Oscar stat review and help.

masterpkpk · Post by **masterpkpk** » Sat Aug 29, 2020 5:39 am

Hey ya'll. I've been lurking for a while now and finally got a night with a cpap machine! Sorry if i'm breaking any rules with this post, i'm still trying to learn all of the in's and outs of the forum. 3 years ago i did a sleep study and came back with an AHI of 5.36. The doctor dismissed it as not being problematic and told me it was likely depression that was causing my excessive sleepiness. My partner has been telling me for a while now that i sound like i'm dying in my sleep, so i went ahead and picked up a machine and used it for the first time last night. I would love if one of you could look over my chart and tell me what you think about min/max pressure and all that jazz. Thanks! - Billy

Pugsy · Post by **Pugsy** » Sat Aug 29, 2020 6:34 am

Do the entire detailed report image and not just a 4 minute segment please.
Show the entire night.
Also....did you sleep soundly or poorly with lots of wake ups?
Were you awake around that 23:30 time frame when the clusters showed up?
If asleep....on your back or on your side if you know???

You zoomed in on one CA/central apnea....and you weren't asleep when that event was flagged.

masterpkpk · Post by **masterpkpk** » Sat Aug 29, 2020 6:40 am

Whoops. Hopefully this screenshot is what you're looking for. Still very new to the program! I don't remember waking up at all so i'd say i slept soundly? I alternate between back and side sleeping, and i don't believe i was awake during that cluster.

Pugsy · Post by **Pugsy** » Sat Aug 29, 2020 7:55 am

It's one night and the first night and if it were my report I would leave things as they are for right now and get 3 or 4 nights and see how things trend. I already know of one flagged event that isn't real...that one you zoomed in on. I am betting some of the others are arousal related as well. Just how many we don't know but the machine responds to awake events with more pressure just like asleep events so I don't know for sure if that one hour where mainly everything got flagged you were really asleep...or on your back or maybe in REM sleep which can also worsen OSA.

Go here and watch the videos. It talks about SleepyHead but since OSCAR is based on SleepyHead all the steps are the same.
http://freecpapadvice.com/sleepyhead-free-software

We don't treat central apneas with more pressure...it can't fix them or prevent them.
Only the OAs and hyponeas ...and your OAs make up about half your AHI. The other half is central.

You might consider increasing the minimum to 7 if after examining that hour of mainly OAs....you feel you were asleep.
Your flow limitation graph is a little active but not horrible and is probably the driving force for the pressure changes..
How important it might be in the grand scheme of things is hard to say based on one night and the first night at that.

Snore statistics show 0.0....so no snoring. That's good.

masterpkpk · Post by **masterpkpk** » Sat Aug 29, 2020 8:16 am

okay great. thanks for the reply! I noticed on another post you mentioned turn EPR off. Would you recommend that?

Pugsy · Post by **Pugsy** » Sat Aug 29, 2020 8:33 am

Actually I only recommend turning EPR off when we suspect the number of centrals might be reduced by a reduction in EPR or turning it off and that's only needed when we see more centrals than we want to see and we are for sure asleep when those centrals get flagged.
Otherwise if using EPR isn't a problem and someone likes it...I see no reason to not use it. I happen to use the equivalent of EPR of 4 on my machine. I really like it and it doesn't cause me any problems so I use it.

You aren't having enough centrals to worry about at this point even if every single one of your centrals were the real deal...and I already know they aren't all asleep centrals.

EPR is mainly a comfort feature...makes the breathing easier and more comfortable and more natural feeling.
I have always felt people need to be able to fall asleep and without sleep...none of this data matters.
Now there is a very small percentage of people that have a problem with EPR or any exhale relief and it triggers some unstable breathing which ends up with the person having a lot of centrals. You are no where close to the number of centrals being a problem. It's normal to have a few centrals here and there anyway.
But using EPR can also help out with flow limitations as well in some people....so while mainly comfort...there is also a chance of a therapy effectiveness component. If you like it...use it. I see not reason at this time that would point to it being a problem.

BUT remember we are only seeing one night report. I don't like to do much changing of anything based on one night unless there is an urgent need....and there isn't an urgent need here.

Any awake/arousal related flagged events that might be seen....we have to ignore. You must be asleep for it to matter and don't assume that because you don't remember being awake doesn't mean arousals didn't happen. We only remember being awake when we are awake long enough to form a memory of the awakening.

masterpkpk · Post by **masterpkpk** » Sat Aug 29, 2020 9:02 am

I see. Thanks for the thorough explanation. Is there a way to tell when you are awake with this data? ill go ahead and keep the settings where they are at for the next few days and then come back with more data.

Pugsy · Post by **Pugsy** » Sat Aug 29, 2020 9:15 am

Yes, sort of a way to figure out awake/arousal vs asleep by examination of the flow rate.

http://freecpapadvice.com/sleepyhead-free-software

Watch the videos. While mainly talking about central/CA apneas...it can actually be any category flagged.

Sometimes easy to tell...sometimes not so easy but usually can get close with the estimate.

Like your zoomed in flagged CA/central above. That is not asleep breathing prior to the flag. Asleep breathing is regular and rhythmic....doesn't vary much. Awake/arousal breathing is very irregular when compared to asleep breathing.

Example below....asleep breathing is circled in red. Everything after that is arousal/awake breathing and not real and don't count.

and a more zoomed out shot of the same thing

Miss Emerita · Post by **Miss Emerita** » Sat Aug 29, 2020 11:05 am

Billy, congratulations on taking your treatment into your own hands. Plus you got in a full night with the machine on your first night, you seem to have the mask-fit challenge under control, and you're using Oscar -- way to go.

I'm curious, did your partner notice a difference in those "dying in your sleep" noises?

Once you have a few more charts to post, I'm sure Pugsy and others can help you tweak your settings.

zonker · Post by **zonker** » Sat Aug 29, 2020 11:28 am

masterpkpk wrote: ↑
Sat Aug 29, 2020 5:39 am
Hey ya'll. I've been lurking for a while now and finally got a night with a cpap machine! Sorry if i'm breaking any rules with this post, i'm still trying to learn all of the in's and outs of the forum.

welcome to the zoo!

and yes, you've broken all the rules. now, get ou!!

joking, of course. and if you've been lurking here for any time, you know you've got one of the best helping you out.

er, i mean pugsy, not me!

good luck!

masterpkpk · Post by **masterpkpk** » Sun Aug 30, 2020 1:11 pm

So i tweaked the minimum pressure up a bit after reading what pugsy wrote. looks like i had a pretty good night last night! Woke up this morning and got out of bed with little to no effort. that never happens! only night 2 of course but still exciting nonetheless. Anyone see anything i should look out for?

masterpkpk · Post by **masterpkpk** » Mon Aug 31, 2020 5:22 am

Here is my third night. Woke up with my mask off this time. Is my minimum pressure looking good?

Pugsy · Post by **Pugsy** » Mon Aug 31, 2020 5:54 am

I would leave things alone for a couple of nights and just get used to using the machine and watch to see if any trends develop.
The one time where the machine went a lot higher...you are probably on your back or maybe in REM or maybe both.
If you see this happening every night...try 7 minimum.

masterpkpk · Post by **masterpkpk** » Mon Aug 31, 2020 9:12 am

Sounds like a plan! One question I have. Is it fairly normal to still feel pretty tired? First two nights had me waking a lot easier than normal, but feeling tired later in the day as per usual.

zonker · Post by **zonker** » Mon Aug 31, 2020 10:15 am

masterpkpk wrote: ↑
Mon Aug 31, 2020 9:12 am
Sounds like a plan! One question I have. Is it fairly normal to still feel pretty tired? First two nights had me waking a lot easier than normal, but feeling tired later in the day as per usual.

for most of us, changes come slowly on cpap. and it can be more of a gradual thing rather BOOM i feel less tired thing.

got to get your brain and body used to the machine, first. neither is keen to let go of the old ways of sleeping, even though those ways weren't the best.

hang in there,

you'll make it.

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