New CPAP User Looking for OSCAR Feedback

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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BatmanMatt
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Re: New CPAP User Looking for OSCAR Feedback

Post by BatmanMatt » Sat Dec 04, 2021 2:56 pm

Pugsy wrote:
Sat Dec 04, 2021 2:23 pm
BTW you may see me use the term Pressure Support (PS) sometimes instead of "difference between inhale and exhale" because that's actually the official term.
Using EPR creates pressure support but until newbies learn about what bilevel does and exhale relief causes a bilevel situation...sometimes it's easier to use the "difference" thing.
Essentially the same thing but a bilevel machine and your autoset go about obtaining that difference in a different way.
Thanks again for all of your feedback. I'm struggling to figure out how to understand Flow Limitation and how to get my graph to look like the Wiki help page. Is it wise to turn on EPR at such an early stage? Should I give it a month or so?

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Pugsy
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Re: New CPAP User Looking for OSCAR Feedback

Post by Pugsy » Sat Dec 04, 2021 3:13 pm

See if this video helps you understand flow limitations a bit better.
https://www.youtube.com/watch?v=-gie2dhqP2c

I don't know what you are trying to obtain in terms of graphs that look like the Wiki thing but what you are showing now is fine by me and if someone needs something different they can just ask.

I sense some hesitancy about turning EPR on full time or setting it to 3...heck...try 1 if you want to go slow.

Try the setting of 3 while awake and under no pressure to sleep...just see if you like it or not. You may not even like it.
You do need the minimum of 7 to be able to feel the difference with EPR at 3 though.
With the starting pressure of 5...the most drop you can actually get even with a setting of 3 is down to 4 cm because the machine can't go below 4.

You seem to fear EPR and centrals and there's really no need to fear either but if you want to wait until you are more comfortable. That's entirely up to you.

There is no urgent need to go changing anything ...... that's why I asked you if you are comfortable making changes yourself.

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Miss Emerita
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Re: New CPAP User Looking for OSCAR Feedback

Post by Miss Emerita » Sat Dec 04, 2021 3:17 pm

As Pugsy has emphasized, you are not going to hurt yourself by trying EPR. It is fine to set it to 1 at first, then go up to 2 and 3.

Flow limitations are limitations on the flow of air through the airway. Sometimes they are in the nose, in which case pressure support is unlikely to help. Often they are in the pharynx, where the tissues lining the airway may relax some during sleep. The limitations can cause you to work harder to complete an inhalation, and that effort can keep you from having as much deep and REM sleep as you need. It can also just be tiring, in some cases.

I use the same machine as Pugsy does, with pressure support of 5. This dramatically reduced my flow limitations, and I think this in turn helps me to sleep better.
Oscar software is available at https://www.sleepfiles.com/OSCAR/

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BatmanMatt
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Re: New CPAP User Looking for OSCAR Feedback

Post by BatmanMatt » Sat Dec 04, 2021 3:57 pm

Miss Emerita wrote:
Sat Dec 04, 2021 3:17 pm
As Pugsy has emphasized, you are not going to hurt yourself by trying EPR. It is fine to set it to 1 at first, then go up to 2 and 3.

Flow limitations are limitations on the flow of air through the airway. Sometimes they are in the nose, in which case pressure support is unlikely to help. Often they are in the pharynx, where the tissues lining the airway may relax some during sleep. The limitations can cause you to work harder to complete an inhalation, and that effort can keep you from having as much deep and REM sleep as you need. It can also just be tiring, in some cases.

I use the same machine as Pugsy does, with pressure support of 5. This dramatically reduced my flow limitations, and I think this in turn helps me to sleep better.

I’m going to live free and try it all out tonight. What’s a good starting pressure typically? Mines at 4.

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Pugsy
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Re: New CPAP User Looking for OSCAR Feedback

Post by Pugsy » Sat Dec 04, 2021 5:33 pm

You are using ramp for 15 minutes.
Ramp starting pressure defaults to the minimum the machine can go which is 4 cm but it can actually be set to anything.
I do suggest turning ramp off if it isn't needed because during ramp the machine doesn't record or respond to anything...and if starting low enough it shouldn't be needed anyway.
Like your prior 5 cm minimum pressure....the machine starts at 4 and takes 15 minutes to get up to 5. Big whoopie. :lol:
Now if your starting minimum was up around 12 or higher...ramp might be more of a help.
Besides a lot of people feel air starved at 4 or 5 cm.

When you do the awake trial just to see what the 3 EPR and 7 minimum feels like...turn ramp off. Otherwise it will take 15 minutes to get the full effect.

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BatmanMatt
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Re: New CPAP User Looking for OSCAR Feedback

Post by BatmanMatt » Sat Dec 04, 2021 5:37 pm

Pugsy wrote:
Sat Dec 04, 2021 5:33 pm
You are using ramp for 15 minutes.
Ramp starting pressure defaults to the minimum the machine can go which is 4 cm but it can actually be set to anything.
I do suggest turning ramp off if it isn't needed because during ramp the machine doesn't record or respond to anything...and if starting low enough it shouldn't be needed anyway.
Like your prior 5 cm minimum pressure....the machine starts at 4 and takes 15 minutes to get up to 5. Big whoopie. :lol:
Now if your starting minimum was up around 12 or higher...ramp might be more of a help.
Besides a lot of people feel air starved at 4 or 5 cm.

When you do the awake trial just to see what the 3 EPR and 7 minimum feels like...turn ramp off. Otherwise it will take 15 minutes to get the full effect.
I just set ramp to auto.

I think I’m going to like EPR because I feel most comfortable when the EPR is active during the ramp up until now.

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Pugsy
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Re: New CPAP User Looking for OSCAR Feedback

Post by Pugsy » Sat Dec 04, 2021 5:49 pm

Ramp set to auto will start out at 4 cm unless you change it and it won't do anything really until you fall asleep or at least the machine thinks you are asleep.
So it won't go above 4 cm unless it thinks you are asleep or 30 minutes have passed. Whichever comes first in auto mode for ramp.

Regular ramp mode there is a linear increase gradually from the 4 cm starting pressure up to your minimum pressure setting.
Gradually increases the pressure over whatever period of time you have selected for ramp to be on.

Remember the machine can't drop below 4 cm...so until the pressure gets up to 7 cm it won't/can't give you a full 3 cm drop with EPR set to 3.

So in auto ramp mode....the machine will stay at 4 cm until it either thinks you are asleep or 30 minutes has passed.

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BatmanMatt
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Re: New CPAP User Looking for OSCAR Feedback

Post by BatmanMatt » Sat Dec 04, 2021 6:00 pm

Pugsy wrote:
Sat Dec 04, 2021 5:49 pm
Ramp set to auto will start out at 4 cm unless you change it and it won't do anything really until you fall asleep or at least the machine thinks you are asleep.
So it won't go above 4 cm unless it thinks you are asleep or 30 minutes have passed. Whichever comes first in auto mode for ramp.

Regular ramp mode there is a linear increase gradually from the 4 cm starting pressure up to your minimum pressure setting.
Gradually increases the pressure over whatever period of time you have selected for ramp to be on.

Remember the machine can't drop below 4 cm...so until the pressure gets up to 7 cm it won't/can't give you a full 3 cm drop with EPR set to 3.

So in auto ramp mode....the machine will stay at 4 cm until it either thinks you are asleep or 30 minutes has passed.
So turn ramp off?

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Pugsy
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Re: New CPAP User Looking for OSCAR Feedback

Post by Pugsy » Sat Dec 04, 2021 6:11 pm

I would turn ramp off for sure for the awake test of 7 cm minimum and EPR set to 3.

Now as to using it to fall asleep...it's only there for your own personal comfort. If you don't feel you need it then turn it off.
If you like the really low pressure and seem to need it to relax...by all means use ramp.

Ramp use is strictly personal comfort. Most people find that 4 cm is actually more uncomfortable than a higher pressure with EPR engaged. It's okay to use ramp if you need it and like it. Just make sure you understand what it does or doesn't do.
Like nothing gets recorded during ramp. Doesn't mean something didn't happen...just means the machine didn't record it.
Probably not a big deal since your starting minimum is on the low side and your ramp time is rather short at 15 minutes but if your minimum was say 10...and the ramp time was 45 minutes...there's a potential for a lot of apneas to happen before the machine gets up to full pressure and we wouldn't know it because nothing gets recorded.

My usual advice to people....keep ramp off unless you just have to use it to slowly work up to a higher starting pressure.

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BatmanMatt
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Re: New CPAP User Looking for OSCAR Feedback

Post by BatmanMatt » Sun Dec 05, 2021 6:59 am

Pugsy wrote:
Sat Dec 04, 2021 6:11 pm
I would turn ramp off for sure for the awake test of 7 cm minimum and EPR set to 3.

Now as to using it to fall asleep...it's only there for your own personal comfort. If you don't feel you need it then turn it off.
If you like the really low pressure and seem to need it to relax...by all means use ramp.

Ramp use is strictly personal comfort. Most people find that 4 cm is actually more uncomfortable than a higher pressure with EPR engaged. It's okay to use ramp if you need it and like it. Just make sure you understand what it does or doesn't do.
Like nothing gets recorded during ramp. Doesn't mean something didn't happen...just means the machine didn't record it.
Probably not a big deal since your starting minimum is on the low side and your ramp time is rather short at 15 minutes but if your minimum was say 10...and the ramp time was 45 minutes...there's a potential for a lot of apneas to happen before the machine gets up to full pressure and we wouldn't know it because nothing gets recorded.

My usual advice to people....keep ramp off unless you just have to use it to slowly work up to a higher starting pressure.
Had a bad night last night. EPR made the mask feel like it was repeatedly sucking to my face. Had to even turn it off for the ramp.

My nose airway contracted enough to force my mouth open. Not congestion more like… it just blocked it itself.

New problems. I guess I go back to what I was doing and try to figure out my nose problem?

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Julie
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Re: New CPAP User Looking for OSCAR Feedback

Post by Julie » Sun Dec 05, 2021 7:47 am

Try EPR on a lower (lowest?) setting.

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BatmanMatt
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Re: New CPAP User Looking for OSCAR Feedback

Post by BatmanMatt » Sun Dec 05, 2021 7:51 am

Julie wrote:
Sun Dec 05, 2021 7:47 am
Try EPR on a lower (lowest?) setting.
Once I felt the sucking sensation even the lowest setting bothered me.

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Pugsy
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Re: New CPAP User Looking for OSCAR Feedback

Post by Pugsy » Sun Dec 05, 2021 8:24 am

Ahh...the brain went into hyper drive once you experienced a sensation you didn't like and it made things worse.
The brain isn't always our best friend.

Did you do an awake test to see what it felt like? If so, for how long?

Here's the deal about experiments...sometimes they work out and we learn that we like something and sometimes all we learn is what a bad idea that experiment was at that time.

Back up and go back to what was comfortable for you and keep telling your brain that "you used to be okay with this" and see if things will calm down sensory wise.

Sleep is always going to be your primary goal and if you aren't comfortable the sleep is going to be hard to come by.
Remember that YMMV sticker...it's on everything and there's nothing wrong with it. We accept it and move on.

With any experiment we always learn something. Now sometimes all we learn is what a bad idea that was but we learn about our own personal preferences, wants and needs.

I have no idea why the congestion just now wants to rear its ugly head. That doesn't compute because we didn't change anything that might cause congestion.

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BatmanMatt
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Re: New CPAP User Looking for OSCAR Feedback

Post by BatmanMatt » Sun Dec 05, 2021 8:30 am

Pugsy wrote:
Sun Dec 05, 2021 8:24 am
Ahh...the brain went into hyper drive once you experienced a sensation you didn't like and it made things worse.
The brain isn't always our best friend.

Did you do an awake test to see what it felt like? If so, for how long?

Here's the deal about experiments...sometimes they work out and we learn that we like something and sometimes all we learn is what a bad idea that experiment was at that time.

Back up and go back to what was comfortable for you and keep telling your brain that "you used to be okay with this" and see if things will calm down sensory wise.

Sleep is always going to be your primary goal and if you aren't comfortable the sleep is going to be hard to come by.
Remember that YMMV sticker...it's on everything and there's nothing wrong with it. We accept it and move on.

With any experiment we always learn something. Now sometimes all we learn is what a bad idea that was but we learn about our own personal preferences, wants and needs.

I have no idea why the congestion just now wants to rear its ugly head. That doesn't compute because we didn't change anything that might cause congestion.
I suspect my nose is closing up more than I thought. I’ve woken up with my mouth open and bloating and gas several times. Any tips?

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Pugsy
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Re: New CPAP User Looking for OSCAR Feedback

Post by Pugsy » Sun Dec 05, 2021 8:38 am

BatmanMatt wrote:
Sun Dec 05, 2021 8:30 am
I suspect my nose is closing up more than I thought. I’ve woken up with my mouth open and bloating and gas several times. Any tips?
You are using a full face mask...is that correct? So any mouth breathing won't harm therapy effectiveness since the mouth is part of the sealed circuit. Mouth breathing is what we do when we can't breathe through our nose.
So ideally we try to fix the cause of the congestion.

As for bloating and gas...common complaint and it's called aerophagia.
https://www.cpaptalk.com/wiki/index.php/Aerophagia

Is this the first time you have experienced it?
You won't like the usual go to fix for it....increase EPR. :lol:

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