Help with Oscar

I'll follow your advice and I'll report back. Thank you very much for your help.

Will you, please, analize the chart from last night? I had change the settings to 7.2 and 10 but I see now that it's not the case. How do I get it fixed on the machine? Autoset on or CPAP?

AHI is higher and overal it seems worse than usual.

https://sleephq.com/public/2ee4ba67-dbb ... ccb719e7ae

You'll find written instructions here - the Autoset 10 manual
https://www.respshop.com/manuals/ResMed ... %20her.pdf

Page 17 "Adjusting the clinical setting"

Do it slowly, not before you're going to bed but rather earlier. You want the Autoset mode, and notice which pressure you're setting, minimum or maximum

Tonight's chart also shows that you're snoring and having flow limitations and obstructive apneas hypopneas. The slightly higher AHI is nothing to be concerned about - our sleep varies.

Ana2024 wrote: ↑

Thu Mar 21, 2024 12:46 am

Will you, please, analize the chart from last night? I had change the settings to 7.2 and 10 but I see now that it's not the case. How do I get it fixed on the machine? Autoset on or CPAP?
(snip)

Your pressure did not change. 7 is too low, you need some more. Min 7, max 10, sounds good for you. You need mode Autoset, this will show the range settings.

Here, watch some LankyLefty27 video, he's funny and he can help:

https://youtu.be/XjsQUFJeb7U?si=W45ENBCL0UlwbUZl&t=134

You should set the Mode to Autoset, then you can see Min Pressure and Max Pressure... set them as above... voila!

Then go back up and Exit Clinical Mode. Now your machine can raise pressure some when you have problems. Sleep with this and share another report, you're doing good!

Thank you for the instructions.
This is the chart from last night. I woke up in the middle of it and it took me some hours to sleep again.

https://sleephq.com/public/11dd7144-e3e ... 189d5c5d40

I must add a few questions regarding the machine settings from the chart. It shows that the humidifier is ON with a humidity level 4. I don't use the humidifier. Also a temperature of 27 C. What do these mean?

How do you feel today? How did you feel with the higher pressures? Do you know what woke you up? What kind of waking was it?


About the humidifier:
Do you mean you have no humidifier? Or do you mean you don't put water in it?
Do you have a heated hose ("Climateline")?

Temp. of 27 and humidifier at 4 are the default settings when the machine is set on Auto for humidity.
If you don't have a humidifier, or prefer not to put water in it, you should go the settings, choose "manual" for humidity, and the dial both the humidity and the temp down to nothing.

Stick to these pressure settings for a few more nights, even though they already show that your never actually stay at 7. Actually, the median pressure shows you spend half the night at a pressure of 9.2, or above.

Thank you for your answer. I can't think of a reason why I woke up suddenly in the middle of the night. That's not my usual sleep pattern. Nevertherless I feel all-right.

Yesterday I made an appointment with my family doctor who prescribed an extensive blood test.
And I just made contact with the provider and they agreed to change the pressure to 7-11.
I'll report back in a few days.

Ana2024 wrote: ↑

Fri Mar 22, 2024 6:55 am

Thank you for your answer. I can't think of a reason why I woke up suddenly in the middle of the night. That's not my usual sleep pattern. Nevertherless I feel all-right.

That's great. Does it also mean you were not alarmed or sweaty when you woke up?

Yesterday I made an appointment with my family doctor who prescribed an extensive blood test.
And I just made contact with the provider and they agreed to change the pressure to 7-11.
I'll report back in a few days.

Sounds like you're on the right track - or maybe I should say tracks.
And yes, definitely let us know what's going on.
How you feel is always an important part of the info.

Back with the charts from the last few days. Pressure is changed by the provider to 7-11.
I don't wake up alarmed and I sweat less or nothing at all. Was that related to adrenaline or that my heart was working at turbo speed?
I feel a bit more tired during the day but it may have to be related to the season and the unpleasant weather conditions. Rain, rain and more rain.

Will you please, advise if more adjustments should be made regarding the therapy? Thanks in advance.

https://sleephq.com/public/b0557b78-875 ... 0c567df503

I see no relevant data on the charts I posted. Second try

https://sleephq.com/public/83a3ed7c-fd8 ... 4426a02b02
https://sleephq.com/public/73d7ada3-0ab ... 7a9b2f13eb
https://sleephq.com/public/0a3d47c6-28d ... 6ec9e1b0e7
https://sleephq.com/public/a6647832-dcb ... 4d16ad1c59

Ana2024 wrote: ↑

Mon Apr 01, 2024 1:53 pm

Back with the charts from the last few days. Pressure is changed by the provider to 7-11.
I don't wake up alarmed and I sweat less or nothing at all. Was that related to adrenaline or that my heart was working at turbo speed?
I feel a bit more tired during the day but it may have to be related to the season and the unpleasant weather conditions. Rain, rain and more rain.

The charts you posted in the next post are very informative.

I'm glad you no longer waking up alarmed and sweat soaked.

The charts all show that when the machine thinks you're breathing smoothly, it drops the pressure, and then at about a pressure of 8 you begin having all the marks of obstruction, whether full or partial, at which point the pressure is pushed up again, and, then as the American's say: "wash and repeat".

The statistics info shows you're spending half the time at a pressure of about 10 or above it ("Median Pressure"). You can also see on the flow charts how your breathing looks pretty smooth at 10, then the pressure drops, and has to zoom up again. If this were my data, I'd try to set the minimum at 10 in the hope of preventing more of those airway full or partial collapses - those we can see in apnea, hypopneas, the beginnings of snores, and in flow limitations.

I would also set the ramp to a minimum of 7 - no need for it to be on 4, unless you feel that's necessary for you to fall asleep.

If the provider only looks at the AHI, they may say no change is necessary. If they look at the flow charts, the snores and the flow limitation, they may agree.

You're doing a great job in taking care of yourself!

About the adrenaline: As far as I know a "turbo speed" hear beat is one of the result of adrenaline secreted in the body. I don't of course what happened in your body, but since it almost no longer happens, it seems to me an academical question.

Thank you very much for your prompt answer.

Following your advice I'll set de machine to pressure 10-11. And the ramp to 7 as I have no trouble falling asleep and see if it works better for me.

If you don't mind I'll post new charts in the following days. I think you solved my issues!

Ana2024 wrote: ↑

Tue Apr 02, 2024 1:10 am

Thank you very much for your prompt answer.

Following your advice I'll set de machine to pressure 10-11. And the ramp to 7 as I have no trouble falling asleep and see if it works better for me.

If you don't mind I'll post new charts in the following days. I think you solved my issues!

We never mind if people post new charts after they make changes. We all learn from that.

Back again. Please look at the records of the last three days. Do I have to change anything in the therapy? I feel tired in the morning. The changes applied to the pressure seem to work although the AHI's results are different every day.

https://sleephq.com/public/6d5e381a-bdb ... 31777ecaf1
https://sleephq.com/public/2a78f2c2-3fd ... bb0201c6e9
https://sleephq.com/public/d96cd635-440 ... 6fe3f76d9a

Please advise.

Ozij is away from her computer this weekend doing fun family stuff and she asked me to keep an eye on you if you posted.
She will catch up in a couple or 3 days.

First of all...the AHI varying each night....that's entirely normal. We expect to see variations because we don't sleep the same each night. I would be more concerned if it didn't vary because lack of variation would NOT be normal.
AHI is going to vary and pressure needs are going to vary each night even if we didn't change any settings. I haven't changed my settings in years now and my AHI still varies every single night.

I did a quick scroll through your 3 nights above.

Fri April 5.....pretty much all your flagged events aren't asleep flagged breathing....arousal/awake related. The arousal breathing is clearly shown PRIOR to the reduction in air flow and subsequent flagging.

Thurs April 4.....more of the same as Fri 4/5

Wed April 3..... more of the same as the other 2 nights.

You have both OAs and centrals flagged but pretty much all of them you have evidence of arousal/awake breathing PRIOR to the reduction and the flagging. You weren't sound asleep so other than pointing to not being asleep they really don't mean much.

How would you say your overall sleep quality was???? Do you remember very many arousals/awakenings or do you feel you slept soundly?

You have quite a bit of arousal breathing being shown without any flagging going on. Very brief and you probably won't remember those but some segments of arousal breathing were a bit prolonged and you might remember those.

So....IMHO you have a sleep quality problem and not so much is it from airway issues...poor sleep quality from some reason or other but not related to airway issues and your AHI. It's not like you have a real asleep apnea happen and THEN the arousal breathing happens which is to be expected......you have the arousal breathing PRIOR to the flow reduction that earns a flag. We don't take big gulps of air (easily seen on the flow rate zoomed in on) when we are asleep.

I haven't read back through all your posts to refresh my memory but I would look hard at any factors that might be disturbing my sleep.
Medication side effects...or other physical or mental health issues.

Your report looks a lot like mine looks....crappy sleep quality with lots of arousal breathing and the majority of any flagged events aren't related to airway issues but instead related to not being asleep.
In my case I have crappy sleep from back/pelvic pain issues. Been a struggle for sure. Fixing the OSA side of my problems was easy....fixing the crappy sleep from the pain is not so easy. It's a battle I expect to wage and sometimes I win and sometimes I lose. At least 75% of any AHI I might have is always arousal/awake related flagging....and yes it varies widely from night to night mainly because my sleep quality varies widely from night to night.

Ozij will be back the first of the week. I will be here though if you need me.

Actually....any of the above reports are quite acceptable at least in terms of the data. I wouldn't go changing anything but instead work on trying to figure out why the sleep quality isn't anywhere near close to "normal".
It's normal to have a few arousals....but you were having more than "a few" plus the nights with the higher AHI...higher number of arousals to increase the chance of arousal flagged event.