Please help interpret Oscar results

[sriteop]

I had an in-lab sleep study in 2021. I slept around 180 minutes over the whole night but they told me that I did not have obstructive sleep apnea or indication of periodic limb movement disorder but it did show that I was barely entering deep sleep.  I continued to be exhausted. In 2024 I had an at home sleep study which indicated an AHI of around 7 but of course they could not say exactly what was causing the arousals. I started cpap and then for a variety of reasons stopped for a while. 

I started the cpap again a month ago. Some nights I sleep several hours with it on and other nights I take the mask off in my sleep. Regardless of my ahi getting quite low I feel just as exhausted if not more so. I have attached my most recent night of Oscar scores. 

Can anyone help me understand them. Do these results look like apnea to you? Could it be restless movement? Something else? Any help is appreciated. 

Thank you

[jdougc]

You had positional apnea around midnight.
You had a few events in a very short time frame.
That is the only episode of Positional apnea that was evident.
But you need more therapy to feel better, 7 1/2 to 8 hours
We need to see the whole flow limit graph.
Are you starved for air? If so raise the minimum a bit.
Are you a side sleeper?
What mask are you using now?
Stay safe.

[ejbpesca]

I can tell you that from 18 years of PAP therapy, I have only had but a few nights with such a good OSCAR report as you posted.  From my research, I do not think one could diagnose sleep apnea from one or more OSCAR reports.  Either you do not have sleep apnea or your therapy is going very well.  

Your machine reacted to a few obstructive apneas it registered close together (a cluster) by raising pressure then the events stopped.  Some will recognize that cluster as "positional apneas," that is you were briefly sleeping in a position that could have restricted the airways causing Flow Limitations and subsequent apneas.  Whatever the cause, the machine is working, apneas were brief, and few.  I have severe apnea and would be very pleased to see a report like what you posted.

I see your Flow Limitations figure under Statistics is low.  

You can rearrange and resize your OSCAR graphs to show the Flow Limitations graph.  Click and drag the left title/label side to move the graphs and the bottom of the graphs to resize them to fit.  Your default graph sizes may work fine without changing heights.  A common order of graphs for review on this forum is:

1. Events (this graph remains at a limit of height)
2. Flow Rate (leave it at its default height)
3. Pressure (can be shortened in height a bit)
4. Flow Limitations (leave at default height)
5. Leak Rate (height can be lessened a bit)

Flow Limitations is one graph advice givers want to see.  Move it up your OSCAR report.  Click on Wiki at the top of the ApneaBoard page to find detailed instructions for OSCAR report organizing.


If you do not have apnea, periodic use of AirSense 10 will disturb your sleep.

Pulling a mask off during sleep is common as people become used to wearing one.  Some, like myself, also have a dream that something has grabbed their face and head and then pulled it off during sleep.  Poor sleep is common as someone adapts to wearing CPAP gear. 

I would be skeptical of the home sleep study and the in lab study.  I have had four in-lab sleep studies.  My first did not show I had apnea. The next three revealed severe sleep apnea.  If I have another sleep study I would like it at home but those continue to be viewed by some as flawed or not accurate as in lab but they may be improving since I last researched them.

[sriteop]

You had positional apnea around midnight.
You had a few events in a very short time frame.
That is the only episode of Positional apnea that was evident.
But you need more therapy to feel better, 7 1/2 to 8 hours
We need to see the whole flow limit graph.
Are you starved for air? If so raise the minimum a bit.
Are you a side sleeper?
What mask are you using now?
Stay safe.

Thank you so much.
Some nights I do achieve the mask being on for 7 to 8 hours. It has not helped me feel better at all-probably the opposite. 
I do not wake up starved for air. 
I am using the ResMed F-40 mask.
I will work on posting my flow limit graph better. 
Thank you.

---

I can tell you that from 18 years of PAP therapy, I have only had but a few nights with such a good OSCAR report as you posted.  From my research, I do not think one could diagnose sleep apnea from one or more OSCAR reports.  Either you do not have sleep apnea or your therapy is going very well.  

Your machine reacted to a few obstructive apneas it registered close together (a cluster) by raising pressure then the events stopped.  Some will recognize that cluster as "positional apneas," that is you were briefly sleeping in a position that could have restricted the airways causing Flow Limitations and subsequent apneas.  Whatever the cause, the machine is working, apneas were brief, and few.  I have severe apnea and would be very pleased to see a report like what you posted.

I see your Flow Limitations figure under Statistics is low.  

You can rearrange and resize your OSCAR graphs to show the Flow Limitations graph.  Click and drag the left title/label side to move the graphs and the bottom of the graphs to resize them to fit.  Your default graph sizes may work fine without changing heights.  A common order of graphs for review on this forum is:

1. Events (this graph remains at a limit of height)
2. Flow Rate (leave it at its default height)
3. Pressure (can be shortened in height a bit)
4. Flow Limitations (leave at default height)
5. Leak Rate (height can be lessened a bit)

Flow Limitations is one graph advice givers want to see.  Move it up your OSCAR report.  Click on Wiki at the top of the ApneaBoard page to find detailed instructions for OSCAR report organizing.


If you do not have apnea, periodic use of AirSense 10 will disturb your sleep.

Pulling a mask off during sleep is common as people become used to wearing one.  Some, like myself, also have a dream that something has grabbed their face and head and then pulled it off during sleep.  Poor sleep is common as someone adapts to wearing CPAP gear. 

I would be skeptical of the home sleep study and the in lab study.  I have had four in-lab sleep studies.  My first did not show I had apnea. The next three revealed severe sleep apnea.  If I have another sleep study I would like it at home but those continue to be viewed by some as flawed or not accurate as in lab but they may be improving since I last researched them.

Thank you so much for this extensive reply.
I often question whether I really have apnea.
I DO have constant fatigue but I'm not convinced it is from apnea.
I have achieved full 8 hours with the mask on and not felt any better but actually felt worse. 
I will continue to wear the machine and track data but if Oscar consistently shows that I am not experiencing much apnea it would make sense that apnea is not causing the fatigue-does that track?
Thank you.

[ejbpesca]

It would make sense to me that your feeling poorly after sleep is due to something other than sleep apnea if OSCAR reports keep showing good results.

I have to get <2.00 to feel PAP therapy benefits of not being as fatigued or sleepy during the day.  Each person is different with what therapy does for them.

I can get very good results and still feel poorly after sleep due to other sleep issues that interfere with sleep other than apneas.  I have other health issues so I know what causes poor sleep.

One can stay asleep and get good PAP therapy but that does not guarantee the sleep was of good quality due to other issues that may be present.