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amurorx - Therapy Analysis
#1
amurorx - Therapy Analysis
Hi Folks,

I was diagnosed with Sleep Apena last month (AHI 87) and provided a CPAP machine last week.  Last week my numbers We between AHI 15-25 (and rising) and I was feeling pretty tired and felt I wasn't getting enough oxygen.  Unfortunately my Doctor is no longer available til Late August (maternity leave) and I have no one to assist me with this issue so I took things in my hands.  I changed their base Rx of Pressure 4-16 (not really a prescription i know) to pressure values 10-20 instead and got better results with an AHI of 4.7.

I finally got my SD card last night (got an AHI of 6.7) and pulled up this OSCAR data that I can't figure out what to do with:

At this point I really need help to fine tune my pressure.  I'm still getting headaches in the morning, but I do feel a bit more rested.

Thanks in advance for any assistance you folks can provide.


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#2
RE: New User confused about Oscar Readings
Your setting look ok, nothing jumps out other than the flow limits and snoring.  I would look at positional apnea...   PA is when you sleep in a position that cuts off your own air way and no change of pressure helps.  Think of it as a garden hose and it is kinked.  No matter the pressure you turn up the watter it won't go through.  You have to find the kink and straighten the hose out - no more kink.

Most PA is caused by chin tucking, where your chin drops to your sterumn cutting off the airway.  Some times it can be helped by NOT sleeping on your back or maybe the pillows are to high.  IF it is that simple fine but if not you will need a collar to keep your neck in alignment.  I have a link to cervical collars in my signature at the bottom of this page.  Please take a look at it.  The collar can be purchased at walgreens or any drug store.  The main measurement you need is the distance between your chin and sterumn. That is how high the collar need to be.

And as a note - usually we can find Flow Limits in the O and H events, clustered together and you do not have this but your flow limits are very large and continuous.  We  use EPR to help with flow limits and you already have your EPR to 3 the max.  If you look at the first few minutes of the nights FL you have very little then they start up.   So your are not typical and I could be wrong about FL being the cause BUT you need to rule it out.
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 User confused about Oscar Readings
Thank you so much. A lot to keep in mind. I will say I am sleeping in my back which I how I like to sleep but I know that's not the best.

I will try to sleep in my side instead. I tried using a CPAP pillow but it gave me a pain in the neck the couple nights last week.

I should say my current. Pressure settings are 11-20 (not 14-17). I was changing things around while the memory card was still in.

Should I raise my minimum to 15 and keep Max at 20. Is having 95% 19 pressure a problem? I'm worried I'm maxing out the CPAP without it even reducing my AHI under 5.
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#4
RE: New User confused about Oscar Readings
In the chart you posted, your min was 12 and your max was 14. Do try min of 15 and max of 20, and if it's not too disruptive for you, turn ramp off or raise your ramp pressures somewhat.

I hope staceynburke's suggestions will work for you. If you can just sleep on your sides and use a low, firm pillow, that might really help. Let's see.

Your FLs and snores are very heavy, and you can't be having restful sleep. In addition, effective PAP treatment should be able to bring your OA index down to 2 or less.

It's possible you need a different kind of machine, but before heading down that road, let's see what happens when you side-sleep on a low, firm pillow, adding a soft cervical collar if need be.
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#5
RE: New User confused about Oscar Readings
Sorry I was messing with the machine after the session .

I was running the machine last night at min 11 and max 20.

I will try to setup the pressure for 15-20 and try to sleep on my side.

You're right I'm not.  I'm falling at sleep at work (regular office job) and it's getting to become a problem.  I hope I can finally get some rests.

I'm at a lost of what to do if these changes don't work
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#6
RE: New User confused about Oscar Readings
Please look into a collar, they are not expensive and you can get one at any drug store. It would be the first thing I would try.
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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#7
RE: New User confused about Oscar Readings
I totally ordered one in Amazon and it's coming today.  Definitely going to try it

Willcom Neck Support Brace for Snoring Sleep Apnea, Soft Cervical Collar for Cervicorrect, Pain Relief, Posture Corrector, Sprainand(Adults,Black, M)
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#8
No idea what to do. Need Help Interpreting this Data,
Hi Folks, I really need help figuring out what to do at this point.  I did try to sleep on my side, but that led to a lot of leaks.  I'm currently planning on getting a soft cervical collar this weekend to see if this might help with any positional apnea.

My AHI just doesn't seem to want to go under 5 and I still feel extremely tried after sleeping.  I don't know if this is some sort of sleep debt that I just need to time to fix or...I don't know.

Any help interpreting this data, where to go from here or if anyone can tell me if I'm on the right or wrong path towards recovery would be gladly appreciated.

Thank you.


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#9
RE: No idea what to do. Need Help Interpreting this Data,
The 1st thing I would suggest is to trial a soft cervical collar also.  You have some clusters of OA's in the middle of your chart.  Lot of flow limitations.  Since you already have EPR on full time at 3, that is good for the flow limits.  

You have pretty high pressures set at 15 min and 20 max.  You are still hitting the 20 max though.  You could go even higher, but that would be very hard to tolerate IMO.  Correcting the positional part of your apnea would be the best investment right now.  Think of your airway as a tube.  It can get "kinked" like a garden hose.  The worst position is a chin tuck straight down.  Not everyone suffers from positional apnea, but that might be happening to you based on your OSCAR charts.  You can try lowering your pillow height (to better straighten the neck and head); or trying a different sleeping position also (from back to side sleeping, etc.).  

I commend you for tolerating the pressures you are at now.  By getting the positional aspect solved, you may be able to lower pressures significantly.  I had the same problem when I first started out in therapy.
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OSCAR Chart Organization
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#10
RE: No idea what to do. Need Help Interpreting this Data,
Thanks for the reply.  Yeah I tend to sleep on my back but I know I shouldn't.  I'm going to try to learn  to sleep on my side.  I have a CPAP pillow but using it made my neck sore.

The high pressure numbers worry me.  I do fin_ pressure at 19 and above very hard to handle.  I can comfortably handle around 15-17 so I was wondering if I should just change it to CPAP mode and leave it at 17 or just stick with the 15-20 for a week and trying fix my sleeping position.  I will get a soft cervical collar this weekend.
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