HELP needed for 13-yr CPAP user!

JoyD. wrote: ↑

Mon Nov 21, 2022 10:14 am

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I HAVE AN OSCAR QUESTION - WHY CAN'T I DOWNLOAD MY DATA THIS MORNING?

After clicking on OSCAR in the dock of my MacBook Air laptop, which takes me to the Welcome Page . . . when I put my SD card in the Mac card reader, as usual, & clicked on the red Import Icon, it looks like it is downloading my data, but it DIDN'T! -- I did have the SD card unlocked when I used it last night, and LOCKED when I put it in my card reader this morning.

The Daily View, Overview, & Statistics icons are dimmed, and unresponsive when I click on them. -- I tried re-installing OSCAR and still the same thing.

The only thing different about this morning is that LAST NIGHT, my Mac had an Update to Ventura 13.0.1 . . . so I updated. Do you think this could this have affected my Oscar App? (As I said, I moved the old OSCAR icon to the trash & reinstalled it this morning.) -- Any Mac or OSCAR wizards out there?

Pugsy wrote: ↑

Mon Nov 21, 2022 10:29 am

Post your problem here so that BlueDragon will see it
viewtopic/t184531/OSCAR-140-Released--June-17-2022.html
I don't think he is following your therapy thread and I use a PC so I am zero help with Macs.

So far I haven't heard from Blue Dragon. But I did get some feedback both from posters on another forum as well as from Apple Support. Both, after having me trying several things on my Mac to "find" the SD card (none of which worked) . . . suggested I replace my Card Reader & use a new SD card, and see if that works to get my SD card mounted so I can import data into OSCAR. Will try that when the new Reader & SD card arrive.

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Regarding WHY I'm STILL UNABLE to mount my SD card to import into OSCAR, I've been working with a couple tech guys on another forum. I also have worked with a Senior Tech Rep on Apple Support. In both instances they suggested I try a new SD Card Reader. I was still in the return window where Amazon would "replace" my old Apple USB-C to SD Card Reader with a new one.

So this morning I went into Applications & clicked on OSCAR , then used the same SD card I have been using all along ("LOCKED" per instructions in red on the OSCAR Welcome page) & put it into the NEW Reader (trying it in both ports) and STILL NO icon appeared on my desktop OR in my Finder!! (The "new" SD card hasn't arrived yet.

HOWEVER, then I went to SLEEP HQ using the same old SD card (but "UN-LOCKED" per instructions on Sleep HQ), & the No Name ICON appeared BOTH on the desktop and in Finder!! So I clicked on the "No Name icon" and dragged the files onto Sleep HQ which WERE THEN IMPORTED!![/b] -- FINALLY, I have software to use again!

So, strangely, I AM able to import into Sleep HQ . . . but NOT into OSCAR anymore. -- Maybe at some point I'll learn WHY!!

JoyD.

PS - I was so glad to find Software that works for me, that I took advantage of the current Sleep HQ $99/year for life cost of Sleep HQ PRO before the offer expires. I would STILL, however, like to also use Oscar if that is ever possible.

JoyD. wrote: ↑

Tue Nov 22, 2022 4:16 pm

ejbpesca wrote: ↑

Tue Nov 22, 2022 5:09 am

I have MacBook Air. The Ventura update did not affect data uploads to OSCAR for me. I leave my SD card from an AirSense 10 unlocked. I install the SD to the Mac with an SD to C port adapter, icon appears on desktop, then I launch OSCAR from its icon on the desktop. So far so good. I use Duck Duck Go. Those tiny lock switches on SDs are tricky. I've never needed to lock an SD card for any device.

EJ, thanks for letting me know that the Ventura update is not likely to be the problem! That's good to know. Re. the locked or unlocked SD card . . . I've always locked mine before reading and it always worked before, so I don't think that's the issue.

What is this SD to C port adapter? Is it a card reader?? Do you put the SD card in the reader, then plug it into your Mac using a USB adapter . . . before importing? Do you click on the red SD card icon on the OSCAR Welcome page, or do you go up to OSCAR's File and click on Import Oscar Data from there? Then, after it finishes importing, are the Daily View, Statistics, etc responsive to click on taking you to those reports? (I do all that with my Card Reader . . . but nothing gets imported because the Daily View, etc remain faded & unresponsive.)

This is really weird . . . I had no problem in the past importing my SD card data to the new version of OSCAR before . . . all of a sudden my routine didn't work anymore. Previous to my import problems I had to redo my Profile because that was disappearing. What am I missing?

What does the ICON look like that appears on your desktop? All I see on my desktop is an icon that says "Oscar Installer". When I click on that, it just takes me back to the install process (dragging the Oscar icon into the App Folder). AND YET, when I look in Applications OR Launchpad the OSCAR icon is there, so I assume that it is installed!

Joy

It is just possible that the SD Card did not seat properly in the cpap machine. When this happens, nothing will be written to the SD Card, for that session.
On a couple of occasions, after inserting the SD Card back into my cpap machine, it did NOT seat just right, and I did not get the "Loading SD Card" message on the front screen of my cpap machine.
Be sure to watch for that message every time that you reinsert your SD Card into the cpap machine.

I'm using OSCAR on a PC, so I don't know if the following works for a Mac.
After opening OSCAR, have you tried the following:

Data
Rebuild CPAP data

I finally got OSCAR working again after I replaced my Card Reader.

So I've been slowly increasing the Minimum Pressure - last night it was 10.8. I've also been experimenting with levels of EPR (which I need to reduce the Flow Limitations). I've found that EPR 3 causes too many Central Apneas. EPR of 1 shows too many Flow Limitations . . . so I've settled on EPR2.

I'm also noticing that when I wake up Supine, that I have pressure spurts during the time preceding that. (My original Sleep Study showed 4X the Events when I was Supine). I'm using a buckwheat pillow behind my back to help prevent rolling over on my back ... but when I toss from side to side it's difficult to drag a heavy buckwheat pillow with me (probably causing a lot of SWJ in the process).

Normally I don't post ALL the graphs, but this once I thought I'd show all the info. in case another graph might shed some light.

So here's my full data from last night when I woke up SUPINE at 4:13am:

Sun night,12/4 (EPR 2) - STATISTICS: https://imgur.com/a/tg4ouyG (AHI = 4.33)
Sun night,12/4 - DAILY VIEW #1 https://imgur.com/a/GUx9QPM
Sun night,12/4 - DAILY VIEW #2 https://imgur.com/a/A6EYkmT
Sun night,12/4 - DAILY VIEW #3 https://imgur.com/a/2MK8z6F
Sun night,12/4 - DAILY VIEW #4 https://imgur.com/a/LxhnoiE

I'd appreciate any feedback. Here are my observations:
* It looks like the higher pressures, from being Supine, are causing my nasal mask to leak. (My mouth tape is secure when I wake up.)
* I have been able to reduce the times I get up at night to pee (less liquids before bedtime) . . . but I still have a lot of SWJ periodically during the night when I zoom & look at breaths. I know that I toss from side to side frequently due to age-related hip pain. That is obviously causing disrupted & unrefreshing sleep.
* It also looks like I have pressure-induced Centrals (?) (Note: No Central Apneas were noted on my 2009 Sleep Study. It was primarily Hypopneas at that time.)
* Wondering if I should continue slowly increasing the Minimum Pressure??

Any observations or suggestions are welcome. (I'd be happy to take a zoomed in shot of a specific time.)

Thanks,
JoyD.

Hi Joy, Nice to see you again.

The one thing that catches my eye may be nothing or may be something.

This is anecdotal input of one person, where everyone varies.

I found the "soft" setting was associated (not necessarily causal) with a much busier FL chart. I turned it on "standard" I think?

From Resmed site:
AutoSet Response mode

ResMed’s AutoSet algorithm now allows for additional customisation of therapy with the new AutoSet Response mode, which offers all the benefits of the enhanced AutoSet algorithm with gentler pressure increases for additional comfort.

For patients who are sensitive to faster changes in pressure during therapy, AutoSet Response can be set to either Standard or Soft. If set to soft, patients will receive gentler pressure rises during therapy.

Available in the AirSense 10 AutoSet and AirSense 10 AutoSet for Her devices.
https://www.resmed.com.au/healthcare-pr ... technology


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I don't recall which machine you have or if you set the soft setting yourself. The AS11 has this option as well. I know everyone is different. But this is the one thing that caught my eye.

Joy,

The thing that most catches my attention from the data you posted is this: Your flow limitations disappear almost completely once your pressure is 12cm. In other words, you may need to bump the min pressure up a bit.

As for whether the CAs are something to be genuinely worried about:

1) While I know that you didn't have any CAs on your sleep tests, the number of CAs on this night is not particularly alarming---particularly since you say there might be some SWJ mixed in.

2) In an ideal world, your xPAP ought to be able to use enough pressure to prevent obstructive events even when you are sleeping supine. But since your OSA is positional, the question is how much additional pressure might be needed and can you tolerate it in terms of aerophagia and the number of pressure induced CAs.

I'll also add this: Sound sleep on your back at a higher pressure beats sleep interrupted by attempts to keep yourself from sleeping on your back, particularly if pain issues are a problem when you are trying to sleep on your sides.

My suggestions, such as they are, are these:

1) Try bumping min pressure up to 11 and see if there's no aerophagia. Leave your max pressure where it currently is set and leave EPR = 2.

2) For the next several nights, don't worry about trying to keep yourself off your back. Let yourself sleep in whatever position seems most comfortable. Make a note of whether you wake up or fall asleep while on your back. Don't worry about a temporary increase in AHI. The point of the experiment is to see where the machine wants to go if you are on your back and just how much the AHI increases when you are on your back.

After you have several days of data, then reevaluate what to do based on the answers to these questions:

A) How bad did the AHI get during the experiment? And what was the distribution of events?

B) Subjectively is sleeping on your back easier, more satisfying, and in any sense more "restful" than trying to focus your attention on keeping yourself off your back?

C) What problems with aerophagia and/or mask leaks happened because the machine was running at a higher pressure for longer periods of time because you were on your back for longer periods of time?

lynninnj wrote: ↑

Mon Dec 05, 2022 9:34 am

The one thing that catches my eye may be nothing or may be something. This is anecdotal input of one person, where everyone varies. I found the "soft" setting was associated (not necessarily causal) with a much busier FL chart. I turned it on "standard"

Lynn, thanks for mentioning that. I have often wondered what difference I might notice selecting "Standard" rather than my usual "Soft" response.

Right now I am in a one-week experiment suggested by RobySue1. After that information is obtained, and any changes made . . . sometime I will see what the difference may or may not be with a "Standard" response.

JoyD.

robysue1 wrote: ↑

Mon Dec 05, 2022 10:47 am

The thing that most catches my attention from the data you posted is this: Your flow limitations disappear almost completely once your pressure is 12cm. In other words, you may need to bump the min pressure up a bit.

An interesting observation! One night I tried the Min pressure at 11.6 and felt pressure against my exhales, not comfortable (I didn't want to raise the EPR to 3 because I seem to have found a "balance" at 2 re. flow limitations & centrals). But that night I changed the pressure from 10.6-11.6, probably too much at one time. I can move it up slowly by 0.2 - shall I begin now or wait until our experiment is over?

robysue1 wrote: ↑

Mon Dec 05, 2022 10:47 am

My suggestions, such as they are, are these:

1) Try bumping min pressure up to 11 and see if there's no aerophagia. Leave your max pressure where it currently is set and leave EPR = 2.

2) For the next several nights, don't worry about trying to keep yourself off your back. Let yourself sleep in whatever position seems most comfortable. Make a note of whether you wake up or fall asleep while on your back. Don't worry about a temporary increase in AHI. The point of the experiment is to see where the machine wants to go if you are on your back and just how much the AHI increases when you are on your back.

I love this plan, and began implementing it last night with a 11-16 pressure. I was achy when I went to bed on my side, so I rolled over on my back and went to sleep. What an eye opener - just look at the difference between SESSION 1 (Supine until I woke up at 4:30am) and SESSIONS 2&3 (slept on my side both times). (By the way, the AHI on my AirSense 10 at the end of Session 1 was 5.8.)

OSCAR Daily View #1: https://imgur.com/a/YBHMITd
OSCAR Daily View #2: https://imgur.com/a/AcmssMV

I'm wondering if perhaps I need to increase the Max to 16.5 tonight to handle any supine sleeping(?) Just look at the clusters of events & continued OAs in Session 1, compared to Session 2&3 - wow!!

I also note that the 95% Flow Rate was only 0.6 - lower than it usually is. -- Not sure what is causing such heavy mask leaking (mouth tape remained intact) . . . Ozji pointed out that the pressure couldn't be causing it [which I assumed originally, then edited out the comment], since leaking didn't happen during the first pressure surge with the large cluster of events early on. My next mask is sure to be the Bleep Eclipse!

BTW, I feel good this morning - we'll see if I still feel alert by evening.

I'll continue with your plan & evaluate after a week. Thx for the suggestions.

What do you think so far?

JoyD. wrote: ↑

Tue Dec 06, 2022 10:54 am

Obviously the pressure surges in Session 1 caused the large leaks with my Zest Nasal Mask (my mouth tape stayed intact)

I don't think so.
Your first pressure surge, during the major cluster starting at 23;40+ did not cause a leak.

Re. my comment that "obviously the pressure surges in Session 1 caused the large leaks with my Zest Nasal Mask (my mouth tape stayed intact).

ozij wrote: ↑

Tue Dec 06, 2022 11:13 am

I don't think so.
Your first pressure surge, during the major cluster starting at 23;40+ did not cause a leak.

Oh yes, you're so right!! So perhaps it's just my active tossing ??

JoyD. wrote: ↑

Tue Dec 06, 2022 11:35 am

Re. my comment that "obviously the pressure surges in Session 1 caused the large leaks with my Zest Nasal Mask (my mouth tape stayed intact).

ozij wrote: ↑

Tue Dec 06, 2022 11:13 am

I don't think so.
Your first pressure surge, during the major cluster starting at 23;40+ did not cause a leak.

Oh yes, you're so right!! So perhaps it's just my active tossing ??

Yes, I was wondering of those apneas caused some restlessness which caused the leaks later.
Were you on your back till the very end of that first session?

Yes, Ozij . . . I was Supine when I went to bed around 10pm (because my hips were bothering me), and woke up 6 hours later Supine, so I "assumed" I was on my back the whole session.

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Here are my results of night 2 of "the experiment" (suggested by RobySue1) of allowing myself to sleep in the most comfortable position, even if Supine, and to see what happens to AHI, event categories, and pressure.

OSCAR Daily View for night of 12/6/22: https://imgur.com/a/AyxZ3z0

Because of hip pain, I went to bed at about 10:30 SuPINE, and woke up about 1:40 SUPINE. Then went back to bed SUPINE about 1:50am and woke up at 4:44am SUPINE. -- NOTE SESSIONS 1 & 2 have many events & clusters during the time I was on my back!! The AHI was 6.7 at the end of Session 2 ( AI = 6.1, CAI=1.0)

When I returned to bed at 5:05am & 7:24 am for Sessions 3 & 4, I was on my LEFT SIDE, and woke up that way each time. There were no obstructions noted, and only a few Centrals. The side-sleeping at the end of the night brought my AHI down to 4.43.

These results were very similar to the previous night when I could compare the first part of the night SUPINE to the last part of the night on my SIDE, showing similar differences in events & pressure.

FLs (quite low for me) were also similar: 95% of the time FL = 0.08 (previous night 0.06).

JoyD.

And how do you feel after each of those nights?