Are you using mouth tape?
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Looking for help with OSCAR analysis
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04-06-2025, 04:57 PM
RE: Looking for help with OSCAR analysis
Your leaks are not good on the 3rd and 4th, your therapy was probably compromised. Long mouth leaks, the plateaus., the spikes are mask leaks.
Are you using mouth tape?
04-07-2025, 10:09 AM
RE: Looking for help with OSCAR analysis
My leaks have gotten worse since I started using the mouthguard. Even with mouth tape, it causes me to drool a bit and it loosens the tape up enough to leak on some nights. I may look for a slimmer option that doesn't have as much separation between the teeth as the one I am using.
I was using EPR 3, tried a couple nights on EPR 1 to see what difference it would make and had much higher flow limits. My actual breathing while I was awake felt the same and I didn't notice any difference in sleep. I think I'll stick with EPR 2 for now as it seems the right balance of less flow limits and not increasing my centrals as much as 3 does. Here are some SleepHQ pages of recent nights. https://sleephq.com/public/8d32c832-e8f8...e6424f4fbe https://sleephq.com/public/e950f10a-9811...fba816acc9 https://sleephq.com/public/e53ea4b9-7a6f...e271c71e93 https://sleephq.com/public/efeb30c6-3280...680168fc97 Those are all with the mouthguard. Here's a couple without the mouthguard. Doesn't seem to make a big difference on average. https://sleephq.com/public/a755eba3-9afe...0584765fe3 https://sleephq.com/public/ed375dfa-8350...5f21ec3c55
04-07-2025, 11:59 AM
RE: Looking for help with OSCAR analysis
Thanks for the SleepHQ links. What I can see when I zoom in is that virtually all of your CAs come after arousal breathing.
Arousal breathing tends to be deeper than regular asleep breathing, and the deeper breaths can wash out a little bit of CO2 from your blood-stream. It's CO2 that triggers your brain to initiate a breath, so the loss of CO2 through deeper breathing can delay your taking a breath. If the delay is 10 seconds or more, it's flagged as a CA. During the delay, CO2 builds back up until your brain gets a breath-now message. For you, I think your real problem is the arousals and not the CAs themselves. You have not just the arousals that lead to CAs, but plenty of other arousals as well. Some may be related to respiration and others may not be. (Those are called "spontaneous.") I'm hopeful that as you get used to the machine, you'll have fewer arousals. But your RDI (respiratory disturbance index) during your sleep study was fairly high (18.5), so we can't be sure where you'll land.
04-07-2025, 12:37 PM
RE: Looking for help with OSCAR analysis
Dormeo,
Juicebox maybe susceptible to pressure swings like many of us, causing the arousals. His obstructive events are well controlled, so tight pressure range might be helpful. Try 7.8 to 8.4 cm for a few nights. The CAs may go down, but keep an eye on the flow limits.
04-09-2025, 11:25 AM
RE: Looking for help with OSCAR analysis
Changed EPR to 3 full time because I guess I shouldn't really be concerned with my centrals too much. Like Dormeo pointed out the majority of them are post-arousal events, although raising it to 3 does cause some treatment-induced centrals I believe. Really not sure which is more effective, definitely still waking up a lot.
This has me thinking, would a bilevel device even be effective here? Because my pressure is so low to begin with, I don't think a higher Pressure Support would be a good thing, unless I increase my pressure to compensate. Which would cause more centrals.... right? Maybe I'm overthinking it, or maybe the bilevel acts a little differently than an APAP with EPR, I'm not sure. Here's my 2 past nights. Took out the mouthguard for now, that's helping keep leaks under control. I haven't changed my pressure range, still on 8-12, but my effective pressure has been 8-9 and 8-9.2 the past couple nights. I have also tried a few nights on straight cpap at different pressures, didn't feel any different than other nights. I don't think the machine changing pressure is waking me up.
RE: Looking for help with OSCAR analysis
When you tried CPAP mode what was your pressure? Around 8.cm?
Consider that as your Obstructive apneas are controlled. Not sure if it is Bilevel or ASV that you should consider. i am not familiar with ASV machines. With bilevel, you can lower your exhalation to maintain the pressure support, makes it so easy to exhale. I experimented and lower mine a bit to much and got OAs. But it was so comfy, I had to check if it was on. Those mouth leaks compromised your therapy after 2am. Consider the SomnoSeal, I am on my 2nd week and it seals my mouth pretty good. I drool when i first put it in and when i wake up. The SomnoSeal fits just inside the mouth and is very soft.
04-09-2025, 12:05 PM
RE: Looking for help with OSCAR analysis
I agree with jdougc that you might benefit from a tight range. (I actually use settings that yield no pressure changes during the night.)
Have we discussed other ways of trying to reduce your arousals? Forgive me if I already posted this in your thread, but here's advice about steps people can take to sleep better: • Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations. • Set a bedtime that is early enough for you to get at least 7 hours of sleep. • Don’t go to bed unless you are sleepy. • If you don’t fall asleep after 20 minutes, get out of bed. • Establish a relaxing bedtime routine. • Use your bed only for sleep and sex. • Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature. • Limit exposure to bright light in the evenings. • Turn off electronic devices at least 30 minutes before bedtime. • Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack. • Exercise regularly and maintain a healthy diet. • Avoid consuming caffeine in the late afternoon or evening. • Avoid consuming alcohol before bedtime. • Reduce your fluid intake before bedtime.
04-09-2025, 12:24 PM
RE: Looking for help with OSCAR analysis
I tried a few nights of CPAP of 8, 8.4 and at 9, 9.8, and 10. No real difference besides some aerophagia around the higher pressures.
I could try doing 7.8 - 8.4 like jdougc recommended, I was initially hesitant because the PA strongly suggested I don't change my pressure range and suggested a larger range. I don't want to sour that relationship but I also don't think they're being any help right now. I do basically follow everything in that list, with the exception of regular exercise and limiting screen time, although I do use a blue light filter and dim the screen on my phone when it's nearing bedtime. Maybe I'll pick up a book instead of my phone for a couple weeks and see how that goes. Should I lower EPR to 2 on a low pressure range like 7.8 - 8.4? Or try a couple nights at 3 and see how it goes?
04-09-2025, 12:26 PM
RE: Looking for help with OSCAR analysis
I'd suggest you see how it goes with a few more nights at 3. In general, experiments need at least 3 nights before they can be properly evaluated.
04-09-2025, 12:29 PM
RE: Looking for help with OSCAR analysis
I agree with you, lower EPR to 2 on an even lower pressure range like 7.6 - 8.0.
If you feel air starve raise the minimum and maximum. If your flow limits look ok, when you zoom around your Flow Rate Chart, then try EPR 1, but see if it is harder to exhale. Good luck. |
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