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apelila
Unread post  Post subject: Help with sharing reports from Oscar  |  Posted: Thu Dec 24, 2020 1:37 pm

Joined: Thu Dec 24, 2020 12:33 pm
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Hi all,
Newbie here. I've been using CPAP for a year now. Events are always low, but I'm never rested and wake repeatedly though the night. I am guessing my pressure is ok since the events are low. But of course, I could be wrong about that. I have COPD and NOT on oxygen so I wonder if I need to be. Anyway, just need feedback but I have no idea how to get the Oscar information here for viewing.


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Pugsy
Unread post  Post subject: Re: Help with sharing reports from Oscar  |  Posted: Thu Dec 24, 2020 2:35 pm
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Screen shots and then just attach to your post.
Some examples here in a thread I did on another forum. Just haven't got around to doing it here.
http://www.cpaptalk.com/viewtopic/t1585 ... eview.html

You can get everything that is needed in one screen shot with a little manipulation of the graphs.

This might help also
http://www.apneaboard.com/wiki/index.ph ... rpretation

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apelila
Unread post  Post subject: Re: Help with sharing reports from Oscar  |  Posted: Sat Dec 26, 2020 1:53 pm

Joined: Thu Dec 24, 2020 12:33 pm
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Hmm I'm feeling a bit dull about this, but let's see if you can view this. One typical night and one with my highest AHI, not sure why most of the graph on this one is blank though?


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Respirator99
Unread post  Post subject: Re: Help with sharing reports from Oscar  |  Posted: Sat Dec 26, 2020 5:58 pm
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Joined: Mon Apr 27, 2020 1:06 am
Posts: 348
Location: Australia
PAP Mask: Resmed Airtouch F20
PAP Machine: Resmed AirCurve 10 CS Pacewave ASV
Pressure Setting: Min EPAP: 8.0 Max EPAP: 11.0 PS Min: 3.0 PS Max: 8.0

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G'day apelila. Happy Christmas to you.

Let's have a look at the stuff Oscar provides which is useful to us and what is just unnecessary clutter. First off, we don't want to see the calendar or the pie chart, so go to the View menu and turn them both off - that will free up screen space for settings and statistics that we do want to see. (Alternatively press F3 and F9 to turn them on or off). Likewise we don't want to see both pressure and mask pressure - turn the mask pressure off. But we do need to see flow limitations. In the View menu there is an option for Reset Graphs - set this to Standard. Finally, the graphs alone without the left side panel aren't a lot of use. There is a link below to "Organise your Oscar charts" - have a look at that for some more details.

When you made your screen shot, did you use the F12 key? This should automatically turn the unnecessary stuff off before capturing the image.

Now let's look at the overview. The Resmed day starts at 12:00 noon and runs through to noon the next day. That way the whole night's sleep is contained within the 24 hour day and not split at midnight. In your case, sleep commences about 11:00 am, which can imply: 1. You're a shift worker or otherwise a night-owl, or 2: the clock in your machine is out by 12 hours. It would be worthwhile sorting this out before you go any further.

To make best use of the data you have (eg on the chart from 5/12) please turn off the second sleep session using the little yellow or blue rectangles at the bottom left of the screen (see image). That will allow the main session to expand and fill the screen.

OK, having got all that out of the way, let's look at the data. The obvious thing is that you got a big cluster of hypopneas and RERAs just after you went to sleep (or maybe you were still awake at this time) on 5/12/20. You also got a much smaller cluster on 23/12/20. Apart from that, the rest of your chart looks pretty good. I'm guessing that the RERAs may be associated with your COPD and the hypopneas are similarly related. Alternatively a strong cluster like that might indicate postural apnea, where something about the way you're lying in bed is compromising the airway. Typically this can be caused by the head dropping forward with the chin touching the chest - this can squeeze the windpipe, making it prone to collapse. There are several ways to alleviate this condition, starting with lying on your side, with your chin slightly raised. If you sleep on your back, try a pillow that gives good support to your neck but lets the head fall back just a tiny bit. You could also think about a soft cervical collar, but let's try the easy ways first.

Two other thoughts about the clusters - the fact they're occurring so early in your sleep session could allow us to write them off as "sleep - wake junk" or sleep-transition apnea, which can usually be safely ignored. Second, do you prop yourself up on a bunch of pillows to read? Falling asleep with book in hand is an easy way to precipitate a cluster.


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apelila
Unread post  Post subject: Re: Help with sharing reports from Oscar  |  Posted: Sat Dec 26, 2020 7:03 pm

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Thank you for looking and for the feedback. I do not sleep during the day, ever. 10pm ish to bed and up by 7am at the latest but I'm usually awake from 3am-5am mask is kept on for the entirety. I am a side sleeper, but I DO bend my neck and tuck my chin, extreme fetal position? lol. Only one pillow. I would consider my sleep good from the only from the time I fall asleep until 2:30-3am when I start to wake and toss and turn till my alarm goes off. I know at one time I set the clock on my machine, but never did it again once the power has shut off. I will adjust the time and record a few more days. I did use the F12 key when making the screen shots. I see in Oscar how to remove the calendar & chart from "view" but will try to learn from the pic you shared so I can provide better attachments next time. Thanks so much.


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DeltaBravo3.8
Unread post  Post subject: Re: Help with sharing reports from Oscar  |  Posted: Tue Dec 29, 2020 7:54 pm
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On your issues, you did say COPD correct? Do you know your GOLD level from 1-4? I'm GOLD 1 and have inhalers to take daily and a new nebulizer to use as needed. I feel better for the using the neb. but have yet made it daily. I have a very complex state of medical affairs as I also have extreme high pre-existing CA on top of the COPD.

OK jumping from the history to more pertinent issues. You are or not sleeping and resting well as is now? No then maybe you need to get on a path to get a different PAP such as the ResMed VAuto. It is BPAP or bilevel and that plus its timing controls make you rest better. Has that been considered?

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https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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apelila
Unread post  Post subject: Re: Help with sharing reports from Oscar  |  Posted: Sun Jan 03, 2021 2:40 pm

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I do have COPD and few other health issues. I have never heard of a GOLD level. That must be something your doc uses like some use Stages of COPD. Anyway, my doc is not any help. I stopped using my inhaler after Christmas because I don't think it was helping. I just paid this CPAP off in Oct so looking for input as to how to make it work for me, if it can. Not in a position right now to go looking for another doc or have another sleep study. I did use an oxygen monitor a few nights but it doesn't look like Oscar supports that data. Wondering if anyone here can look at those reports along side Oscar reports to determine what is happening just before I start waking up every night.


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apelila
Unread post  Post subject: Re: Help with sharing reports from Oscar  |  Posted: Sun Jan 03, 2021 3:01 pm

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I'm not sure I'm still understanding how to organize this... still trying. This is a report after I changed max pressure. Then I changed min pressure and got 3 nights of 0.00 events but I'm still waking up between 3am and 5am.


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Pugsy
Unread post  Post subject: Re: Help with sharing reports from Oscar  |  Posted: Sun Jan 03, 2021 3:41 pm
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It's more important to see the AHI breakdown above the Statistics than it is to see the machine settings.

When you wake up between 3 and 5 AM...what do you do? Have trouble going back to sleep? Get up? Go right back to sleep.

Google "sleep stages" and look at the normal hypnograms. Did you know that it is normal to wake after a REM stage cycle is completed. Most of the time we aren't awake long enough to form a memory of the awakening but sometimes we have trouble going back to sleep so we remember being awake or we can't go back to sleep.

Do you take any medications of any kind? If so, what?
Any other health issues besides the COPD?

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apelila
Unread post  Post subject: Re: Help with sharing reports from Oscar  |  Posted: Sun Jan 03, 2021 3:52 pm

Joined: Thu Dec 24, 2020 12:33 pm
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Sorry I thought the AHI wasn't wanted. :( I try to go back to sleep when I wake up, because I'm never rested, always fatigued. From that point until my alarm goes off at 6am I dream and wake, dream & wake hate it. I never used to dream and always slept though the night 6-8 hours. That's my goal and doc said if I used CPAP it would come back to me, but it's been a year and it hasn't come back. I also have hypothyroidism and am on hormone replacement for that.


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Pugsy
Unread post  Post subject: Re: Help with sharing reports from Oscar  |  Posted: Sun Jan 03, 2021 4:55 pm
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There is an AHI graph on the right side...it doesn't do much except tell us how many apnea events happen per hour. Maybe that's the one someone said wasn't needed.

Do you have much nasal congestion going on? Your Flow Limitation graph is a bit active but then again you are in the for Her mode and it always makes the FL graph look worse because that's what it is designed to look for in the for Her mode...flow limitations.
Nasal congestion can also show up a flow limitations as well.

You are having some sleep maintenance insomnia issues. The waking and not being able to sleep soundly after the waking. The dreaming..sleeping in and out. You wouldn't be remembering a dream if you didn't wake during it. Also don't assume you only dream in REM sleep...that's not the case because we can dream in any sleep stage.

Now why you are waking up so much...million dollar question but I don't see anything really obvious on this report. The Flow Limitations...a maybe but I have seen a lot worse.

Have you tried the other auto adjusting mode? If not..might give it a try and see if it makes any difference.

Sleep maintenance insomnia can be caused by any number of things and only one of the items on that very long list is sleep apnea.
If your issues aren't from airway related problems then the machine can't fix it because it only fixes airway problems. Might also consider adding another 1 cm increase to your pressure (assuming we aren't blaming nasal congestion for the flow limitation activity). I don't know that it would help or not but it's worth trying.

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DeltaBravo3.8
Unread post  Post subject: Re: Help with sharing reports from Oscar  |  Posted: Sun Jan 03, 2021 6:21 pm
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Location: Waynesboro, Pennsylvania, USA
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I'm thinking that a gameplan to do some careful consideration and then enact changes to your PAP are in order. Why? Big part is to enhance rest and comfort.

Maybe trying the regular Auto MODE may be first. Probably same settings just mode change. Consider and try it. Then give OSCAR chart and tell us how it did.

As for COPD and Gold levels, my understanding was that is how to grade symptoms and severity for all COPD patients. Don't worry, it's not a big deal regarding PAP therapy, at least not for you at this time.

Now I'm not able to make you do anything, but maybe on the inhaler use, it's maybe best to consult doc before stopping these inhalers. You might be hindering COPD control of symptoms. For me when COPD gets worse, PAP treatment goes bad too. Again handle it as you see fit, but I've learned if I'm not on the inhalers on schedule, I'm in a bit of trouble. No finger pointing or similar. Just passing on what I've gone through.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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apelila
Unread post  Post subject: Re: Help with sharing reports from Oscar  |  Posted: Sun Jan 03, 2021 8:14 pm

Joined: Thu Dec 24, 2020 12:33 pm
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I don't have nasal congestion, but neither do I ever breathe through my nose, unless I'm awake and I make myself do that. I have had severe asthma all my life and breathing has always been difficult. Very shallow breather and undeveloped diaphragm. Prior to CPAP when I was waking in the middle of the night, I was panting, my doc decided that was from having apneas and told me the CPAP would help me stop gasping and panting in my sleep. So I got the machine with the min/max pressure of 6-11 and changed it myself to 6-13 after a few months and again to 7-14 a few days ago. My doc says as long as my events are low, the therapy is fine and there is nothing else to do. :( Clearly he nor I really understand this therapy, and I realize I may have other issues going on but I just want to make sure I'm getting what I should from this equipment before I start chasing other rabbits. Is the flow limitation related to the max pressure? I have no idea what the "auto" adjusting mode is.... are there sites or articles you can recommend for me to understand what that is?
I believe if I was getting actual "rest" I wouldn't be dreaming because I never used to dream, I know people say everyone dreams but I'm not young and know I never started dreaming until a few years ago when this constant waking up thing started. I slept with an oxygen monitor a couple of nights and oxygen dropped to 84% which seems low to me, but again, I'm not sure where I can learn if this is an issue or not.
I really appreciate any direction or suggestion because I'm on my own here, doc is useless & clueless.
Thanks!

Pugsy wrote:
There is an AHI graph on the right side...it doesn't do much except tell us how many apnea events happen per hour. Maybe that's the one someone said wasn't needed.

Do you have much nasal congestion going on? Your Flow Limitation graph is a bit active but then again you are in the for Her mode and it always makes the FL graph look worse because that's what it is designed to look for in the for Her mode...flow limitations.
Nasal congestion can also show up a flow limitations as well.

You are having some sleep maintenance insomnia issues. The waking and not being able to sleep soundly after the waking. The dreaming..sleeping in and out. You wouldn't be remembering a dream if you didn't wake during it. Also don't assume you only dream in REM sleep...that's not the case because we can dream in any sleep stage.

Now why you are waking up so much...million dollar question but I don't see anything really obvious on this report. The Flow Limitations...a maybe but I have seen a lot worse.

Have you tried the other auto adjusting mode? If not..might give it a try and see if it makes any difference.

Sleep maintenance insomnia can be caused by any number of things and only one of the items on that very long list is sleep apnea.
If your issues aren't from airway related problems then the machine can't fix it because it only fixes airway problems. Might also consider adding another 1 cm increase to your pressure (assuming we aren't blaming nasal congestion for the flow limitation activity). I don't know that it would help or not but it's worth trying.


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Pugsy
Unread post  Post subject: Re: Help with sharing reports from Oscar  |  Posted: Sun Jan 03, 2021 8:24 pm
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copy of what I sent to OP in response to a private message.
Posting it to save others from repeating what I posted.

Quote:
Think of flow limitations as hyponeas that haven't grown up to be hyponeas or obstructive apneas. There's a reduction in air flow but it doesn't meet criteria to earn any sort of apnea flag.
The airway has narrowed and the air flow has reduced.

https://www.youtube.com/watch?v=-gie2dh ... e=youtu.be
or this one...it's like breathing through a straw.

https://www.youtube.com/watch?v=-gie2dhqP2c

You have to work hard to move enough air to be comfortable....and potentially made more difficult because of COPD

Here's what my own Flow limitation graph looks like...compare it to yours...yours has more junk on it compared to mine. I have never had FL problems as my diagnosis was primarily OA/hyponea stuff

Image

BUT....yours is far from horrible and it may not be the source of your problem

This one below...now it's horrible.

Attachment:
ugly fl graph.JPG
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DeltaBravo3.8
Unread post  Post subject: Re: Help with sharing reports from Oscar  |  Posted: Sun Jan 03, 2021 9:41 pm
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 595
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: Required to start over on ResMed AirSense 10 AutoSet.
Humidifier: HumidAir and Heated hose
Pressure Setting: Auto PAP 7-14, EPR full time 3

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agreed, stats aren't bad, seems it's the symptom/complaint list we ought to focus on IMO

if OP wants to edit pressures for better feel it's not a wrong idea, also letting it ride is OK as well, depends on feel/symptoms/complaints we're trying to address

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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