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New Oscar user
#1
New Oscar user
Hello,

I am super new to the Oscar program and am learning what everything means.  Quite overwhelming, to be honest.  

For the past 5 years, my snoring was obnoxious.  Finally broke down and had a sleep study.  AHI indicated 30 and was prescribed the Phillips DS.  AHI dropped to the 5 range.  Then, the recall and a Resmed Airsense 10 purchase.  AHI has been consistent in the 3 range.  

I have become a real light sleeper.  Not sure if it is the awareness of the machine or the fear that the full face mask will leak as I tend to sleep on my side.  Regardless, it just doesn't feel like I get a true, good sleep.  I imagine that is the learning curve of the CPAP world.  Really cannot complain about the AHI in the 2's or 3's.  I just see so many low AHI numbers and wonder if lowering mine further would improve the quality of the sleep.  Any suggestions would be greatly appreciated.




       
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#2
RE: New Oscar user
Take a look at your pressure chart and the flow limits chart. You can see your pressures increase with the flow limits.

I would like to see if adding EPR will reduce your flow limits. The problem with that is many times adding EPR will help FL but increase your centrals. If that happens we would have to balance the two the best we could.

To use EPR you have to have more min pressure. I would suggest for one night you try these settings and post the charts tomorrow.

Min=7
EPR=2
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: New Oscar user
Thank you! I changed the setting to minimum pressure of 7 and EPR of 2. Will post the charts in the am.
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#4
RE: New Oscar user
Welcome to the forum.
First our machine is not IMHO set up correctly.

Min of 4 is considered by many to be a pediatric pressure and many adults have difficulty breathing at that pressure as illustrated by comments like breathing through a straw, gasping, removing the mask so you can breath etc.

Your Flow Limits, while at a generally acceptable level are high enough that they are driving your pressure higher than it needs to be. A setting of 4-20, such as yours, is frequently prescribed because of the false, iMHO, impression that the Auto machine will find your optimum pressure. The machines react to parameters, hypopneas, obstructive Apneas, flow limits and snores, via algorithms to head off future events. ResMed's algorithms are more aggressive than PR,'s algorithms and as such can allow for lower pressures, but still should be set for the best performance.

EPR, which you are not currently using is a very effective tool to treat flow limits, and hypopneas, so...

Set min pressure to 7 this gives the EPR room to work and should be more comfortable.
Set EPR=2, Fulltime, this should reduce your flow limits and the higher pressures your machine is currently generating. This reduces your exhale pressure by 2 cmw which should also be more comfortable
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#5
RE: New Oscar user
Agreed, edit your settings as described and I'm sure things will begin getting better. Edit and post the OSCAR Daily tomorrow.
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#6
RE: New Oscar user
I have posted the results from last night.  The hypopnea numbers were the lowest since I started the Resmed last week, whereas the clear airway numbers were the highest.  It was one of the better nights of sleeping in a while, which is a major plus.  

I cannot express how appreciative I am for just the suggestions and feedback!





          
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#7
RE: New Oscar user
Right now your centrals are your largest events.  They will in most likelihood start to reduce on their own after a couple weeks to months if they are treatment emergent events.  Most people have some so they will not go away completely but will reduce on their own.

If you had a good night on these setting I would keep them for a few nights and see how you feel - that idea of "how do you feel" is right now the most important part of what we look for.  Your numbers are ok, they may not be the lowest you will see, as the centrals decrease your numbers will lower.
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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#8
RE: New Oscar user
It has been almost 2 weeks since I changed my minimum pressure settings to 7 and EPR to 2.  The numbers improved the first week and now they seem to be back to where I was before.  I have noticed that I am sleeping better throughout the night.  I may wake once, as opposed to 4 or 5 times.  Unfortunately, it feels like I am waking up not as refreshed as I could be.  

Any further suggestions or just accept my current range?



   
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#9
RE: New Oscar user
Keep EPR= 3 and increase min pressure to 8

Your Flow limits are still high and driving your pressure.

Set the Y axis on your flow rate chart to +/-50 to provide better resolution for the zoomed images, also add the zero line

Post several random 5 minute zoomed views of your night to actually visualize your flow limits

Finally, consider getting a ResMed VAuto. You will do better with the higher PS it is capable of. You are currently effectively at PS=3 with your EPR=3. IMHO you have UARS, Upper Airway Resistance Syndrome
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#10
RE: New Oscar user
Thanks. I will make those changes and try to figure out the Oscar settings to enhance those images.
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