New to Oscar data and CPAP

I almost hesitate to add this to the discussion, since it's so obvious, and I would assume your doctors would have checked for that too.
But just in case.
The association between diabetes and nocturia: A systematic review and meta-analysis

Conclusions
Diabetes has an association with a 1.49-fold higher risk of nocturia. This association is more robust for Asian and male subjects or those at a lower nocturia cut-off.

Dano1465 wrote: ↑

Fri Feb 24, 2023 5:44 pm

That was the reason after multiple urologists tests that I was tested for sleep apnea. I'm hoping that with more nights under my belt these bathroom trips will stop.

Amen to that!

While sleep apnea is well known to be a common cause for nocturia it isn't the only potential cause out there.
I experienced nocturia because of the sleep apnea myself but it was the first symptom of apnea that totally went away pretty much when I got effective therapy. Pretty much immediate results.

Given what we see in terms of AHI on your reports I would expect to see a marked reduction in pee breaks if the noctoria was solely caused by untreated apnea events in your situation and you should have experienced that reduction straight away.

I think that you and your doctor should continue to explore potential culprits for the nocturia.

ozij wrote: ↑

Fri Feb 24, 2023 10:27 pm

I almost hesitate to add this to the discussion, since it's so obvious, and I would assume your doctors would have checked for that too.
But just in case.
The association between diabetes and nocturia: A systematic review and meta-analysis

Conclusions
Diabetes has an association with a 1.49-fold higher risk of nocturia. This association is more robust for Asian and male subjects or those at a lower nocturia cut-off.

Dano1465 wrote: ↑

Fri Feb 24, 2023 5:44 pm

That was the reason after multiple urologists tests that I was tested for sleep apnea. I'm hoping that with more nights under my belt these bathroom trips will stop.

Amen to that!

Thanks for asking. i have been checked multiple times for diabetes,

Pugsy wrote: ↑

Sat Feb 25, 2023 7:51 am

While sleep apnea is well known to be a common cause for nocturia it isn't the only potential cause out there.
I experienced nocturia because of the sleep apnea myself but it was the first symptom of apnea that totally went away pretty much when I got effective therapy. Pretty much immediate results.

Given what we see in terms of AHI on your reports I would expect to see a marked reduction in pee breaks if the noctoria was solely caused by untreated apnea events in your situation and you should have experienced that reduction straight away.

I think that you and your doctor should continue to explore potential culprits for the nocturia.

I'm seeing my doctor in a couple weeks so I will discuss it again. Last night was the same... Up 5 times...

Nocturia is a common symptom of BPH (enlarged prostate).

Okie bipap wrote: ↑

Sat Feb 25, 2023 12:21 pm

Nocturia is a common symptom of BPH (enlarged prostate).

Yes and very common one.

Dano1465 wrote: ↑

Fri Feb 24, 2023 10:13 pm

I'm a 57 year old male. I have had my prostate checked and it was a bit enlarged. I'm on meds for it.

Since the OP is under a doctor's care for the BPH perhaps the first person to talk to is this doctor and a discussion about changing meds or dosage is in order....or maybe if recently put on those meds more time is needed to attain better results. I don't know much about BPH meds in terms of dosage or types or how long to wait to expect positive results.
Whatever meds the OP is taking for the BPH....not doing a good job but maybe he just recently started the meds and just needs more time. Maybe they were hoping the nocturia was all apnea related and cpap would fix things....but it hasn't and I doubt that apnea was the sole cause for the nocturia in this situation.

https://www.denverurology.com/male-urology/oab/

Overactive bladder in men at a glance

Overactive bladder is the result of malfunctioning bladder muscles and nerves that send sensations to the brain, causing involuntary and unnecessary contraction of the bladder muscles.
The primary symptom of OAB is a sudden, uncontrollable urge to urinate, often resulting in leakage of urine, which is incontinence.
OAB, also called urge incontinence, affects up to 30 percent of males, preventing them from controlling when and how much they urinate.
Nearly two-thirds of cases of OAB in men are caused by an enlarged prostate.

What is overactive bladder?

Overactive bladder (OAB) is a urological condition that causes the urgent and frequent need to urinate. The urge may be difficult to stop and might lead to involuntary loss of urine (incontinence).

With OAB, bladder muscles and nerves do not operate properly, resulting in inaccurate and often frequent signals to the brain to contract the bladder muscles to release urine when the bladder does not need to be emptied. OAB can also occur because bladder muscles are too active, contracting frequently causing an urge to urinate.

Typically, adults urinate four to seven times a day. Patients with OAB, however, may use the bathroom up to 30 times a day and may be unable to reach the bathroom before urination.

OAB frequently disrupts the life of the men who have it. Many men are uncomfortable even talking about these problems so they fail to seek treatment. OAB can cause them to feel nervous about being out in public because they might release urine involuntarily. Frequent urges to urinate can send them to the bathroom constantly. Men can begin to shy away from social activities and can experience depression due to OAB.
Causes of overactive bladder in men

About two-thirds of overactive bladder cases in men are due to benign prostatic hyperplasia (BPH), also called an enlarged prostate. The prostate gland surrounds the urethra, which is the tube that urine passes through from the bladder out of the body.

Although an enlarged prostate does not account for all cases of OAB in men, many who are treated for the symptoms are assumed to have an obstruction in the bladder caused by an enlarged prostate.

Pugsy wrote: ↑

Sat Feb 25, 2023 1:08 pm

Okie bipap wrote: ↑

Sat Feb 25, 2023 12:21 pm

Nocturia is a common symptom of BPH (enlarged prostate).

Yes and very common one.

Dano1465 wrote: ↑

Fri Feb 24, 2023 10:13 pm

I'm a 57 year old male. I have had my prostate checked and it was a bit enlarged. I'm on meds for it.

Since the OP is under a doctor's care for the BPH perhaps the first person to talk to is this doctor and a discussion about changing meds or dosage is in order....or maybe if recently put on those meds more time is needed to attain better results. I don't know much about BPH meds in terms of dosage or types or how long to wait to expect positive results.
Whatever meds the OP is taking for the BPH....not doing a good job but maybe he just recently started the meds and just needs more time. Maybe they were hoping the nocturia was all apnea related and cpap would fix things....but it hasn't and I doubt that apnea was the sole cause for the nocturia in this situation.

https://www.denverurology.com/male-urology/oab/

Overactive bladder in men at a glance

Overactive bladder is the result of malfunctioning bladder muscles and nerves that send sensations to the brain, causing involuntary and unnecessary contraction of the bladder muscles.
The primary symptom of OAB is a sudden, uncontrollable urge to urinate, often resulting in leakage of urine, which is incontinence.
OAB, also called urge incontinence, affects up to 30 percent of males, preventing them from controlling when and how much they urinate.
Nearly two-thirds of cases of OAB in men are caused by an enlarged prostate.

What is overactive bladder?

Overactive bladder (OAB) is a urological condition that causes the urgent and frequent need to urinate. The urge may be difficult to stop and might lead to involuntary loss of urine (incontinence).

With OAB, bladder muscles and nerves do not operate properly, resulting in inaccurate and often frequent signals to the brain to contract the bladder muscles to release urine when the bladder does not need to be emptied. OAB can also occur because bladder muscles are too active, contracting frequently causing an urge to urinate.

Typically, adults urinate four to seven times a day. Patients with OAB, however, may use the bathroom up to 30 times a day and may be unable to reach the bathroom before urination.

OAB frequently disrupts the life of the men who have it. Many men are uncomfortable even talking about these problems so they fail to seek treatment. OAB can cause them to feel nervous about being out in public because they might release urine involuntarily. Frequent urges to urinate can send them to the bathroom constantly. Men can begin to shy away from social activities and can experience depression due to OAB.
Causes of overactive bladder in men

About two-thirds of overactive bladder cases in men are due to benign prostatic hyperplasia (BPH), also called an enlarged prostate. The prostate gland surrounds the urethra, which is the tube that urine passes through from the bladder out of the body.

Although an enlarged prostate does not account for all cases of OAB in men, many who are treated for the symptoms are assumed to have an obstruction in the bladder caused by an enlarged prostate.

Thanks so much for the information you have provided. I have been on the same dose of meds for awhile. I have had so many tests that have been ordered by my urologist. All of them have come back clean.

I think you are right that the hope was that CPAP would fix the issue. I've been using CPAP for a week any there has been no improvement to peeing at night. I don't feel as tired over the past week so I'm hoping that is due to CPAP.

Someone suggested I ask questions on the same post.

My questions are on the graph that I have linked below. It is to do with AHI.

1, The first event looks like it is 45 minutes. Is that possible? Does that mean I was shallow breathing for 45 minutes?
2, On the example the y-axis numbers range from 1 -2. I have seen it as high as 3. What is the significance of these number

https://imgur.com/RMc5MaB

Thanks so much

Go to the details on the left.
Click on the Events tab.
Then click on whatever category that first event happens to be.
I can't tell what it is but click on the category and the category will expand and show all the events in that category along with the time it happened and in parentheses at the end of the time is a number that is the duration in seconds of that event.

The AHI graph...pretty much useless. It resets every 60 minutes and it isn't a duration of events that it gives you.
What you see on that graph is approx how many events you had during that 60 minute period.
Same data point can be seen easily on the Events graph.

Pugsy wrote: ↑

Sun Feb 26, 2023 2:12 pm

Go to the details on the left.
Click on the Events tab.
Then click on whatever category that first event happens to be.
I can't tell what it is but click on the category and the category will expand and show all the events in that category along with the time it happened and in parentheses at the end of the time is a number that is the duration in seconds of that event.

The AHI graph...pretty much useless. It resets every 60 minutes and it isn't a duration of events that it gives you.
What you see on that graph is approx how many events you had during that 60 minute period.
Same data point can be seen easily on the Events graph.

Thanks so much!!! I had no idea what those numbers in the parentheses were for.

All categories provide a time but not numbers in seconds. I provided an example in the link.

https://imgur.com/NK7KCN4

Thanks also for the info on the AHI graph

Dano1465 wrote: ↑

Sun Feb 26, 2023 5:45 pm

All categories provide a time but not numbers in seconds. I provided an example in the link.

Yes.

Some categories won't have duration in seconds but that's because the machine doesn't record them for OSCAR to show them.
You aren't missing anything critical. You could always drive yourself crazy and zoom in on each of those and manually count the seconds.

Hello

On the Oscar reports There is a header called statistics. There are numbers associated to Min, Med, 95% and Max. I'm not sure what numbers mean with regards to leak rate. Last night my numbers were min - 0, med - 5, 95% - 35 and max - 50. I'm not sure if these are good, bad or awful. I hope this makes sense.

I have attached a link

https://imgur.com/Qbmt94W

Thanks so much

Posting this here for completeness.

Dano1465 wrote: ↑

Tue Feb 28, 2023 4:57 pm

Hello

On the Oscar reports There is a header called statistics. There are numbers associated to Min, Med, 95% and Max. I'm not sure what numbers mean with regards to leak rate. Last night my numbers were min - 0, med - 5, 95% - 35 and max - 50. I'm not sure if these are good, bad or awful. I hope this makes sense.

I have attached a link

https://imgur.com/Qbmt94W

Thanks so much

Your data looks like this:


The units for leak rates are Liters/min, and this represents airflow being lost to the semi-closed, pressurized system comprising the blower, the hose, the mask, and your upper airway. Because you are using a PR DreamStation, your machine actually reports two sets of leak numbers: The Total Leak Rate and the Leak Rate. The Total Leak Rate includes the intentional leak rate for your mask that is designed to prevent you from rebreathing the CO2 you exhale with each breath. The Leak Rate is an approximation of the excess leakage---i.e. the difference between the Total Leak Rate and the expected, intentional leak rate for your mask.


The Min Leak Rate, Median Leak Rate, 95% Leak Rate, and Max Leak Rate are Liters/min numbers have statistical definitions. For a very detailed explanation of how Median and 95% numbers for a given data set are defined, go to my blog entry about Average, Median, and 95% numbers

The medium length version:

The Min Leak Rate is the smallest leak rate recorded during the entire night. The fact that your Min Leak Rate = 0 L/min means there were some periods during the night when the only leaks detected were the expected, intentional leaks designed into your mask.

The Median Leak Rate is the number where for 50% of the night, your leaks were AT or BELOW this number, and for 50% of the night, your leaks were AT or ABOVE this number. The fact that your Median Leak Rate = 5 L/min means that for 50% of the night (about 4 hours and 25 minutes), your excess leaks were AT or BELOW 5 L/min. And for 50% of the time (about 4 hours and 25 minutes), your excess leaks were AT or ABOVE 5 L/min.

Whether a Median Leak Rate of 5 L/min is acceptable depends on information we don't yet know because you haven't told us enough information. In general, leaks in the neighborhood of 5 L/min are so small that they don't affect the efficacy of therapy, regardless of how long they last. But many people find long lasting leaks of 5 L/min pesky in the sense that they wake up frequently to fiddle (unsuccessfully) with the mask. And all those mini-wakes needed to fiddle with the mask disrupt the quality of the sleep. And if that's the case, the person definitely needs to figure out a way to fix the leaks.

The 95% number is the number where for 95% of the night, your leaks were AT or BELOW this number and for 5% of the night, your leaks were AT or ABOVE this number. The fact that your 95% Leak Rate = 35 L/min means that for 95% of the night (about 8 hours and 25 minutes), your Leak Rat was AT or BELOW 35 L/min. And for 5% of the night (about 25 minutes) your Leak was AT or ABOVE 35 L/min. Since the "Large Leak territory" for PR machines is greater than that for Resmed machines, this means that it is highly unlikely that your largest leaks lasted long enough to have a severe affect on the efficacy of your therapy. And sure enough, the Oscar report says that you spent 4.65% of the night (less than 20 minutes) with leaks that were large enough to be flagged as official Large Leaks. So once again, the importance of this number is whether the leaks you are experiencing are disrupting your sleep rather than affecting the efficacy of your therapy.

The Max Leak Rate is just the largest leak rate recorded during the entire night. At some point your leak rate reached 50 L/min. Since the Oscar report indicates that you did spend time in official Large Leak territory, that tells us that and excess leak rate of 50 L/min is large enough (at your pressures) to trigger a Large Leak Flag. Since the time spent in Large Leak territory is minimal, whether to worry about the leaks goes back to whether the leaks you are experiencing are disrupting your sleep rather than affecting the efficacy of your therapy.

Dano1465 wrote: ↑

Tue Feb 28, 2023 4:57 pm

Hello

On the Oscar reports There is a header called statistics. There are numbers associated to Min, Med, 95% and Max. I'm not sure what numbers mean with regards to leak rate. Last night my numbers were min - 0, med - 5, 95% - 35 and max - 50. I'm not sure if these are good, bad or awful. I hope this makes sense.

I have attached a link

https://imgur.com/Qbmt94W

Thanks so much

The only time that it's "bad" is when the machine flags "large leaks", other than that, the machine doesn't care, and as long as the leaks aren't waking you up, you shouldn't either.

Sorry if this is silly question.

Is the flex setting on a Phillips Dreamstation the same as EPAP on other machines? The reason I ask is I don't see a EPAP in my set up but I do see a flex setting that in numbered 1 to 3.