Accuracy of OSCAR Data and RESMED Data

[jlsmithseven]

Hi Guys
I had a few other questions in the forum and I appreciate all the assistance so far. Anyways, this question is in regards to how accurate the data is coming from my machine and OSCAR program.
I am a mouth breather most of my life. I've been using the nasal masks because they're so much more comfortable and seem to be working just fine for me. My AHI starting was 11.0 and I've been getting consistently under 2.0 every night for a while using the nasal masks.
However, I haven't been using a chin strap or anything else. I have been waking up more than I want to, average of 3 times per night that is really affecting my sleep quality.
Anyways, my OSCAR data is showing my 95% being around 9.0 and my average being around 5.5 for the pressures. Can I set my range from 5-9 and have a better quality sleep, maybe the max pressure of 20.0 that it's currently set at is too high? I have almost a year of data and this is the averages.
I just feel like I have to be leaking at night through my mouth because my sleep quality suffers compared to a full mask (when it actually works all night). I've been using a Navage with the salt packets every night before bed and it does wonders at keeping my nose clear. Without it, like last night, I barely got any sleep because my nose was clogged all night. I don't want to rely on the Navage forever either so I'm trying to get down to that as well.

[Pugsy]

OSCAR just reports whatever data the machine records and writes to the SD card. So OSCAR's accuracy is going to depend on the machine's accuracy....which is pretty darn accurate. There may be some very minor differences in some numbers due to rounding up or down. The machine only goes to one decimal point but OSCAR goes to 2 decimal points.

The max of 20 cm setting is a moot point if the machine never ever gets close to that setting. Doesn't really matter if your max is set at 10, 15, 20 or heck even 100 (if it could go that high) when it never ever hits even 9 cm.
In your case it looks like the max might hit around 14 cm on a rare occasion.

The max setting itself isn't the cause of your unwanted wake ups.
Now some people want to blame the machine going higher for causing wake ups but it could very well be that the apnea events the machine is going higher to try to prevent might be causing the wake ups.

Did you know that it is normal to wake after the end of a REM sleep cycle? Google "sleep stages" and look at the normal hypnograms and see what I mean. For all we know your wake ups are related to the end of REM.

[jlsmithseven]

OSCAR just reports whatever data the machine records and writes to the SD card. So OSCAR's accuracy is going to depend on the machine's accuracy....which is pretty darn accurate. There may be some very minor differences in some numbers due to rounding up or down. The machine only goes to one decimal point but OSCAR goes to 2 decimal points.

The max of 20 cm setting is a moot point if the machine never ever gets close to that setting. Doesn't really matter if your max is set at 10, 15, 20 or heck even 100 (if it could go that high) when it never ever hits even 9 cm.
In your case it looks like the max might hit around 14 cm on a rare occasion.

The max setting itself isn't the cause of your unwanted wake ups.
Now some people want to blame the machine going higher for causing wake ups but it could very well be that the apnea events the machine is going higher to try to prevent might be causing the wake ups.

Did you know that it is normal to wake after the end of a REM sleep cycle? Google "sleep stages" and look at the normal hypnograms and see what I mean. For all we know your wake ups are related to the end of REM.

Thank you for the information, I was reading a bit about REM. I believe you might have something there because I do usually wake after very Vivid dreams usually so it my apnea might be just starting then, as I am into my REM sleep, then waking me up after each cycle perhaps...I wonder if setting my max to 9 would only allow the machine to get to that point, instead of going up to 12 like it normally does to find the right pressure of 9. Does that make sense? I think the 12 pressure could be waking me up while it dials back to 9 to get my airways open, and I'm guessing this happens during REM sleep. I just know there was only 1 night in the past year I slept throughout the entire night didn't wake once, and I felt like a new person. I was just so happy and felt so great. I just want to get closer to that on a more consistent basis. I have come a long way though and if the numbers are accurate and it would detect a mouth leak I'm happy with that. I think the frequent wakeups is my next puzzle to solve.

[Pugsy]

I wonder if setting my max to 9 would only allow the machine to get to that point, instead of going up to 12 like it normally does to find the right pressure of 9. Does that make sense?

Without seeing your detailed reports to get a feel for what or why the machine wants to go to 12 sometimes I can't really offer much of an opinion one way or the other except to say that the machine usually has a good reason (in it's auto adjusting algorithm) for going to where it wants to go.

I have no idea if restricting the max will fix your sleep issues or not. There's a chance if whatever the machine is trying to kill when it goes to 12 and since it could only go to 9 that what the machine was maybe preventing might even make the sleep issues worse because the machine couldn't prevent something from happening that it was trying to prevent.
Could very well make things worse and not better.

But there's nothing stopping you from doing that experiment and learning for yourself....one way or the other.
I have always said that we always learn something from any experiment....now it might be that all we learn was what a bad idea that experiment was or maybe we learn something positive.....but we always learn something.

[dataq1]

OSCAR just reports whatever data the machine records and writes to the SD card.

I could be mistaken, but actually some of the data that OSCAR reports on the Daily page is actually derived values. For example, inspiration and expiration times are not reported by Autoset, rather are calculated by OSCAR and is not on the SD card.

[Pugsy]

OSCAR just reports whatever data the machine records and writes to the SD card.

I could be mistaken, but actually some of the data that OSCAR reports on the Daily page is actually derived values. For example, inspiration and expiration times are not reported by Autoset, rather are calculated by OSCAR and is not on the SD card.

That is a question for the OSCAR developing team I suppose....as to exactly how they come up with those values but I would assume from some sort of data point provided on the SD card by the machine as a starting point.
I don't think that they just pulled it out of their butts without some sort of back up.

BUT....ResScan used to also report insp and exp times and ResScan got that information from somewhere by some means.
I don't know if it still does (ResScan) because I no longer have it and don't wish to go get it.
Years ago there was a big to do made about the machines collecting data points that whether or not ResScan showed those data points depended on the machine used. I don't remember all the particulars though.

In general though the data provided by OSCAR is as accurate as the data the machine collects....at least for the major data points that most people will be looking at. The basics in terms of reported AHI, pressures, leaks, etc.

Feel free to contact the OSCAR development team with your questions.....I am not, nor have I ever been, part of that team.

[jlsmithseven]

Thank you for the replies. So I did a test last night. Usually I change a bunch of stuff and I never know which helped or which didn’t. Anyways, I caught myself doing that and just changed one thing. I set my min pressure to 5 and my max pressure to 10. I figured since my average over a year was 5 and 95% of the time over the year my pressure never went over 9.5 I would use these numbers. The result was, and amazing night of sleep. I woke once to use the restroom. I also woke up a few minutes before my alarm and saw my pressure was 7 at that time. This was about 6.5 hours into my sleep. I’m guessing I was at the end of my REM cycle at that point. Either way I woke up fully refreshed and ready to go. I realize it’s only one night of data but I’m going to test this longer. I’d like to get EPR to 0 as my next experiment. Any ideas on how to gradually do this?

[Pugsy]

I’d like to get EPR to 0 as my next experiment. Any ideas on how to gradually do this?

Why?

[jlsmithseven]

I have read that it can help with therapy and is safer. I think the substantial change from exhaling and then inhaling might be waking me up as well once I get to higher levels? It was several places I’ve read that not just one. But a majority of people say if it works for me it’s fine because everyone’s different. Also Pugsy thank you for being so active on this forum I’ve learned a lot from you.! I also saw you use the Bleeps which I recently just bought and it is so nice not having headgear. I’m excited for the eclipse but I don’t think I’m going to preorder until people have used them a little.

[Pugsy]

I have read that it can help with therapy and is safer. I think the substantial change from exhaling and then inhaling might be waking me up as well once I get to higher levels? It was several places I’ve read that not just one. But a majority of people say if it works for me it’s fine because everyone’s different. Also Pugsy thank you for being so active on this forum I’ve learned a lot from you.! I also saw you use the Bleeps which I recently just bought and it is so nice not having headgear. I’m excited for the eclipse but I don’t think I’m going to preorder until people have used them a little.

Well.....I don't personally agree with the exhale relief can be dangerous theory or makes for "better" therapy.
I actually strongly disagree with it but I suppose everyone is entitled to their opinions but it's sad when something that can make therapy easier for a lot of people gets the bad press from a few.
Exhale relief is a comfort setting...period. Don't you think that if it wasn't safe and effective that it wouldn't be so easily available for change on these machines?

Yes...there are a few who might get centrals pop up from the bilevel situation that exhale relief creates but the number of people who might have this happen is actually an extremely small number of people and it's usually easily dealt with.
Yes...the drop during exhale can affect therapy in some people but that's only a problem when the drop ends up going below therapeutic levels...and again easily dealt with in most cases by simply raising the minimum a bit so the drop during exhale no longer goes down below therapeutic levels.

Do you know what the first line of defense is when people have centrals pop up after starting cpap (and they didn't have a problem with centrals before cpap) might be??? It's a regular bilevel machine and that's usually what doctors go to first in an effort to reduce treatment emergent centrals. Yep...a regular bilevel machine is tried first and then if no joy they go on to the ASV type of machines. Using EPR on your AutoSet is effectively creating a bilevel machine but with the 3 cm limit instead of higher pressure support available on full blown bilevel machines.
Duh....

But again you are free to try reducing or eliminating EPR if you wish. Nothing stopping you but don't go doing it because you think EPR is unsafe because it's not unsafe at all. If you wish to reduce EPR...your choice either reduce slowly or go cold turkey to none if you wish. It's all up to you and what you are comfortable with.

I actually use a machine that let's me use the equivalent of 4 EPR if the AutoSet EPR limit was 4 and not 3.
First time I ever used a bilevel machine I realized immediately that this was something that I really liked and I actually sleep better because it mimics my normal breathing. My AHI last night was 0.2. It certainly doesn't cause centrals for me and it certainly isn't affecting my overall therapy.

So try it if you wish but don't go believing that scary stuff you might read because the majority of people who do use exhale relief DON'T have a problem pop up from using exhale relief.

As far as the Bleep goes and the new Eclipse version....again your choice on waiting or not.

Here's the beauty of all the stuff you are wondering about....your choice in everything you do.
Remember that the minimum pressure is going to be your most critical setting....be it with or without exhale relief.
That is the pressure that does the bulk of the work of holding your airway open and preventing the collapse of the airway tissues that make up apnea events.

Use whatever settings that work well for you and you are comfortable with and you sleep good and feel good with.
That's the most important thing...what works for you. You get to choose.

[palerider]

I have read that it can help with therapy and is safer.

You ave read wrong There's a lot of garbage on the internet, and that's part of it.

If 0 EPR is 'safer' then all the people prescribed BiLevel machines are probably dead, since they have an effective EPR of 4-15 depending on the machine, and I'm pretty sure I'm not dead, no matter what some lusers on this board might wish.

[zonker]

I have read that it can help with therapy and is safer.

You ave read wrong There's a lot of garbage on the internet, and that's part of it.

If 0 EPR is 'safer' then all the people prescribed BiLevel machines are probably dead, since they have an effective EPR of 4-15 depending on the machine, and I'm pretty sure I'm not dead, no matter what some lusers on this board might wish.

<snerk> but,but, but....you ARE dead and speaking to us from the depths of hades, as your avatar plainly shows.

[D.H.]

If you've got the max at 10, and you see that you never went above 7.5 you can set the max higher (even all the way up). It still won't go above 7.5, given the same conditions.

[palerider]

I have read that it can help with therapy and is safer.

You ave read wrong There's a lot of garbage on the internet, and that's part of it.

If 0 EPR is 'safer' then all the people prescribed BiLevel machines are probably dead, since they have an effective EPR of 4-15 depending on the machine, and I'm pretty sure I'm not dead, no matter what some lusers on this board might wish.

<snerk> but,but, but....you ARE dead and speaking to us from the depths of hades, as your avatar plainly shows.

Am not! I decided to head to Texas in the summer for a little relief from the heat. I had some PTO. >:-)

[palerider]

If you've got the max at 10, and you see that you never went above 7.5 you can set the max higher (even all the way up). It still won't go above 7.5, given the same conditions.

No, but tomorrow will quite likely have different conditions.