR metrics vs. just sticking with certain settings and being patient.
It days a few days for our bodies to get used to changes.
The slight number of CAs, could just be treatment emergent clear airway events. They should diminish over time.
But the more you tinker, you could trigger a few more of those CAs.
It is good to change only a few things at a time to track what you have change and the effect.
Also, settings that worked well, may become ineffective at a later date.
