Help understanding OSCAR data / optimizing treatment

jmrose · Post by **jmrose** » Mon Aug 17, 2020 10:43 am

Thanks, Miss Emerita. I will try that soft cervical collar and see how that goes. This'll be my next change. One step at a time. And thank you for clarifying the CA data.

Tiny steps! All worth it.

zonker · Post by **zonker** » Mon Aug 17, 2020 11:12 am

jmrose wrote: ↑
Mon Aug 17, 2020 9:19 am
No problem, zonker! (I started seeing some posts about attachments not uploading here because of space reasons and thought maybe that's why you didn't see mine.)

a little tip-when you compose this reply, you'll see at the bottom of the text window "save draft" "preview" and "submit". if you hit the preview button first, you'll see exactly what you will post. that includes any attachments.

jmrose · Post by **jmrose** » Mon Aug 17, 2020 12:10 pm

Got it! Thanks, zonker.

jmrose · Post by **jmrose** » Fri Jun 11, 2021 12:04 pm

This is a follow-up to the last post I made, which was 10 months ago.

I am so appreciative of the feedback I received to my earlier posts. At miss emerita's suggestion, I tried a soft cervical collar, and that made a HUGE difference, overall. I also changed the min pressure on my machine to 7 (it had been 4). Definitely works better. Since last fall, my nightly AHI has been often under 1, sometimes a little over. Feeling good. The fatigue / brain fog / morning headaches have stayed away.

However ... I still sometimes struggle with some aerophagia. It's not too bad (like it used to be) — some nights are better than others.

I've been reading about ways to manage that and have tried a few things. I tried upping my lower pressure past 7, but even at 7.4, the aerophagia just got worse. I lowered the max pressure to 18 (and have kept it there — my average pressure is 10.5. Max pressure is between 14-16).

EPR is 1. Ramp is off. Not sure if this is relevant, but humidity level is 4, and I also have a humidifier on at night. I'm a side sleeper , and I keep my head a bit elevated.

Also, about a month ago, I started using mouth tape — no more mouth breathing. I use XClear spray and a Breathe Rite strip (deviated septum), which has helped keep things (more) clear.

Any thoughts on what else I can do to try and minimize the aerophagia?

Pugsy · Post by **Pugsy** » Fri Jun 11, 2021 12:10 pm

You might try increasing EPR to 3 and see how much of an impact that makes on the aerophagia issues ....also would be interesting to see what happens with the Flow Limitations which are your primary culprit driving the pressures up.

jmrose · Post by **jmrose** » Fri Jun 11, 2021 12:44 pm

Thanks, Pugsy. I'll try that.

fstrife · Post by **fstrife** » Fri Jun 11, 2021 6:38 pm

Does the cervical collar help with the CAs? Or did those just gradually reduce as you got used to the pressure?

Pugsy · Post by **Pugsy** » Fri Jun 11, 2021 6:46 pm

fstrife wrote: ↑
Fri Jun 11, 2021 6:38 pm
Does the cervical collar help with the CAs? Or did those just gradually reduce as you got used to the pressure?

The cervical collar will only help with keeping the airway open or more stable from the obstructive apneas and hyponeas.
It won't do much to help reduce central apneas because the reason for a central apnea is the brain isn't sending the signal to breathe but the airway is open and not blocked. So the lack of air flow is from simply not breathing and not because the airway is blocked so the collar won't really do much to tell your brain to send the "breathe" signal to your body.

To reduce central apneas we have to figure out what is causing the brain to not tell the body to breathe and try to fix that cause if at all possible.
Bear in mind a few centrals are normal and no big deal. Centrals are only a problem when present in really large numbers and maybe causing desats or bouncing someone repeatedly out of sleep.

And yes...sometimes centrals will reduce with time and the body just getting used to the cpap pressures....it all depends on if the cpap pressure itself is the cause of the centrals. Sometimes there are other causes...cpap pressure isn't the sole cause of centrals.

zonker · Post by **zonker** » Fri Jun 11, 2021 8:19 pm

jmrose wrote: ↑
Fri Jun 11, 2021 12:04 pm

However ... I still sometimes struggle with some aerophagia. It's not too bad (like it used to be) — some nights are better than others.

Any thoughts on what else I can do to try and minimize the aerophagia?

went through this particular hell my ownself. got to the point about two years ago where it was really having an impact on my therapy. pugsy has said many times that anything that disrupts sleep is unwanted. after all, how can you lower your ahi at all if you can't actually sleep?

so, here is what i did. i ignored my ahi altogether. i lowered my minimum pressure. i kept going back until i found a point where i could tolerate the machine and have no or very little aerophagia.

at this point, i don't remember what that minimum pressure was. but for sake of this discussion, let's say it was 13. i set my machine at min of 13 and max of 20. i was using the very same machine yiu use. and that's important. because i could raise my min pressure by .2 at a time.

i'd push that sucker up, give a few nights and then, if i still felt okay, i'd raise it another .2 and so on. AT ANY TIME if i felt the aerophagia monster coming on, i'd dial it back. i'd let it settle for a few nights and i'd try again.

the drawback to this method (which forum friend dogslobber calls "the zonker protocol".) is that it took months to do. BUT i succeeded in the end!

today, i use a pressure from 18 min to 20 max with no problems.

now, mind you, i still get gas. that hasn't gone away. but i don't have that belly tightening pressure that i suffered from for so long.

i know it's a lot to do. but maybe if pugsy's suggestion of epr doesn't work out, you can try it.

good luck!

jmrose · Post by **jmrose** » Sat Jun 12, 2021 11:06 am

Thanks, Zonker. It's good for me to read other people's stories about this. Just knowing it's a process (instead of a quick, easy solution) is helpful. Good to hear that you "zonker protocol-ed" your way to machine-setting success!

Last fall, I tried upping that lower pressure by increments over a month — I went as high as 7.6, from 4 (I didn't know any better, and neither did my doctor) — then I backed off to 7, where things felt more comfortable.

I keep thinking of when I first started using my machine, and I had the WORST aerophagia. Awful (as you well know). But, over a couple of months, things got better. I may try to up that lower pressure by .2, again, and see what happens. Could be that I just needed lots more time to adjust to the 7 setting, and I could go higher.

And I will for sure try pugsy's suggestion of changing the EPR. (Didn't try it last night. I know this sounds weird, but I have to "psyche" myself up to make any changes to the machine, especially when I know it's working for me pretty well, most of the time.)

zonker · Post by **zonker** » Sat Jun 12, 2021 11:35 am

jmrose wrote: ↑
Sat Jun 12, 2021 11:06 am
Thanks, Zonker. It's good for me to read other people's stories about this. Just knowing it's a process (instead of a quick, easy solution) is helpful. Good to hear that you "zonker protocol-ed" your way to machine-setting success!

that's why i say we are each of us different. and we have to explore any option (within reason, of course!) to see what works or not for each of us.

keep us posted on how you go, please.

Help understanding OSCAR data / optimizing treatment

Re: Help understanding OSCAR data / optimizing treatment

Re: Help understanding OSCAR data / optimizing treatment

Re: Help understanding OSCAR data / optimizing treatment

Re: Help understanding OSCAR data / optimizing treatment

Re: Help understanding OSCAR data / optimizing treatment

Re: Help understanding OSCAR data / optimizing treatment

Re: Help understanding OSCAR data / optimizing treatment

Re: Help understanding OSCAR data / optimizing treatment

Re: Help understanding OSCAR data / optimizing treatment

Re: Help understanding OSCAR data / optimizing treatment

Re: Help understanding OSCAR data / optimizing treatment