Help me interpret my Oscar data

[resmeds11se]

Hi!

I’ve been using CPAP for a couple of years now. However, I’ve never felt well rested as others seem to feel. I searched around google to see if I could see my data in more detail and found Oscar. After I imported my data I quickly realized that I have no idea what to look forget. It would be really kind if someone would help me get a sense of what could be improved.

Thanks!

[Pugsy]

viewtopic/t172378/StickyIf-you-want-CPA ... Gquot.html

viewtopic/t88983/Pugsys-PointersSleepyH ... Hints.html

http://www.cpaptalk.com/viewtopic/t1585 ... eview.html

[resmeds11se]

Updated images and added equipment.

[Pugsy]

Do you take any medications of any kind? If so, what?

Are you having much nasal congestion at night?

Why the upper limit of 13 cm? Any special reason?

Are you waking often during the night?

[resmeds11se]

Do you take any medications of any kind? If so, what?

Are you having much nasal congestion at night?

Why the upper limit of 13 cm? Any special reason?

Are you waking often during the night?

I take a few medications daily: Duloxetine, Propranolol and Promethazine.

No, no nasal congestion at all.

13 was the initial value set by the clinican. I live in europe so I rent the cpap equipment from the government. They unfortunately don’t follow up on the data if I don’t actively reach out to them.

Hm, sometimes, it depends. I wouldn’t say that I do it very often, not to my knowledge at least.

[Pugsy]

Duloxetine......research it and its side effects as well as what SNRI meds can do with sleep in general and sleep stages (reduced REM)

What makes you say

I’ve been using CPAP for a couple of years now. However, I’ve never felt well rested as others seem to feel.

What unwanted symptoms are you having that you wish you didn't have? Fatigue? Sleepiness? Anything?

You are hitting the max of 13 fairly often. I don't know if that is impacting your sleep quality or not but it might be especially since your Flow Limitation graph is fairly active. If you had complained of some nasal congestion we might blame that FL graph on nasal congestion but since you say "no nasal congestion" then we can't blame your nose and have to think maybe real FLs disturbing sleep.
You may not be sleeping as soundly as you think. We don't remember all arousals. Only those where we maybe were waking up often but briefly so as to not form a memory of the wake up but it can still disturb sleep quality which in turn affects how we feel during the day. We don't get good sound sleep and instead have to keep restarting the sleep stage cycle progress repeatedly which in turn usually makes us not get those later stages of sleep (in the amount we need for restorative sleep) and we feel like crap the next day.
Plus your medication could be contributing to the issue. It's well known to cause problems with sleep and unwanted side effects.

[resmeds11se]

Duloxetine......research it and its side effects as well as what SNRI meds can do with sleep in general and sleep stages (reduced REM)

Great point! Unfortunately, it’s a pain to get off. I’m suspecting duloxetine to be the root to a lot of issues I’m having.

What unwanted symptoms are you having that you wish you didn't have? Fatigue? Sleepiness? Anything?

Mostly fatigue I guess, I never wake up feeling energized. I have a hard time getting up in the morning because of fatigue. I often feel sleepy in the afternoon and have to focus to stay awake.

I have some other issues that probably is disturbing my sleep, like teeth grinding and kicking my legs while sleeping.

[Pugsy]

Yep....Duloxetine is a well done trouble maker but then so is the problem that it is designed to treat.
Damned if you do and damned if you don't.

I suspect that the bulk of your problem isn't apnea related. I think your settings are close enough and you have a problem that is a common complaint.
"Help, my AHI is good but I still feel like crap" problem. Wish I had a dollar for every time I have heard that one.

So for FLs....maybe increase EPR to 3 and bear in mind you might need a little more minimum if you do that and increase the max a little. Again....probably not a silver bullet but it is something to try that might make a positive impact.

As far as medication side effect potential....something to talk to your doctor about.

Nothing on your report stands out screaming "fix me and you will feel like superman". Wish there was....that would make it a whole lot easier.

[resmeds11se]

Yes, it’s probably a combination of everything! Thanks for helping out! I really appreciate it!

So for FLs....maybe increase EPR to 3 and bear in mind you might need a little more minimum if you do that and increase the max a little. Again....probably not a silver bullet but it is something to try that might make a positive impact.

Do you have any suggestion for min/max values? Or should I just increase one step at a time and evaluate?

[Pugsy]

Do you have any suggestion for min/max values? Or should I just increase one step at a time and evaluate?

I like small changes in situations like this. There is no urgent blatant need but some experimenting might help.
No big changes though.....if you increase EPR from 2 to 3 then that will drop the minimum pressure a little and increasing the minimum to compensate for that small change might be worth doing.
I wouldn't increase the max just yet though....a little more minimum pressure might make it so the machine doesn't need or want to go to that max.

Wait and see what happens with EPR at 3 (using EPR has been known to help reduce FLs) and then if you see the max of 13 being hit often then you can at that point increase the max a little. I suspect that an increase to 15 max will be enough.

Remember.....if you go making multiple changes or big changes in something you won't know what change brought about what result....like if it was a success or even a disaster you won't know which change is responsible (or to blame).

[resmeds11se]

So would a good starting point be to set EPR to 3 and bump up the minimum pressure to 9?

[zonker]

So would a good starting point be to set EPR to 3 and bump up the minimum pressure to 9?

she said epr to 3. she said nothing about min to 9.

also, she advised one change at a time.

[resmeds11se]

she said epr to 3. she said nothing about min to 9.

also, she advised one change at a time.

Thanks for your helpful advice!

No big changes though.....if you increase EPR from 2 to 3 then that will drop the minimum pressure a little and increasing the minimum to compensate for that small change might be worth doing.

I was referring to this part.