How is my wife doing based upon these two screenshots from OSCAR

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Jeffj318
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by Jeffj318 » Mon Nov 22, 2021 10:59 am

Hello, "Doctor" Pugsy and all CPAP friends.
Just checking in for a follow-up to make sure how my wife is coming along.
I picked what I think is one very good night and one mediocre night.

How are the event flags looking? Leak rate? EPR is zero and starting pressure remains at 7.
She normally sleeps through the night and appears refreshed in the morning.
You might remember she has Stage 4 colon cancer.
She received a second opinion, and for positive reasons, maintenance chemo was stopped 6 months ago. Only scans every three months at this time.

I hear what I guess are leaks or at least a "wind" sound, however, Michele never wakes up so it must not be bothering her.
If all is good, then let's not rock the boat as Pugsy said earlier in these posts.
Thanks for the invaluable assistance. I am forever thankful to gain such great insight rather than what MyAir shows or most Facebook groups.
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Okie bipap
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by Okie bipap » Mon Nov 22, 2021 7:56 pm

Even the "mediocre" night looks pretty good. Leaks are a little high, but if they aren't bothering her sleep, I wouldn't worry about them. The only thing I see is her flow limits graph is pretty active. Looking at the pressure graph, her pressure seldom drops much below 11, I would raise her minimum pressure to at least 10, or maybe even 11.
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GrumpyHere
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by GrumpyHere » Mon Nov 22, 2021 9:22 pm

And if she has problems exhaling against 10 or 11 (per Okie's suggestion) while falling asleep, try using EPR.
Designed to make therapy more comfortable, Expiratory Pressure Relief (EPR) maintains optimal
treatment for the patient during inhalation and reduces the delivered mask pressure during
exhalation.

EPR
On—EPR is enabled.
Off—EPR is disabled.

The following settings are only available if EPR is On:

EPR Type
Full Time—If set to Full Time, EPR is enabled for the whole therapy session.
Ramp Only—If set to Ramp Only, EPR is only enabled during ramp time.

EPR Level
1, 2, 3 cm H2O (1, 2, 3 hPa)

When EPR is enabled, the delivered pressure will not drop below a minimum pressure of 4 cm H2O
(4 hPa), regardless of the settings.
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Pugsy
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by Pugsy » Mon Nov 22, 2021 10:37 pm

The machine itself is essentially setting a new minimum and maintaining it...and doing it fairly rapidly so I don't see that increasing the minimum is going to change that aspect of things.
A change from 7 cm minimum to 10 or 11 minimum is going to be uncomfortable for sure.
She's already tried a bit higher minimum and didn't like how it felt while awake. I don't remember if EPR has been added or not.

Yes the machine is likely trying to kill the FLs but at this point we don't know just how important it is to kill those FLs (if we can even kill them).

Since she is sleeping well and feeling decent....I still maintain that I don't know that I would go messing with stuff.
Now if the pressure varied a lot...yeah maybe more minimum to stabilize it but it's already fairly stable once it goes up on its own.

Now if someone wants to experiment just for the sake of experimenting...that's sure a good enough reason to experiment but not everyone is geared up for experiments and at this point it hasn't been proven that there is a real tangible need to experiment.

If there was a lot of up and down with the pressure all night long then yeah...maybe more minimum to stabilize the pressure a bit but as it is now it's pretty stable once it gets up to where it wants to go.
I don't know what one would gain by raising the minimum because the machine is already doing it.
It's not like there is a truckload of events happening while the machine is going up to where it wants to be.

How about asking the wife what it is she wants to do??? Is there anything that she wants to maybe deal with...or not??
How about thinking what the primary goals are???
Are the goals sleeping good and feeling decent or are they cleaning up FLs (that at this point we don't know if they are a negative or not) so that the reports look cleaner on paper??

She's sleeping good and feeling decent given what all she's going through. There's no guarantee that will or can be improved and she might not like starting out with a pressure that is substantially higher even with EPR added.

Her sleep apnea is well treated and she's feeling good. If she has a mind set to play with the settings then by all means give it a try but I don't see an urgent need to go changing things if SHE DOESN'T WANT TO.
Her AHI is nice and low....leaks are for the most part minimal and short lived and more importantly they don't disturb her sleep.....
If it ain't broke....I see no reason to go trying to fix something.

Ask the wife what she wants to do....it's her life and her sleep and there isn't any real urgent need at this point IMHO to go changing stuff.
It's not like the AHI is high and she's reporting poor sleep and feeling like crap during the day.
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Jeffj318
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by Jeffj318 » Tue Nov 23, 2021 10:57 am

"Ask the wife what she wants to do....it's her life and her sleep and there isn't any real urgent need at this point IMHO to go changing stuff.
It's not like the AHI is high and she's reporting poor sleep and feeling like crap during the day."

Thanks for all the responses. I was just checking in to be sure things looked good and to continue forward.

Pugsy, I agree with you. I will let things be as they are as Michele does not say anything about being uncomfortable or CPAP not working as it should. Since I am the caregiver, I was doing some follow up.

Due to taking care of the cancer business, Michele had 0% interest in anything dealing with CPAP, equipment, cleaning, etc., and still has no interest. She actually had no interest in even completing the home sleep apnea test. She did so unwillingly, however, today she is glad she did. I did all the research and at first, it was overwhelming for me because there was so much to know and learn. I asked Michele to let me know how she felt using CPAP because that would be the only way I would know to make changes, etc. She said she is fine with everything the way it is now.

God has blessed her and us with finding great doctors (second opinion) after a lot of years with the former oncologist. She now has a semblance of life and does not have to receive any chemo treatments at this time. Before, that's pretty much all she did. Now, scans every three months which if they continue to show NED (no evidence of disease) will be pushed further into perhaps every four months. Of course blood work and port flush as needed.

This site is wonderful. It is much better than the Facebook CPAP groups IMHO. God bless everyone!
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Pugsy
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by Pugsy » Tue Nov 23, 2021 11:24 am

I hear you and understand your concerns. You just want to make sure she's getting the best care possible and I don't blame you one bit.
If I remember correctly you did briefly try a little more minimum a while back and she really didn't care for it and it's that reasoning behind my thoughts of not increasing the minimum. The machine is doing that for you already and trying to force the issue just a few minutes sooner than what the machine is doing could potentially make her uncomfortable and not be able to fall asleep. Gotta get the sleep first before any of this other stuff even matters.
Good sleep is always my primary goal because without it....doesn't matter what the reports show.

If I were in your shoes...given the wife just doesn't want to deal with it....I would still leave well enough alone and trust the machine to do its job and not risk trying more pressure (the machine is eventually giving you the more pressure once she is asleep and needs it anyway) just to maybe clean up some FLs that we don't know for sure need to be cleaned up.

I repeat...I see no urgent need to go changing the minimum at this time. The machine is doing it for you once she goes to sleep and that's pretty quickly.
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Jeffj318
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by Jeffj318 » Tue Nov 23, 2021 8:36 pm

Thanks so much, Pugsy.
Seems like starting at 7 pressure works and she is very comfortable.
She does indeed sleep through the night and wakes up much better than ever.
She tells the family how much better she feels since stopping chemo and I add CPAP also helps.
The combination of both has certainly given her a new lease on life.
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Cecioboe
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by Cecioboe » Sat Nov 27, 2021 7:43 pm

I’m so glad your wife is NED and doing well. My husband is a stage 4 rectal cancer survivor, NED for 10 years now. She is lucky to have you there for her. Blessings to you both.
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Jeffj318
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Re: How is my wife doing based upon these two screenshots from OSCAR

Post by Jeffj318 » Sun Nov 28, 2021 10:13 am

Cecioboe wrote:
Sat Nov 27, 2021 7:43 pm
I’m so glad your wife is NED and doing well. My husband is a stage 4 rectal cancer survivor, NED for 10 years now. She is lucky to have you there for her. Blessings to you both.
Thank you for the kind words. I am so glad your husband is NED and hopefully thriving. God bless you. Each day is a victory!
Resmed Airsense 10 For Her
Phillips Dreamwear nasal cushion mask
My wife is the CPAP user.