CPAP data from OSCAR, plus OX data, questions about AirCurve 10 ASV pressure settings for pillows vs full face

EDIT: new data:
My FFM (SleepyHead) vs Nasal Pillows (OSCAR) stats, 2 images:
https://imgur.com/a/Qpdyv4F


=-=--
older, and less useful DATA images:
https://imgur.com/a/vrprag8
The third image is pulse ox. The few times O2 goes below 90 and pulse goes way down isn't me, it is when I was awake for a moment and moving the sensor from one finger to another.

Hi,

7 years well treated, obstructive apnea, and central apnea. 58 year old male.

Recently got new machine. Decided to switch over from FFM to pillows. I like them. But my old mask settings feel too high on pillows. Like air-boarding me, blowing me awake over and over.
I lowed them and like the results, and am getting good data.

Use machine with 2 liters oxygen.

Before just saying "stick to your old settings" as some have done here, please look at data.

I did just under 5 hours with pillows, then was a bit much, I turned off machine and did about 3 hours with just canula (without CPAP) with 2 liters oxygen. Here is my OSCAR summary, and my pulse-ox recording (F50, read with software that comes with it, can't seem to import to OSCAR with it...is that a known issue with the devices? I got a new F50 recently because the screen wore out, as it does after a few years.)

Data from OSCAR attached.

The first 20 min or so where heart is high on ox is me getting ready to bed, before I actually got in bed.

Thank you.

PRESSURE SETTINGS:

OLD WITH MASK
ASVAuto
Min EPAP: 14
Max EPAP: 15
Min PS: 0
Max PS: 11

CURRENT WITH PILLOWS:
ASVAuto
Min EPAP: 8
Max EPAP: 11
Min PS: 0
Max PS: 7

This is a case where posting the data with the left sidebar information would be useful.

It appears you are using an ASV machine, but I can't pick up the setting information and I can't tell how wide of a range your PS is allowed. But the larger the max PS setting, the higher IPAP is allowed to go for a particular EPAP.

There are times, however, where the PS is getting exceptionally high in an effort to smooth out the flow rate (i.e. improve your breathing). Yes, the result is what appears to be a pretty flow rate graph, but you say you're frequently waking up.

Answers to several questions would be useful:

1) What diagnosis got you the ASV? Do you have a documented issue with central sleep apnea as shown on a sleep study? Were you ever on a plain CPAP/APAP? What about a Resmed VAuto or a PR BiPAP? If so, what triggered the switch to the ASV?

2) Did you have a titration study done to determine the ASV settings? If so, do you have a copy of the results and are you willing to post them?

3) How does this data compare to a typical night from when you were using the full face mask? In particular, when you were using the FFM did you have as large of swings in the IPAP & PS? In other words, what did the top red pressure curve look like when you were using the FFM?

4) How long did it take you to fall asleep? The stuff between 13:20 and 14:00 all looks like it could be sleep-wake-junk at this scale. But notably, the machine didn't like the flow rate graph's shape and it was really cranking up the PS & IPAP during that period.

5) Any chance your wakes correlate to other periods where the red IPAP pressure curve is super high as compared to the green EPAP pressure curve? In other words, it is possible that drastic increases in PS may be what you are noticing rather than the actual IPAP/EPAP pressures themselves.

6) What did your median and 95% PS levels look like when you were using the FFM? (This information is available on the left sidebar of Oscar's daily report.). What do your median and 95% PS levels look like when you use the nasal pillows?

MichaelWD64 wrote: ↑

Wed Mar 22, 2023 10:26 pm

PRESSURE SETTINGS:

OLD WITH MASK
ASVAuto
Min EPAP: 14
Max EPAP: 15
Min PS: 0
Max PS: 11

CURRENT WITH PILLOWS:
ASVAuto
Min EPAP: 8
Max EPAP: 11
Min PS: 0
Max PS: 7

These settings with an ASVauto mode and variable PS are not possible on the Resmed 10 Vauto Bilevel that you have listed in your signature. I use that machine myself and it does not have an ASVauto mode.

The machine you are using appears to be a Resmed Aircurve 10 ASVauto bilevel with heated humidifier which is no longer sold by our host. That means you can't find the machine on the pull-down menu for equipment and you will just add the name of the correct machine in the "additional comments" section of Edit Equipment part of the user profile settings. It would help us help you if you corrected your signature so that it shows you using a Resmed Aircurve 10 ASVauto rather than just an Aircurve 10 Vauto.

You also might want to take a closer look at the area corresponding to 1700-1730 on the oximetry. Seems to be a chain of desats there.

robysue1 wrote: ↑

Thu Mar 23, 2023 8:29 am

These settings with an ASVauto mode and variable PS are not possible on the Resmed 10 Vauto Bilevel that you have listed in your signature. I use that machine myself and it does not have an ASVauto mode.

The machine you are using appears to be a Resmed Aircurve 10 ASVauto bilevel with heated humidifier which is no longer sold by our host. That means you can't find the machine on the pull-down menu for equipment and you will just add the name of the correct machine in the "additional comments" section of Edit Equipment part of the user profile settings. It would help us help you if you corrected your signature so that it shows you using a Resmed Aircurve 10 ASVauto rather than just an Aircurve 10 Vauto.

Thank you for the answers. My machine is a AirCurve 10 ASV, below is a photo of the menu with ASVAuto mode. I put what I thought was right, but I'll correct my info with "additional comments."
https://imgur.com/x1ICl5O
That's a photo I took of my new machine's settings before starting Pillows and lowering pressure.

Last sleep study I had was 7 years ago, My AHI was 140. Nurse said it was the highest she'd seen. I have central and obstructive apnea. Also, I smoked for 30 years, quit right before I got on oxygen and CPAP. I'm not on oxygen during the day anymore, only when I sleep.

I reedited those screenshots with sidebars. Sorry about that, and will do correct next time. Here they are:
https://imgur.com/a/ap2kolP

It did take me I think 30 to 40 min to fall asleep, I wasn't in bed for half that, was setting up room, moving cats, lol, going to the bathroom, setting water by my bed, then got in bed and futzed with pillows straps.

I got up once during night to use bathroom. But also woke up in bed for a minute or so a few times to move the PulseOx finger thing from one finger to another. Also got up at one point and answered the door, UPS, but I think that was after I went to just Canula, so should only show on pulse-ox. Was a daytime sleep schedule. I'm retired, my sleep drifts, I'm on a 24 hour and some minutes cycle, is a little later every day. Sometimes I sleep at night, usually at day. Haven't had titration study since my sleep study 7 years ago. I'm a better candidate for take-home study. Couldn't sleep first attempt at sleep study, and often sleep in day, so very awake at night.

Will look more into your answers with detail and reply later.

Can OSCAR still read Pulse-Ox wrist recorders? Or did the recorders change. I wasn't able to get that to work, so had to use the minimal software that came with the F50.

I really appreciate the help!
Michael

MichaelWD64 wrote: ↑

Thu Mar 23, 2023 8:50 am

Last sleep study I had was 7 years ago, My AHI was 140. Nurse said it was the highest she'd seen. I have central and obstructive apnea. Also, I smoked for 30 years, quit right before I got on oxygen and CPAP. I'm not on oxygen during the day anymore, only when I sleep.

So it makes sense that you were put on an ASV.

It did take me I think 30 to 40 min to fall asleep, I wasn't in bed for half that, was setting up room, moving cats, lol, going to the bathroom, setting water by my bed, then got in bed and futzed with pillows straps.

You obviously had the mask on and the machine running between 13:20 and 14:00 because there's ASV data for that period. Were you awake and moving around with the mask on during this time? If you were awake between 13:20 and 14:00, did the pressure seem noticeably too high?

I got up once during night to use bathroom. But also woke up in bed for a minute or so a few times to move the PulseOx finger thing from one finger to another. Also got up at one point and answered the door, UPS, but I think that was after I went to just Canula, so should only show on pulse-ox.

The bathroom break and the break to answer the door don't show up as breaks in the flow rate data. I'd love to know how you got up and went to another room without turning the machine off or triggering a period of "large leak" or "no breathing detected".

Can OSCAR still read Pulse-Ox wrist recorders? Or did the recorders change. I wasn't able to get that to work, so had to use the minimal software that came with the F50.

Someone else is going to have to answer this: I don't monitor O2 levels.

robysue1 wrote: ↑

Thu Mar 23, 2023 9:23 am

You obviously had the mask on and the machine running between 13:20 and 14:00 because there's ASV data for that period. Were you awake and moving around with the mask on during this time? If you were awake between 13:20 and 14:00, did the pressure seem noticeably too high?

I was getting ready for bed. I have two hoses put together, I can reach the bathroom and all over my room. I'd disregard that period for this. I almost edited it out, but decided not to.

MichaelWD64 wrote: ↑

Thu Mar 23, 2023 8:50 am

I reedited those screenshots with sidebars. Sorry about that, and will do correct next time. Here they are:
https://imgur.com/a/ap2kolP

I still only see the graphs on the right side of the Oscar window.

I'd like data to look like this:


That will allow us to see what the median and 95% PS and IPAP levels are.

Also if it is possible to post a typical day from when you were using the full face mask, that would also be useful.

robysue1 wrote: ↑

Thu Mar 23, 2023 9:54 am

I'd like data to look like this:
Also if it is possible to post a typical day from when you were using the full face mask, that would also be useful.

Edit: Here is whole thing with the sidebar.
https://imgur.com/atgQeL8

To post data with me using FFM I'd have to do it from where I already have it (since I like pillows so much more I'm not using a mask and have packed them into the attach). Where I already have it is in the old program SleepyHead and I've seen people have fits here at even the mention of that program, even this week to me, but worse to other people here previously.

Will I get in trouble if I post that here for you?

Thank you!
Michael

Please stop playing the snipping game.

Just do a full screenshot and post that.

palerider wrote: ↑

Thu Mar 23, 2023 3:52 pm

Please stop playing the snipping game.

I have no idea what that means. I don't know that term. I'm not playing games.

Is it a roundabout why of saying "Just post the old SleepyHead data you mentioned above on this thread, it's OK this time" or are you saying "stop posting part of a page, post the whole page."? I've already said that I'm going to do that, and I said in the post you're replying to!

You've posted to me twice this week and sounded angry both times. No idea why.

Edit: Ah, just read your post history. You're angry most of the time.

MichaelWD64 wrote: ↑

Thu Mar 23, 2023 3:56 pm

palerider wrote: ↑

Thu Mar 23, 2023 3:52 pm

Please stop playing the snipping game.

I have no idea what that means. I don't know that term. I'm not playing games.

Is it a roundabout why of saying "Just post the old SleepyHead data you mentioned above on this thread, it's OK this time" or are you saying "stop posting part of a page, post the whole page."? I've already said that I'm going to do that, and I said in the post you're replying to!

You've posted to me twice this week and sounded angry both times. No idea why.

Edit: Ah, just read your post history. You're angry most of the time.

You're snipping out parts of what people have asked you to post, instead of just posting a whole page screenshot, as has been asked of everyone *repeatedly*, and is indeed in the very first post on the forum, the one where it says "read this first".

Edit: Yes, I have little patience for people that waste our time because they can't be bothered to read and follow simple instructions. If you want to call that "angry" you're welcome to, no matter how wrong you are.

Have a nice day.

MichaelWD64 wrote: ↑

Thu Mar 23, 2023 3:56 pm

Edit: Ah, just read your post history. You're angry most of the time.

not angry; direct.

If you can run SleepyHead to show your older data with a full face mask, then by all means, do that.

Follow the suggested instructions about how to set up the screen. Then, create an image of that full screen.
OSCAR - see the instructions - has an option to creat a screen image.
If SleepyHead does not have that option, use the Window Snipping Tool to create an image of the full screen.

ozij wrote: ↑

Thu Mar 23, 2023 9:27 pm

If you can run SleepyHead to show your older data with a full face mask, then by all means, do that.
Follow the suggested instructions about how to set up the screen. Then, create an image of that full screen.
OSCAR - see the instructions - has an option to creat a screen image...

Thank you.

Where are the suggested instructions about how to set up the screen for OSCAR to take full-screen screen shots? Do you mean in the program or somewhere on here?

I searched in the OSCAR online help with these terms, got nothing that seemed right:
taking a screenshot
and
taking a screen shot
and
setting up screen
and
screen image

Searched similar here in forum search and mostly got people posting their screen shots.

In OSCAR, under View / Take Screenshot it says to use F12. I did that and it only took a photo of the part of the screen that's showing.