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hedwigtheowl
Unread post  Post subject: OSCAR Data Help  |  Posted: Tue Oct 08, 2019 5:21 pm

Joined: Tue Oct 08, 2019 4:42 pm
Posts: 3
PAP Mask: Philips Respironics DreamWear Full Face Mask
PAP Machine: ResMed AirSense 10 AutoSet for Her
Pressure Setting: 7-10

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Hello!

I was diagnosed with mild OSA (6.1 AHI).

I have been using my AirSense 10 AutoSet for Her for about 6 weeks. I recently switched to a DreamWear Full Face Mask. Throughout the 6 weeks, I have had some trouble with "clear airway" apneas. I got an AHI of 0.6 one night last week (yay!), but over the last two weeks or so my AHI ranges from 1 to 4 and is usually around 3. Most of this is "clear airway" apneas.

I am trying to figure out if they are "real," if they might be correlated to mask leaks, and also if I should try anything regarding pressure adjustment. I attached two screenshots (the graphs are the same in both, but I had to scroll down on the left side to show the machine settings and such).

FYI I have played around with EPR, with it off, at 1, and at ramp only 1. When I first started I had it on 3, and then turned it off when I learned it cause central apneas. However, now with it at 1, off, or ramp only at 1 I haven't seen a difference in my AHI.

Thank you so much! I've been trying to understand all the graphs, but I'm not there yet.


Attachments:
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Pugsy
Unread post  Post subject: Re: OSCAR Data Help  |  Posted: Tue Oct 08, 2019 7:42 pm
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1376
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

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To figure out if any event is a real event and not related to an awakening or arousal you have to zoom in a lot closer.
http://freecpapadvice.com/sleepyhead-free-software

The first cluster of CAs is so close to when you first turned the machine on I would suspect you weren't even asleep yet.
What about when you see the other clusters? Any chance you were awake then?

How come you are limiting the maximum at 10? The machine wants to go higher (probably because of the ugly flow limitations) but can't.
It's possible that the flow limitations are causing arousals (you may or may not remember them) and the CAs are a byproduct of the arousal.


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hedwigtheowl
Unread post  Post subject: Re: OSCAR Data Help  |  Posted: Tue Oct 08, 2019 8:12 pm

Joined: Tue Oct 08, 2019 4:42 pm
Posts: 3
PAP Mask: Philips Respironics DreamWear Full Face Mask
PAP Machine: ResMed AirSense 10 AutoSet for Her
Pressure Setting: 7-10

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Thank you so much for your response. I had set the max at 10 because I was worried about CAs, but you are right— I am having multiple arousals throughout the night, waking up during dreams. I am guessing those CAs correspond to that. I will increase the max pressure and see what happens. Thank you!


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hedwigtheowl
Unread post  Post subject: Re: OSCAR Data Help  |  Posted: Thu Oct 10, 2019 6:29 am

Joined: Tue Oct 08, 2019 4:42 pm
Posts: 3
PAP Mask: Philips Respironics DreamWear Full Face Mask
PAP Machine: ResMed AirSense 10 AutoSet for Her
Pressure Setting: 7-10

Offline
As a follow-up, the last two nights I upped my max pressure and am now at 13. I'm thinking I still need to go higher.

In looking at last night's data, it appears I have a few clear airway/central apneas at the beginning of the night so I may not have been asleep yet (or they were sleep onset centrals). The cluster between 5:30-6:30 am were after I had woken up and was lying there for awhile trying to go back to sleep.

What I'm seeing is an uptick in hypopneas and RERAs. I'm attaching a few graphs (including a zoomed in one showing two RERAs) and would be most grateful for any insights.


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Pugsy
Unread post  Post subject: Re: OSCAR Data Help  |  Posted: Thu Oct 10, 2019 7:29 am
User avatar

Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1376
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

Offline
The pressure still wants to go upwards because of the Flow Limitations.
Flow Limitations (assuming not related to nasal congestion which is a different problem) are early warning signs that the airway is trying to collapse. It doesn't fully collapse to the point of earning a hyponea or OA flag which is good but they still could be a factor in disturbing your sleep.

The CAs/centrals.....probably SWJ or sleep/wake/junk related to arousal breathing and not a real central. Ignore them for now.
I don't see any evidence of your increasing pressures causing them or else we would see a lot more of them when your pressure is at 13.
Higher pressures causing centrals is actually relatively rare and I just don't see you being one of those rare ones.

You probably are going to need more minimum as well as maximum to tame the FLs.
If you were reporting that you were feeling good and sleeping soundly then I wouldn't be as concerned about the FLs but you aren't...which is why I would continue to try to reduce the FLs if possible.

To give you an idea what a boring FL graph looks like

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