Need Help (Oscar Charts attached)

[Murph08]

Hello All!

I was diagnosed with sleep apnea in July 2024 and unfortunately I have not been one of the instant success stories. I've read it can take some people up to a year of therapy before they really start to feel better so I am sticking with it. However after ~7 months, I figured I should see what I can do to improve my results which lead me to this forum and my first post. I've been lurking for awhile but after getting an SD card, card reader and getting Oscar installed I'm ready to see what recommendations the experts here may make as to me the charts look good but I am sure that is not the case as I often awake feeling unrested and tired.

Some history:

• Diagnosed July 2024: 31.9 AHI/hr
  
• - Therapy Recommendation: APAP Pressure 6-15
  
• Trialed ResMed AirSense 10, with ResMed F20 Full Face Mask for 30 days
  
• - This mostly went well but the machine was loud and I wasn't a fan of the full face mask as it often left red marks around the bridge of my nose and sides of my mouth even with proper cleaning and losening the straps caused a lot of leak.
  
• Purchased ResMed AirSense 11 Autoset, with ResMed AirFit P10 Nasal Pillow Mask
  
• - This was much better but I had a tendency to open my mouth and experienced mouth leak
  
• Purchased Chin Strap, Raptor Hose Suspension System and later mouth tape
  
• - Due to the mouth leak I purchased these to help reduce the leak, the chin strap helped but was not ideal as someone with a beard so I alternated between it and the mouth tape.
  
• Purchased ResMed AirFit F40 Mask (This is where I am at now)
  
• - I decided to try this as the P10 nasal mask was better but I still had a tendency to roll to my sides causing the nasal mask to pull away and leak and I had watched a review that indicated the F40 mask's flexibility would help with that.
  
• - With this mask I have I think reached a comfortable fit and something I can manage regularly as the only discomfort is the occasional dry mouth in the morning.
  
• - I turned off the starting pressure/ramp and set it my APAP to be from 6-13 to tighten up the air pressure range based on things I had read on the forum here.
  
• - Lastly, if it helps I use a knee pillow, neck pillow (trying to reduce neck pain and sleep with good posture) and weighted blanket most nights to try and sleep only on my back.
  

Alright, I hope that informs enough to be helpful! I will now attach my Oscar charts for three nights.

Please let me know if you need any other information and I will be glad to reply with it!
           

[Deborah K.]

You have a large number of CAs.  Was this the case in your sleep study?  If you don't know, please post a redacted copy of your study.  That will help us help you.  Ask your doctor's office for one if you don't have a copy.

You would do well to raise your pressure settings to 8 to 17.  This is because your median pressure is over 8, and you are hitting your high-pressure setting far too often.

Try both of these.  I think things will improve.

Again, welcome, and best wishes with obtaining your best therapy and comfort!  

[Murph08]

Hi Deborah,

Thank you for the welcome and the advice! I will change those settings and try them out tonight.

Regarding the Clear Airways (CAs) on my sleep study report, I did not see them listed at all though the report is quite thorough. I am attaching screen shots of the first 3 pages of my sleep study report below. Please let me know if you would like screenshots of any of the other pages as well (Page 4 looks like definitions for reading the report, Pages 5-7 are charts detailing events that occurred it seems: Page 5 "EKG in REM", Page 6 "Phasic Legs", Page 7 "Low spo2 88% OH supine REM").

I did have to redact through Canva which shifted things a bit when the text was close, so if anything looks like irregular/off let me know and I can look at my original PDF.

           

Thank you!

Murph08

[Murph08]

I realize from my research OSCAR calls them Clear Airway but they are also referred to as Central Apnea so in that case my sleep study report shows a few but I will defer to you if it’s on the same level as what you see in my Oscar charts. 

Also I’m not sure this will be relevant but after seeing an ENT late last year I am on the list for a rhinoplasty at some point due to a deviated septum, “spurs” and other things so I imagine when that happens I will need to revisit my settings.

[Murph08]

Hi Deborah and anyone else looking!

I've used the new settings for a little while now and I think I feel a bit better but some mornings I still wake up groggy. I do wish it was an immediate and glaring improvement but alas we will continue trying to improve things! The new settings of 8-17 have occasionally brought back a bit of the bloating I experienced earlier on but nothing unmanageable. 

I wanted to post three days of updated Oscar Charts and ask if there are any further settings I should adjust. As well you had asked about the CAs so I posted my redacted sleep study that shows a few so I'm not sure if/how that may factor in.

Thank you in advance!

           

[Deborah K.]

In your sleep study, your AHI was 31.9.  The CAs were only 0.4, so I would ignore them.  They are treatment-emergent and will lessen on their own as time passes.

I think you would do well to change your pressure range to 9 to 11 for now.  Raising to 9 is because that's where you are now for median pressure.  Lowering to 11 is to help you with the aerophagia (bloating/gas problem).  As your body accustoms itself to the change, we can try slowly raising your high pressure setting.  You need to be using enough pressure for good therapy while not causing aerophagia.

Since the CAs are nothing to worry about it would be good to raise your EPR setting to 3.  This will make breathing more comfortable, and, more importantly, will lower your flow limits.

[JCinPA]

It's fun for me to observe these and listen to the more experienced members. I was going to say go 9-12 and raise EPR to 3. Deborah is very experienced, so I'm thinking that means I'm learning. This place has certainly been helpful to me.

Stick with Deborah's settings, I'm just happy I'm learning. And when I was playing with my settings, I learned if I felt an improvement I should stick with it for 2-3 nights before the next change, sometimes I'd "settle into it" a bit. I've not had any trouble adapting, but I learned not to change stuff every night.

Glad you're feeling at least a little better. Good luck!