Any advice?

[DaveC]

My boss asked me to look at his SD card...he doesn't have OSCAR. He's been on cpap for many years. I'm going to post a few screenshots from his data and see what information and advice you can give that I can pass along to him. You all know I'm no expert but his looks like it might could use some work.
Since we can't post attachments here's a link to his OSCAR screenshots. More than one way to skin a cat.
https://drive.google.com/drive/folders/ ... sp=sharing

[Pugsy]

Please post the graphs shown in the examples here

viewtopic/t158560/How-to-post-images-for-review.html

Just pick the best one and the worst one within last couple of weeks.

Maybe use imgur.com (free) instead of google drive....it takes me forever to load and it's a PITA.

You have omitted some needed information and included information that is useless for offering advice.

[clownbell]

Congratulations on posting pics to Google Drive. I have never seen anyone do that.

With all due respect, my advice would be for your BOSS to be responsible for him/herself by getting OSCAR and doing some reading on the wiki to learn about sleep apnea. That may sound like a harsh response but I don't intend it that way. Putting an employee in the middle of the boss's own medical care seems unwise to me. Makes me question the boss's judgement and professionalism. Don't be an enabler.

The boss will have to invest some time. OSCAR just takes a few minutes to download. The majority of the time will be reading the wiki carefully and thoroughly. I am amazed at the questions that are clearly answered in the wiki but asked in the forum, indicating folks who don't invest the time to learn; they expect someone else to do things for them. Most people value things more when they have to invest time/money in them. And the BOSS does have skin in the game. To me, this is the boss's issue not yours (unless the boss is threatening your job).

Good Luck.

[DaveC]

As you wish Pugsy.
https://imgur.com/a/4DPaTNI

[DaveC]

Congratulations on posting pics to Google Drive. I have never seen anyone do that.

With all due respect, my advice would be for your BOSS to be responsible for him/herself by getting OSCAR and doing some reading on the wiki to learn about sleep apnea. That may sound like a harsh response but I don't intend it that way. Putting an employee in the middle of the boss's own medical care seems unwise to me. Makes me question the boss's judgement and professionalism. Don't be an enabler.

The boss will have to invest some time. OSCAR just takes a few minutes to download. The majority of the time will be reading the wiki carefully and thoroughly. I am amazed at the questions that are clearly answered in the wiki but asked in the forum, indicating folks who don't invest the time to learn; they expect someone else to do things for them. Most people value things more when they have to invest time/money in them. And the BOSS does have skin in the game. To me, this is the boss's issue not yours (unless the boss is threatening your job).

Good Luck.

To be clear the boss didn't ask me to do this for him. He is not only "the boss" but he is a good friend. I am the Godfather to his daughter. He has been on CPAP for a long time and I don't think he even realizes he might be able to improve his therapy or that he might even need to. I appreciate your advice though.

[chunkyfrog]

Keep spreading the gospel, according to Oscar.
Helping others is a good thing--it brings us together;
and it all goes on "the great wheel".

[Pugsy]

Thank you. Much easier for me to see and formulate thoughts.

Some clustering of events....either he's on his back or REM stage sleep or maybe a combination of each.
He needs more pressure at those times.
BUT since he is using the Elite machine and it can't auto adjust during those times then he needs more baseline pressure.
Settings are currently 12.6 and EPR at 3.
I would suggest trying 13.6 for 2 or 3 nights....and then 14.6 if the cluster are still present.
Keep EPR at 3.

Ask him what position he sleeps in and if he knows if his OSA is worse on his back or in REM.

Good candidate for auto adjusting machine at some point in the future but probably not critical at this point unless the higher pressures he is going to need all night becomes a problem.
If he was using an auto adjusting machine the machine would only increase the pressure during the times of those clusters in an effort to prevent the clusters from ever happening.

Most likely he is very close with this fixed pressure and 1 or 2 cm more pressure will break up the clusters well enough.
His AHI isn't horribly horrible and some parts of the night the 12.6 setting is doing a good job.

You know that both supine sleeping and REM stage sleep can worsen OSA and cause a need for more pressure.

[zonker]

As you wish Pugsy.
https://imgur.com/a/4DPaTNI

not pugsy, obvs, but i can see something straight away. he's on fixed pressure. on all of those graphs, see the one labeled pressure? the third one from the top? the line never moves. it can't because it's set at fixed.

imho, that sucker needs to be able to increase the pressure in order to handle the events going on.

unfortunately, his is an "elite" model and can't be set in an auto range, which would make it easy to setup to help vanquish those events. so i'm leaving this to others as to what, if any, changes will help.

sorry.

eta: never mind, i see pugsy has answered.

[Pugsy]

that sucker needs to be able to increase the pressure in order to handle the events going on.

unfortunately, his is an "elite" model and can't be set in an auto range, which would make it easy to setup to help vanquish those events. so i'm leaving this to others as to what, if any, changes will help.

Crossing our fingers here in that those clusters will only need a little more pressure to deal with them effectively.
Hoping that whatever is the cause won't require a lot more pressure.
Would sure be a rude surprise to find out that one needs 20 cm just to deal with those clusters and has to use 20 all night instead of part of the night. I am hoping and crossing my fingers that he won't need much more.

No way to know until we try though.

[Miss Emerita]

It’s also conceivable the clusters of events and flow limitations are due to his tucking his chin down toward his chest. The fix for that would be a soft cervical collar.

[zonker]

No way to know until we try though.

true, dat.

[DaveC]

Thank you all for the suggestions. I figured with the clusters, the crazy flow limits and the leaks there was something he could try. I'll pass on the suggestion to increase pressure a little and hopefully that will be helpful.