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PSG Results: Could this be UARS?
#31
RE: PSG Results: Could this be UARS?
Quote:My biggest concern is dismissing UARS because the CPAP isn't improving my sleep, without knowing for sure if that's just because the CPAP has been failing to prevent RERAs. Are there any little clues of RERAs that would be visible in the OSCAR data? Like flow limitation or abnormalities in the breathing curves around the time of an awakening?

Look for periods of flow limitation (there aren't very many) and look for a spike in inspiratory flow that arises out of flow limit. These usually correspond to where the pressure increases, then decreases sharply.  An abrupt increase in inspiratory flow arising out of flow limit is likely RERA.   As far as settings, If you're oing to use EPR at 3, start at a minimum pressure of 7. Otherwise start at 6 and cut it to 2.  A minimum pressure of 5 with EPR 3 means your EPAP doesn't move and it is not optimal. Other than that, your therapy is incredibly good at low pressure.
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#32
RE: PSG Results: Could this be UARS?
I got up around 2:20 and went to the bathroom and again around 5:15...and I had trouble getting back to sleep at 5:15 so I got up out of bed for a few minutes as well.  And the Oura ring shows that and it also seems to show that in my Flow Rate in the Oscar data.
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#33
RE: PSG Results: Could this be UARS?
Oh duh I figured it out... You are zoomed in on the oscar data so not everything is visible.
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#34
RE: PSG Results: Could this be UARS?
In OSCAR right click on the flow rate chart label and change the y-axis so it goes from -80 to 80.

Then replace respiration rate with leak rate (move leak rate up).

Then let's see a zoomed in screen shot showing 4 minute duration(duration length seen on flow rate chart) starting around 5:05.
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#35
RE: PSG Results: Could this be UARS?
Ok I attached another zoomed out image of the whole night, and two more closer to the awakening around 5 AM.

           

And here's one around the awakening around 2:20 AM

   
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#36
RE: PSG Results: Could this be UARS?
Pretty good capture of an arousal at 04:55. Not much else there.
Sleeprider
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____________________________________________
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#37
RE: PSG Results: Could this be UARS?
I think you should try CPAP mode, set pressure of 7 cm with 3 EPR. You are having flow limitations and EPR is what will help with that, in order to take advantage of the full 3 EPR your pressure has to be at least 7 so that is the reason for using 7 cm pressure. Reason I think you should try CPAP mode is because so far I don't see that much need for higher pressure and the pressure changes may do more harm then good in your case (increasing pressure is more effective with apnea).

I want you to turn ramp off too, you will probably find it more comfortable anyways since you will have EPR.
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#38
RE: PSG Results: Could this be UARS?
(02-13-2020, 10:59 PM)Geer1 Wrote: I think you should try CPAP mode, set pressure of 7 cm with 3 EPR. You are having flow limitations and EPR is what will help with that, in order to take advantage of the full 3 EPR your pressure has to be at least 7 so that is the reason for using 7 cm pressure. Reason I think you should try CPAP mode is because so far I don't see that much need for higher pressure and the pressure changes may do more harm then good in your case (increasing pressure is more effective with apnea).

I want you to turn ramp off too, you will probably find it more comfortable anyways since you will have EPR.

That sounds good, the only problem is I'm doing a trial with the CPAP through a sleep clinic, and I'll have to go into the clinical menu and make changes to the settings, which I'm assuming they will see?  Will they be notified that I'm messing with the settings? I'm not sure they'll be happy about that since they're probably used to dealing with patients who don't know what they're doing.
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#39
RE: PSG Results: Could this be UARS?
You have two options.

1) Pass the idea of changing the settings and reasons for doing so by the therapist and see if they agree with making the changes.

2) Make the changes and ask for forgiveness if they get mad/notice.

I guess three options, do 1 and then 2 if they say no lol.

The therapist is only going to be watching AHI and isn't going to be making recommendations to change anything when your AHI looks this good. If it is UARS AHI doesn't even matter, it is the flow limitations which you do have some of and which are best treated by increasing min pressure to 7 cm to get full EPR.
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#40
RE: PSG Results: Could this be UARS?
(02-13-2020, 10:59 PM)Geer1 Wrote: Reason I think you should try CPAP mode is because so far I don't see that much need for higher pressure and the pressure changes may do more harm then good in your case (increasing pressure is more effective with apnea).

I don't agree.

If OP changes min pressure to 7 (which as I said earlier, I recommend), pressure will stay pretty stable, unless they need more.

And at least on my machine, the fixed mode doesn't track FL (I can't remember if this is true on the autoset as well, but I suspect it is).

Auto mode effectively offers treatment benefits, and more useful information.

In short, my own view is one should always be on auto mode, and if necessary, adjust settings (typically raising min pressure or EPAP) to stabilize pressure.
Caveats: I'm just a patient, with no medical training.
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