Journey to cure UARS. OSCAR data attached

[gzaw]

I've taken two sleep tests, both showed AHI < 2, but RDI =14 the 1st time and RDI = 11 the 2nd time

Recently I've used a Resmed 10 VAuto on VAuto mode to help fix it. Using p30i mask. PS 1.6 over 7.8-11.


I've attached last night's OSCAR data - how does it look? Any room for improvements?

I see few flow limitations, flow rate looks relatively normal for most of the duration, and leak rate looks acceptable.

Thoughts/feedback? [this is after multiple nights of crappy leaks, waking up in middle of the night, etc.]

[Crimson Nape]

gzaw  -  Both your threads deal with your therapy. In order for the reader to have your history in one place, I have merged them.  Please use this thread for all your therapy posts.  The thread title can be changed to a more inclusive name.  Just ask.

You seem to only have one attachment for your account. Look in the Attaching Images and Files on Apnea Board, Allowable Images for additional information. If you always delete attachments in your user control panel. It is listed ad UserCP at the top of every page. Here nis a quick link: https://www.apneaboard.com/forums/usercp...ttachments

- Red

[gzaw]

Hi, here's an update.

How do my charts look on BiPAP?

BTW, I'm not showing the AHI or flow limitation graphs, because AHI is close to 0, and my FLs are also close to 0. However, I don't think OSCAR is able to catch all flow limitations.  Even though the below are just zoomed in snapshots, they are pretty representative of my entire night.

It does not look like there are any inspiratory RERAs / flow limitations.


12 IPAP / 8 EPAP (4 PS)





11 IPAP / 6.6 EPAP (4.4 PS)




^ looks perfect to me




However, it looks like there may be expiratory RERAs / flow limitations in the 1st and 3rd pics. Notice the jagged lines as soon as I inhale.

Here, Barry Krakow points out what expiratory RERAs look like. They are jagged limbs when you breathe out, and on the immediate breath in. Here is what expiratory RERAs / EPI looks like (do i have them?):  https://youtu.be/qHuKNfc8Pow?t=148

I personally feel best on 11 IPAP / 6.6 EPAP (4.4 PS) but it's only been a couple nights. More testing is needed.

For UARS, my theory is that EPAP needs to be low enough to prevent expiratory RERAs, but IPAP needs to be high enough to prevent inspiratory RERAs (the common flow limitation / flat top air curve) - the key is to find the right PS.

Also, I may need to increase trigger to high, to remove some of the inspiratory effort at the very beginning of each breath intake (e.g. remove the jagged lines that you see at the very beginning of each breath intake).

And also help out the lower part of the upper airway by doing tongue / myofunctional exercises to prevent things like tongue or epiglottis collapse. And improve the nasal cavity (upper upper airway) through flonase spray, nasal rinse, and breathe right strips. And wear a MAD.

Thoughts?

[gzaw]

Hi,

Would love someone to help analyze these OSCAR flow rate spikes.

I've been getting good results lately with 12/7 pressures. (better than 14/9.. i think because 14/9 gives me more resistance with higher EPAP - aka expiratory pressure intolerance - so a lower EPAP is better).

However, I've been getting these OSCAR flow rate spikes that correlate with heart rate spikes on my apple watch (so they ARE sleep apnea disturbances)

What are these flow rate spikes? According to the wiki, it looks like those flow limitations could be mouth breathing related.. does this mean i should use better mouth tape (i'm using tape) to prevent mouth breathing? Thoughts?

[gzaw]

Hi,

Would love someone to help analyze these OSCAR flow rate spikes.

I've been getting good results lately with 12/7 pressures. (better than 14/9.. i think because 14/9 gives me more resistance with higher EPAP - aka expiratory pressure intolerance - so a lower EPAP is better).

However, I've been getting these OSCAR flow rate spikes that correlate with heart rate spikes on my apple watch (so they ARE sleep apnea disturbances)

What are these flow rate spikes? According to the wiki, it looks like those flow limitations could be mouth breathing related.. does this mean i should use better mouth tape (i'm using tape) to prevent mouth breathing? Thoughts?

Bump. Any idea as to what kind of flow limitations these are? Looks like expiratory pressure intolerance.

I've lowered my EPAP by a little bit and while I symptomatically feel better, i still see these same looking FLs.

[BoxcarPete]

Doesn't look like flow limitations at all. Spontaneous arousals most likely, confidence level even higher if you are correlating them to heart rate spikes. That's just the result of you holding your breath while tossing and turning, and not driven by respiratory effort.