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Anderson5420's OSCAR Data
#21
RE: Anderson5420's OSCAR Data
Probably captain obvious, but there's several things stealing good sleep from you. PLM, CA, oxygen drops.

I'll let one like sheepless discuss his PLM journey, I've not had to deal with it. CA and oxygen issues OK I've done something with those to a degree. My opinion is if a doc is ready to issue supplemental oxygen, you may need to accept. There's PAP hoses that have the oxygen bib connector that'll put the oxygen through the PAP mask, at least at night.

Part 2, if me I'd be demanding the ASV to treat CA. Centrals have been on both diagnostic and titration. Make a fuss, not much of a stretch, but you're not getting rest with this garbage going on that OSCAR shows. Only ASV takes care of the CA.

Part 3 is PLM. I think sheepless used ASV for a bit, but I don't think it was really successful. His goal may have been PLM more than CA. Again he can fill you in better there.

That's my take. Make some calls and get what you need.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#22
RE: Anderson5420's OSCAR Data
idk if this applies to anderson5420 but maybe useful to someone...

re: Dave's part 3 in the previous post:

asv did a great job of getting my ahi down and I liked it much better than apap. continuing to struggle with daily tiredness though, led me on an excursion with vauto which enabled me to use a more or less set epap and pressure support, thereby capping ipap. only after this did I realize the asv was rapidly and repeatedly raising and lowering pressure support against my plm induced flow limitations. completely unaware of it but I realized after the fact that it was exhausting. (asv max ps has to be at least 5 cmw above min for it to properly address ca). in the beginning, vauto was more comfortable with fixed pressures and I was less tired during the day. very high trigger setting effectively reduced my ca on vauto as well so now I can use either vauto or asv with much the same results. I should add - and this is important - that I think finding a med that at least partially reduces my plm is why I can now go back and forth between vauto and asv and achieve similar results. with rampant plm, vauto is the better choice for me, even though it isn't intended to treat ca.

anderson, just something to keep in mind IF you suffer plm and IF you are considering asv for your ca.
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#23
RE: Anderson5420's OSCAR Data
No arguments here. Just want him to find the best answer.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#24
RE: Anderson5420's OSCAR Data
(03-13-2021, 07:29 PM)staceyburke Wrote: Pat do you wear glasses?  If so check out [Image Containing a Commercial Website or URL Removed] Search for Oxyview
I own them and they are great, no more cannula!!!


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I do wear glasses but I returned the oxygen stuff to Apria a week or so before my sleep study. My oxygen levels have always been OK during the day while I am awake, and I am assuming that with the CPAP they must be better while I am asleep now. The Titration Study showed mean oxygen saturation levels above 90 for the entire night.
Pat Anderson
Happily retired in Birch Bay, WA
Blog: http://daydreamsloop.blogspot.com
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#25
RE: Anderson5420's OSCAR Data
(03-13-2021, 08:10 PM)SarcasticDave94 Wrote: My opinion is if a doc is ready to issue supplemental oxygen, you may need to accept. There's PAP hoses that have the oxygen bib connector that'll put the oxygen through the PAP mask, at least at night.

Part 2, if me I'd be demanding the ASV to treat CA. Centrals have been on both diagnostic and titration. Make a fuss, not much of a stretch, but you're not getting rest with this garbage going on that OSCAR shows. Only ASV takes care of the CA.

That's my take. Make some calls and get what you need.

Yes, I have seen the CPAPs with the supplemental oxygen connection. The Titration Study however showed the mean saturated oxygen level through the whole study night to be in the 90s, so I think the CPAP was/is probably getting me all the oxygen i need.

I sent my sleep therapist, who is a PA not a doc (I have never met the doc who reviews the overnight data and writes the study reports), a message through the patient portal yesterday pointing out both the Titration Study and all my OSCAR reports indicate CA not OA, that I am concerned about this, and that we will need to discuss at my follow-up with her, which is in about a month. If OSCAR continues to show almost all CAs, I will bring the screenshots in and ask why they don't think they need to address the CAs. I might call her before my follow-up depending on her response, which I don't expect until tomorrow or the next day. There is of course the possibility that she will call me in before the follow-up. It is still puzzling though why the Full Night Polysomnogram report show more OAs the CAs and they just kind of ignored that.
Pat Anderson
Happily retired in Birch Bay, WA
Blog: http://daydreamsloop.blogspot.com
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#26
RE: Anderson5420's OSCAR Data
(03-13-2021, 08:35 PM)sheepless Wrote: idk if this applies to anderson5420 but maybe useful to someone...

re: Dave's part 3 in the previous post:

asv did a great job of getting my ahi down and I liked it much better than apap. continuing to struggle with daily tiredness though, led me on an excursion with vauto which enabled me to use a more or less set epap and pressure support, thereby capping ipap. only after this did I realize the asv was rapidly and repeatedly raising and lowering pressure support against my plm induced flow limitations. completely unaware of it but I realized after the fact that it was exhausting. (asv max ps has to be at least 5 cmw above min for it to properly address ca). in the beginning, vauto was more comfortable with fixed pressures and I was less tired during the day. very high trigger setting effectively reduced my ca on vauto as well so now I can use either vauto or asv with much the same results. I should add - and this is important - that I think finding a med that at least partially reduces my plm is why I can now go back and forth between vauto and asv and achieve similar results. with rampant plm, vauto is the better choice for me, even though it isn't intended to treat ca.

anderson, just something to keep in mind IF you suffer plm and IF you are considering asv for your ca.

I wish to heck there was a sleep issue glossary here! I am starting to understand the lingo, but I have a way to go!
Pat Anderson
Happily retired in Birch Bay, WA
Blog: http://daydreamsloop.blogspot.com
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#27
RE: Anderson5420's OSCAR Data
sorry about that. look in the wiki (link in black banner top of this page) and under help in oscar. also, feel free to ask.
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#28
RE: Anderson5420's OSCAR Data
Feel free to ask any thing you don't get or understand. Surely someone will know it. And best to your success in getting the point across you're not at all successfully treated as is.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#29
RE: Anderson5420's OSCAR Data
OK, last night's OSCAR screenshot is attached, and boy, am I embarrassed. It is well-known around the Anderson household that IF I can put something on backwards or upside down, I will. For the first part of the night, I was sort of struggling to breathe. Finally I got up, took the mask off and looked at it and realized I had been wearing it upside down. In my defense, nobody showed me how to use a nasal pillow mask and there were no instructions, and although I scored in the 90th percentile in most categories on standardized tests, I scored in the 10th percentile in spatial relationships, that is the part where they show multiple gears engaged and you are supposed to say which way it will turn at the other end! So ignore everything on the graphs to the left of the part where I had the mask off! Also, the leakage is apparently high, not sure what I can do about that, suggestions welcome. I had finally got leakage more or less under control with the full face mask when I switched to the nasal pillow, now it is pretty high again.


Attached Files Thumbnail(s)
   
Pat Anderson
Happily retired in Birch Bay, WA
Blog: http://daydreamsloop.blogspot.com
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#30
RE: Anderson5420's OSCAR Data
in a nutshell, my post #26 may only be relevant to you if you have periodic limb movement and central apnea. as such, what follows may or may not interest you.

rereading that post, however, I'm feeling a little guilty of acronym- and jargon- itus. below are abbreviated, mostly off the top of my head descriptions of some terms I used; look in wiki and oscar help for additional detail.

apap: automatic positive airway pressure

vauto: resmed's bilevel pap machine (primarily for obstructive issues that cpap and apap don't resolve)

asv: adaptive servo ventilator / ventilation (primarily for central and mixed apnea, cheyne-stokes respiration, periodic breathing)

oa: obstructive apnea

ca: central or clear airway apnea

ahi: apnea + hypopnea index: average frequency per hour

flow limitations: partial airway restriction, less than apnea, less than hypopnea (think of obstruction as a continuum, from least to most restriction: flow limitation, hypopnea, apnea)

cmw: centimeters of water (pressure)

epap: expiratory pressure

ipap: inspiratory pressure

ps: pressure support; ipap minus epap; resmed epr- expiratory pressure relief - is a limited form; additional capability in higher level machines

trigger: setting in vauto to adjust timing of it's transition from epap to ipap; higher settings help reduce central events for some people.

plm: periodic limb movement

plm induced flow limitations: a personal assumption: I think of typical flow limitations as passive; e.g., weakened, floppy, fatty, sagging tissue creating a restriction. in contrast, I think of plm induced flow limitations as active or non-passive, like a consequence of a grunt/groan. like chin tucking, positive pressure produced by these machines won't overcome this.

no worries though. while you learn the lingo, AB members will help you determine what's important to know and help guide you through optimizing your treatment.
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