Please Help with Sleep Study and Oscar Readings

Hi,

I have finally gotten Oscar to work with my computer (the problem was my computer) and have dug out my sleep study report. Would you please help me learn from them how to optimize my apap experience. Thanks for your help!


I can't get anything else to load, so I'll try to put the Oscar screen shots in a second post.

Hello, Deborah, and congratulations on mastering Oscar! Could you provide a little more information?

The two charts you posted show fairly different AHIs, and I'm curious whether you think maybe your sleep position was different. I'm wondering why you had more obstructive events on the one night than on the other. Mind you, both are MILES better than the severe apnea you exhibited in the sleep report.

It'd also be helpful to know how you're feeling during the day. Starting to feel better? Or not yet?

One other thing: your sleep study has some personal information on it. Do you want to take it down and white out the information before reposting?

Awake vs asleep flagging can also be a factor (in addition to the sleep position thing Miss Emerita posted about).
It wouldn't be impossible for higher AHI nights to be nothing more than maybe a night with poor sleep quality and maybe an increase in SWJ flagging. A couple of weeks ago I had an AHI night of 9.4...way high for me but when I went in and looked at each flagged event up close they were 90% SWJ Sleep/Wake/Junk arousal related flagging. I think I just had a bad night due to back pain and didn't sleep so great.

Overall I think you are doing well at least on paper. If you have more nights like the lower AHI number...I see no reason to go messing with things unless you are having a problem.
If you have more nights like the higher AHI number....I would do some investigating as to whether those are real events or not and then maybe make a slight adjustment if those are real asleep events.

How are you feeling and sleeping? That's as important, if not more important, than the numbers.

Awake/arousal flagged events simply don't count other than they point to poor sleep for some reason.
We must be asleep for them to matter.
Go here and watch the videos and learn about arousal/awake flagged breathing.
While it talks mainly about central/CA....false positives aren't limited to centrals. They can be any event category.
http://freecpapadvice.com/sleepyhead-free-software

Wow, what an amazing beginning! You've taken control of your sleep therapy and you're succeeding.
Welcome, Deborah!

Chris

Thanks for your responses! I feel like I'm sleeping well and feeling fine. Most of my life I was a side sleeper, but a couple years back I read that it was better for people with lower back pain to learn to sleep on their back. It was difficult, but I am now a back sleeper. I usually wake up for a bathroom break, and when I come back, sometimes I feel antsy, so I'll switch to my right side for the last couple of hours. On those nights I usually have a higher AHI. I can't make sense of it, because my sleep doctor told me my apnea was worse on my back. But now that I'm being treated, it's worse on my side. Maybe I tuck my chin while on my side. I don't know. In case I have been chin tucking I chopped a deep hole for my head into an old Tempurpedic pillow and I think that keeps my head back pretty well.

The screen shots I provided were just the past two nights, and I was on my back all night both nights. My AHI does vary. I have been as low as 0.7 and about a week ago I hit 6.something. That night I felt like there was way too much pressure, and my 90% pressure reading was 16. I am usually at 10 or 11 most nights. My husband (also on apap) suggested I change out my filters, even though it was early, so I did. The pressure has been back to normal since then, so I suppose he was right.

Well, any additional advice would be welcome.

Again, thank you for helping me.

Deborah

I'm so happy! I hadd an AHI of 0.4 last night! This is the best I have seen so far. Here's the Oscar report:




I just had to share my good news.

Deborah K. wrote: ↑

Mon May 04, 2020 5:02 pm

I'm so happy! I hadd an AHI of 0.4 last night! This is the best I have seen so far. Here's the Oscar report:
screenshot-20200504-165400.png
I just had to share my good news.

Congratulations!
It looks like you're in the territory of good sleep therapy!
Why not stay with these settings for a while and just track how things go?

Chris

Chris,

I forgot to mention that I upped my starting pressure from 8.5 to 9 last night. Maybe that's why I did better than usual. It's funny, I had tried raising the pressure to 9 before, and it was too overwhelming. But last night it was remarkably easy. I guess my body had to adapt in it's own good time. I will leave it at 9 for now. If nothing on Oscar seems to you to indicate a change that should be made, I'll just stay where I am for the present.

Deborah K. wrote: ↑

Mon May 04, 2020 5:23 pm

Chris,

I forgot to mention that I upped my starting pressure from 8.5 to 9 last night. Maybe that's why I did better than usual. It's funny, I had tried raising the pressure to 9 before, and it was too overwhelming. But last night it was remarkably easy. I guess my body had to adapt in it's own good time. I will leave it at 9 for now. If nothing on Oscar seems to you to indicate a change that should be made, I'll just stay where I am for the present.

Excellent!

Last night I had an even better AHI! 0.3!!! I'm so glad I found this site and can finally use Oscar.

I have a couple of questions about Oscar readings I hope someone can help me with.

1. I show a Flow Limitation of 1.52. Is this something that I can improve somehow, or is it nothing to worry about?

2. I show Variable Breathing of 7.18. Again, is this something I can improve or should I ignore it?

3. On the pie chart most of the chart is FL. Does this FL mean Flow Limitation as in question 1, or does it indicate something else, perhaps meaning the times when I have no sort of sleep disturbance? That makes more sense to me.

I'm just trying to get a better understanding of what Oscar is telling me. Thanks for your help. Here's my newest chart.

Deborah

Deborah K. wrote: ↑

Tue May 05, 2020 11:54 am

Last night I had an even better AHI! 0.3!!! I'm so glad I found this site and can finally use Oscar.

I have a couple of questions about Oscar readings I hope someone can help me with.

1. I show a Flow Limitation of 1.52. Is this something that I can improve somehow, or is it nothing to worry about?

2. I show Variable Breathing of 7.18. Again, is this something I can improve or should I ignore it?

3. On the pie chart most of the chart is FL. Does this FL mean Flow Limitation as in question 1, or does it indicate something else, perhaps meaning the times when I have no sort of sleep disturbance? That makes more sense to me.

I'm just trying to get a better understanding of what Oscar is telling me. Thanks for your help. Here's my newest chart.

Deborah


screenshot-20200505-104045.png

This is so great! Consider... most people are happy to get below 1.0 AHI. You're at 0.3! That's where a lot of us are happy to hover. Your apnea is essentially well controlled. There is a tendency to want to tweak the dials just a little more, but you're already in the sweet spot range. You're dialed in.

Why not just let it go for a week or two and see how you feel? Seriously, there's a point after which it's time to say other things are important. For instance, you could check out information on here about sleep hygiene or read mask reviews for masks that look promising to you. You could read about what things other people are going through and maybe offer comfort or suggestions, or at least learn how they're solving challenges you may one day face. You're arming yourself with knowledge as you take even better control of your therapy.

Others will come along to tell you more about Flow Limitation and Variable Breathing.

It's so great you're making progress!

Chris

Thanks Chris. I very much appreciate your encouragement.

The pie chart is just an overview of the ratio of each event compared to the whole pie.
Doesn't mean much....if you only had one event then the entire pie would show that event. If you had a 100 events of the same kind it would still show the whole pie as being that event.

Flow limitations are reductions in air flow that don't make criteria for earning an OA or hyponea flag. I think of them as baby hyponeas for lack of a better thought. The airway is trying to collapse but since your OA and hyponea count is low it means those FLs haven't grown up to earn a hyponea or OA flag.
You aren't having enough of them to worry about IMHO.
The machine will try to increase the pressure to better prevent them though and that's why you see the pressure increase when you had that first little grouping of the FLs early in the night. I suspect maybe you were on your back.
It was relatively brief though and you really didn't have much more the rest of the night so I wouldn't worry about them.
Now if we saw the same sort of clustering all through the night with those FLs and much higher hourly averages than maybe we would try to prevent them with a little more pressure minimum but for such a short period of time and it didn't repeat ...I would shrug my shoulders and move on.

Thanks Pugsy. That helps.