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Stubbornly high AHI
#1
Newbie seeking advice on Oscar data - ResMed 10
Greetings! Been learning about my sleep apnea ... a whole new world!
I was diagnosed with obstructive sleep apnea and given three week trial on a Resmed !0. 
AHI from sleep test ws 43.7 Lowest desatuaration was 66%
I felt better quickly and bought my own Resmed 10  (the sleep clinic wanted and exhorbitant price for one)
I copied the settings from the trial machine to my own but would appreciate any advice,
particularly whether I need to change any settings to lower my AHI
I hope the attached info is sufficient and appropriate to give such advice
Many thanks to everyone on here ... a fantastic and helpful resource - my sleep clinic 
is a dead loss!


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#2
RE: Newbie seeking advice on Oscar data - ResMed 10
Welcome to Apnea Board,

Do you have either EPR or Ramp on? If yes, turn both off for the time being. Either can increase CA, of which you have a fairly high amount. Also for Hypopnea, let's increase your Min. 4 to 7, if 7 is too much right now then try 6. Let's see how that changes things overnight. Post an OSCAR and tell us if that feels any better.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Newbie seeking advice on Oscar data - ResMed 10
Wow ... Thanks .... I'll try those things and report!
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#4
RE: Newbie seeking advice on Oscar data - ResMed 10
And I'll add you have a positional aspect to your events. Your machine cannot fix these but you can. See how your obstructive events are clustering together? That is the tell. This is most likely caused by your chin tucking toward your chest. It may be fixed with a simple pillow adjustment. If you are using multiple pillows reduce the number, or try a flatter pillow. Another option that works for many is a soft cervical collar. See the link in my signature. That article show a users charts that went from ugly to gold overnight by using a collar.
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#5
RE: Newbie seeking advice on Oscar data - ResMed 10
I'll try that! .... Thanks so much!
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#6
RE: Newbie seeking advice on Oscar data - ResMed 10
Hi .... I made the reccomended adjustments to my settings and pillow, but unfortuantly ... at least for one night ... with not great results. I woke at 4:25 am with leking noise from my mask, and struggled for a while to get it right but seemed to keep on leaking - keeping me awake. I gave up about 5 am. My mask is a ResMed F20 L The AHI was very high. I've attached my oscar report. Does anyone have any idea what's going on? Advice will be most appreciated!


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#7
RE: Newbie seeking advice on Oscar data - ResMed 10
On the mask, I've found for myself the F20 was difficult to get it where leaks were minimal and controlled. I switched to a Fisher and Paykel Vitera full face and things are a lot better. It's more comfortable and it requires a loose fit to minimize leaks. Opposite the F20 mask for me.

The OSCAR data indicates that you're still having a lot of CA which didn't diminish enough if at all with removing Ramp and EPR. Since it appears you've not been on PAP very long, CA may yet diminish with more time on PAP. With this PAP, we can't treat but avoid CA, as we've already tried with the actions taken. There's still the chance CA diminish with more time.

The other Apneas, Hypopnea and Obstructive, appears to need more min pressure. I'd raise it from 4 to 7 or so and see if this reduces these other events.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Newbie seeking advice on Oscar data - ResMed 10
As was mentioned before I see a lot of positional apnea.  What is Positional apnea - It is when you get into a position during sleep that cuts of your airway.  It is different than other type of apnea which can be treated with a cpap machine.  Positional apnea can NOT be treated by any machine.  The only way to help is to find a way to stay out of that position.  Most of the time it is from chin tucking.  Meaning your chin is dropping down to your sternum and CUTTING off your airway.  It was mentioned that sleeping on you back can cause it, having to high of a pillow, or sleeping in a fetal position.  Any of these cause the problem. 

Most people can not control what they are doing during sleep so the Collar that I have a link to at the bottom of the post, has shown to be the best - and most times the only way to stop positional apnea.  PLEASE take a look at  the link.
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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#9
RE: Newbie seeking advice on Oscar data - ResMed 10
It appears from your first post that you were not using EPR but were using ramp which you turned off. You said you made the recommended adjustments which included increasing your minimum pressure but it appears it is still at 4. Am I missing something? An increase in minimum pressure should result in fewer pressure swings and a reduction in CA. As Gideon mentioned, you have significant positions apnea. Be sure to read the link below on soft cervical collars and also selet the embedded link to positional apnea.
Download OSCAR

Organize Charts
Attaching Charts

Mask Primer
Soft Cervical Collar

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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#10
RE: Newbie seeking advice on Oscar data - ResMed 10
No, you're noit missing anything ... sorry ... I thought min pressure was set to 7, but it wasn't ... I set it (and confirmed) it's a 7 last night. Much better nigh ... slept well (for me)  but my AHI is still high. Any suggestions?  I used a very thin pillow as suggested as well. Thanks so much!! Oscar from last night attached.


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