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LofiDreams
Unread post  Post subject: Help using OSCAR to determine pressure settings  |  Posted: Tue Apr 20, 2021 5:56 pm

Joined: Tue Apr 20, 2021 5:30 pm
Posts: 2
PAP Mask: Nasal pillow
PAP Machine: Phillips Respironics Dreamstation
Pressure Setting: APAP 7.5 to 18, with 20 minute ramp up from 4

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Hi everyone, I'm relatively new to CPAP and new to these forums. I've just started using OSCAR over the last few days, after watching some videos about the basics of how to use it. I think I understand what the different events are now but I'm having trouble figuring out what it all means for what pressure settings I should try.

I started off using APAP, which reduced my AHI compared to what it was during the sleep study. But then I got a call saying the doctor wanted my on a steady setting of 8, with a 45 minute ramp up from 4. I tried that for about a week, but my AHI was pretty consistently higher than when I was using APAP settings before. So I've gone back to using APAP, and trying to figure out the best pressure settings for me.

Right now I'm using APAP with the pressure set between 7.5 and 17, with a 20 minute ramp up from 4. I was getting obstructive apneas before with lower pressure settings but last night with these settings my main 2 event types were hypopneas and clear airway events. I'd think maybe increasing the low pressure could help with the hypopneas but with what I understand about the CA events higher pressures can cause those, which makes me wary of increasing the pressure more now.

Anyway, if anyone could help with interpreting this and offer any suggestions, it'd be much appreciated. I'm trying to get a better understanding of it all so I can better manage my care, and know what to discuss with the doctor. I'll attach some photos of my chart from last night. I have a screenshot of the whole night, then some zoomed in on areas where I had a lot of events, and on specific events.


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DeltaBravo3.8
Unread post  Post subject: Re: Help using OSCAR to determine pressure settings  |  Posted: Thu Apr 22, 2021 2:43 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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OK here's a few tips, don't use Flex 3, it'll be most likely be more disruptive. Since you're on a DreamStation, we need to work at getting your pressures on top of the Apnea, as these Respironics have a notorious fatal flaw of being slow to raise pressures for events, letting quite a bit sneak past. So the pressure needs to go up a bit more. Let's bump it to a Min pressure of 8. Try it a night and report back with an OSCAR Daily and tell us if it and you feel better.

BTW docs like static pressure, because if it's not right, they want you to pay them a visit with some money for them to script a new pressure to send to your machine supplier to edit it. Rinse and repeat several times with money/boat payments. OR you do it yourself for free. You can change it whenever you want instantly. But I'm thinking you see the point. Static pressure is a lot of miss and very little hit. But it generates business for Dr. Dolittle.

_________________
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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LofiDreams
Unread post  Post subject: Re: Help using OSCAR to determine pressure settings  |  Posted: Mon Apr 26, 2021 1:54 pm

Joined: Tue Apr 20, 2021 5:30 pm
Posts: 2
PAP Mask: Nasal pillow
PAP Machine: Phillips Respironics Dreamstation
Pressure Setting: APAP 7.5 to 18, with 20 minute ramp up from 4

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Thanks for the response! Could you briefly explain what the Flex option is? I don't think I've come across any info. on that yet.

I've changed the minimum pressure to 8 and have used that for a few nights now. Most of those nights my AHI was under 5 but the last couple of days it was over 6. Still primarily hypopneas and CA events. I'm also noticing a steady increase in variable breathing over the last few nights, and I'm not yet sure what the meaning of that is.

In terms of my feeling I do think I feel better with the APAP settings vs the static pressure settings from before, but I'm not sure I'm noticing much of a difference from the 7.5 to the 8 minimum pressure. I've been going to sleep a bit late recently so that could also be messing me up.

I'll attach some screenshots of my OSCAR daily like the last time, in case those are helpful. I think I'm close to a good level but still not feeling perfect so I'd like to get my AHI a bit lower.


Attachments:
OSCAR 4.png
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OSCAR 3.png
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OSCAR 2.png
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OSCAR 1.png
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DeltaBravo3.8
Unread post  Post subject: Re: Help using OSCAR to determine pressure settings  |  Posted: Tue Apr 27, 2021 1:11 pm
User avatar

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

Offline
Sure, Flex is to help comfort levels with exhale pressure relief. The PAP senses whether your inhaling or not, so basics is that when the PAP senses you're in an exhale it tries to back off the pressure slightly to make it feel better and comfortable.

Respironics has a murky level of secrecy to how Flex does what it's supposed to be doing and what the 3 levels mean. So it's hard to say what it really is exactly, but my description is pretty close. A ResMed conversely with its EPR meaning exhale pressure relief is not so secret in how it works. It does relive pressure during exhale. There the 3 steps means cmH2O just like the therapy pressure of between 4-20. It's advertised as comfort but we've seen OSCAR charts with it on, and EPR makes a CPAP into a limited PS BPAP.

Flex 3 has been reported as disruptive to a lot of users, limiting flex to 2 at most is best. Try Flex and see if you like it. Try full-time flex 1 or 2. Note how it feels, and compare current OSCAR events, particularly CA and Hypopnoea events. These are your higher marks of events on this OSCAR. Watch that they don't increase and if your comfort goes down.

_________________
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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Pugsy
Unread post  Post subject: Re: Help using OSCAR to determine pressure settings  |  Posted: Tue Apr 27, 2021 1:21 pm
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 2461
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirCurve 10 VAuto

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