Anderson5420's OSCAR Data

[SarcasticDave94]

On the ResMed PAPs, this OSCAR graph of leaks, 0 and upward is leaks above intended/calculated, if I remember correctly. Move up the leak rate where 24 is, that's the ResMed redline. OSCAR has the option to mark that leak graph with the redlined 24 to be clearly indicated. Below the red line equals under 24 and above equals more than 24. I think it's an edit if you right click on leaks graph.

[anderson5420]

It has been a bit since my last post, mostly because everything had been going along the way it was since the beginning (badly, all centrals per OSCAR).  Thanks to OSCAR data which I had plotted on a spreadsheet for more than two months along with selected screenshots, which I regularly sent to the PA through the patient portal, the PA finally ordered another Titration Study, which was last night, and guess what. Perhaps the Tech was perhaps talking out of school and telling me things that only the PA should after the mysterious doc signs the report, but I learned two things. First, although I have been using nasal pillows, as soon as I fell asleep, my mouth popped wide open, and a lot of the air that should have been going down the airway was going out my mouth. She finally after a couple of masks changes switched me to a Phillips Dreamware full face mask, that problem solved. The biggie, however, is she told me I would be getting a new machine - as soon as she switched the program to ASV, my centrals completely disappeared. The CPAP only pumps air when I breathe in. The ASV shoots a blast of air, and I mean a blast, when it detects I SHOULD be breathing but am not - and that first blast of air was an experience but not difficult to get used to. I fell back asleep and slept great until she woke me up at 6:45 a.m. She sent me home with the Dreamware mask. The only downside was that their coffee machine was broken! I am home now and we have coffee! Follow up with PA is 5-18, and heaven only knows how long it will take Kaiser to approve the new machine and then how long it will take Apria to get it to me, but there is light at the end of the tunnel!

[anderson5420]

Yesterday I met with the PA and the sleep doc, Dr. Webb, who it appears is an actual living, breathing human being. The second Titration Study report is apparently too large to attach. But it is ASV for me, with one catch. My cardiologist has to clear me for a sufficient ejection fraction. The echocardiogram is scheduled for July 1 (nothing happens fast around here). But I think it is good news.

[SarcasticDave94]

Congrats on the progress. The echocardiogram test including LVEF is still an expected ASV path hurdle. Unless you have fairly serious heart conditions, it will be an easy pass. Typical is go to the local hospital's imaging department and get it done there. It's an ultrasound test records an audio/visual of the heart.

PS let use know when you've got your results. LVEF over 45% is what you're looking for. I've had 2 for different reasons, for ASV in 2017 at 55% and heart check in 2020 that netted a 63%.

[Sleeprider]

The precaution for LVEF is typical today is pretty common. Don't worry about it. ASV will serve you well.

[jaswilliams]

Congratulations you have a great machine on the way eventually make sure you get a Resmed ASV

[anderson5420]

Well, I have been absent from the forum for a long time, as things were just going along as always, consistently inconsistent, although I was starting to see lower AHIs more frequently. I had tried to track down what was going on with the ASV machine with Apria and the sleep doc (whom I have now met once and is actually a real person) which I was told back in May the sleep PA had ordered for me without success. Then in August Apria billed me a small amount ($66) as the payoff on the AirSense 10 AutoSet. Since I now owned it, I was thinking there was no way I was going to get a new machine. Then,  out of the blue, Apria sent me documents to sign electronically yesterday, and the AirCurve10 ASV showed up via Fedex today. Tonight will be my first use. I really don't know what to expect. There will be a report tomorrow!

[anderson5420]

OK, first night with AirCurve 10 ASV - 8 hours and 43 minutes, 100% of events were hypopneas!


I guess that would be an AI of zero - nada - nothing!

[SarcasticDave94]

A 95% leak rate 33.6 and Max of 54 tells us you need to work on mask fit, strap adjustment, or maybe mouth leaks. Your therapy was blown by the very high leaks, not even an ASV can work with them this high.

[sheepless]

congrats on the new machine. I didn't re-read this thread but seem to remember you had considerable ca in the past.

your median leak rate is not bad at all but good to get your 95%tile below 24 or better. looks like most of your leaks are above 18ish cmw so if you could try reducing max pressure to see if it improves leaks without allowing a lot of ca.

based on this last chart alone, if it was me, I'd reduce max ps to 12. if it helps leaks, great. if it helps leaks but enough ua/ca crop up to affect how you feel, you can go back up 1 cmw at at time looking for the sweet spot.

we don't know if your hypopnea are obstructive or central. you can try raising min ps to 4 to see if it helps. personally I'd also raise epap to at least 6, especially if your h turns out to be obstructive, but it probably isn't all that necessary. your max epap appears to be set at 14 but it's not going anywhere near that so you can drop it to say, 10 or just leave it.

the main thing is to try to reduce pressure related leaks by reducing max pressure.