Oscar Question

[Kiralynx]

I have a Bipap ASV.

Epap is 6-7.5
Min PS is 4
Max PS is 8.

But Oscar reports my min EPAP anywhere from 3.2 to 4.6 and my min IPAP anywhere from 6.6 to 7.2 and my Max IPAP at 12-12.3.

And my AHI is higher than it should be -- which may be a result of these lower pressures.

What's the deal?

[Pugsy]

Are you using Flex relief at all?

BUT....with PS of 4 minimum you should be see at least a difference of 4 cm between EPAP and IPAP.

OSCAR and SleepyHead are both known to have a bug in the reported settings department. Even more so with the DreamStation ASV models.
So it may simply be reporting the numbers in the settings wrong. Your graphs should be correct though. If you zoom in on the pressure graphs what are they showing as actual pressures at the very beginning of the night while you are awake and we would assume the machine shouldn't be responding to anything?

Use of Flex exhale relief can cause the EPAP to drop a bit during exhale depending on setting and force of breathing but PS of 4 minimum should remain constant at least until the machine starts trying to respond to whatever and it might want to increase the PS.

Any special reason for the really tight EPAP min and max range?
If the higher than you want AHI is mainly hyponeas or OAs...maybe the machine needs more than the max EPAP of 7.5 to prevent the obstructive stuff from happening.

[Kiralynx]

My original EPAP was 6 -- my original machine didn't have a range, and I could not breathe out against anything higher.

When I got my Dreamstation, which DID have a range, I did not have any recommendations. I don't currently have a doctor to consult with on the PAP, so, like many of us, I'm winging it.

I knew that my original values had been an EPAP of 10 and an IPAP of 14, and I could NOT breathe out against the 10. Or 9, or 8. My doctor then set it to 6. So, since I could not breathe out against 8, I figured in setting a range, I would go with 6-7.5, keep it under what I couldn't breathe against, and above the EPAP I'd been using. (My AHI with EPAP 6, MinIPAP 10, Max IPAP 14 was usually 1-2.)

[Pugsy]

How much of a higher AHI are we talking about?
Are you sleeping well and feeling pretty good?
You know if you let the machine go a little higher with that EPAP max you should be asleep and it shouldn't be a noticeable issue.
If it is you can always back up again.

The general rule is for OAs...a little more EPAP and for hyponeas a little more IPAP. Which can of course be accomplished in more than one way.
Though unless the results are just horrible or you aren't sleeping well no and you feel like crap then I don't know that I would do anything more than shrug my shoulders.

Oh...if the increase in events happen to be CAs/centrals...then you probably need a little more PS.

[Kiralynx]

Talking an AHI of 6.4 which is almost triple what I usually had -- that's why I was concerned about Oscar showing the lower pressures. (BTW, if there are directions for copying an SD card, I could provide data from both the Dream Station ASV and the System One 950, since I am still using my 950 as a travel machine.)

Not sleeping terribly well. I'm not getting enough sleep because the honored husband hasn't been going to bed until around 2a, and if I go to bed ahead of him, he'll just doze off in his chair and won't bother to come to bed or put on his CPAP. He seems to do fine on 5 hours; I need a bit more.

May see about raising that EPAP and see if, after 11 years of practice, I can breathe against it.

[Kiralynx]

Addendum: Oscar shows, at the beginning of a night, EPAP 4.7, MinIpap 7.6, IPAP 7.7, Max IPAP 8.01, and PS 3.00

None of which is correct.

[Pugsy]

I think it is the settings bug in action....and I don't know if I would even trust the other stuff unless I could confirm it with Encore Pro.
Do you have Encore Pro and a very new version at that?

[Kiralynx]

I think it is the settings bug in action....and I don't know if I would even trust the other stuff unless I could confirm it with Encore Pro.
Do you have Encore Pro and a very new version at that?

I have Encore Pro, but I (ahem) managed to lose my password, so I should probably just uninstall it. The version I have is around three years old.

[Pugsy]

I think I would just go get the latest version of Pro from the apneaboard.
I have my doubts as to whether your older version would even work even if you did have the password.
They did some wonky file structuring on the DreamStation and that's how come it's been so difficult to get rid of that settings bug especially with the ASV.