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[CPAP] First Night on AirSense 10 - New Member
#11
RE: First Night on AirSense 10 - New Member
I think you're conspiratorial thought is right on the money, literally and figuratively.
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#12
RE: First Night on AirSense 10 - New Member
OK here's some stats: Apnea 103 Hypopnea 141, very little Mixed at 0.1, CAI 7.4, OAI 6.6. I would say this indicates that CA is an issue along with Obstructives and a bunch of Hypopnea or partial apneas. What does OSCAR look like after what I believe is several month's usage? If it looks similar to the older ones, you're not really receiving good therapy. But before we make any opinions, show us some recent OSCAR.

BTW doc is calling QUACK QUACK I see no CA. It's not an issue. Oh really? Complain until the doc's ears and eyes bleed.
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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#13
RE: First Night on AirSense 10 - New Member
(11-15-2020, 09:30 PM)SarcasticDave94 Wrote: OK here's some stats: Apnea 103 Hypopnea 141, very little Mixed at 0.1, CAI 7.4, OAI 6.6. I would say this indicates that CA is an issue along with Obstructives and a bunch of Hypopnea or partial apneas. What does OSCAR look like after what I believe is several month's usage? If it looks similar to the older ones, you're not really receiving good therapy. But before we make any opinions, show us some recent OSCAR.

BTW doc is calling QUACK QUACK I see no CA. It's not an issue. Oh really? Complain until the doc's ears and eyes bleed.

Hi Dave. Thanks for the reply. My personal Sleep Dr. wasn’t concerned with CSR based on discussions we had, and my overall good health other than my Sleep Apnea. He did not ignore the CA. We actually discussed it. He did mention ASV at one point during my initial consultation, but he wanted to see how therapy went initially. After a few weeks, my CA numbers were significantly reduced. Again, I’m averaging around 1 or below nowadays. I’ll post charts soon. 

I guess my specific question is why did the Dr. writing the report say I had mild Central Sleep apnea and Severe OSA when the CA index was higher than the Obstructive index? Are there other factors in the calculation with which I’m unaware, or was that an oversight?

Thanks!
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#14
RE: First Night on AirSense 10 - New Member
If it were a write up or 2 across the country then that's an oversight. Most sleep doctors do not recognize Central Apnea to be an issue. So if they are a disturbance to your sleep, you must make it an issue by giving doc a symptom and complaint list that this isn't addressed and is an ongoing issue you demand be given attention, if true for you about the CA.

To be clear I am talking about CA, not CSR. CA is central apnea while CSR that was discussed earlier as probably mis-flagged and is a totally separate issue. My understanding is ResMed may flag events and call it CSR but is really periodic breathing.
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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#15
RE: First Night on AirSense 10 - New Member
Thanks Dave. Yes, I know you were referring to CA now.  I was simply responding to the comment in your 2nd paragraph, where there was a reference to a quack doctor ignoring the CA. I just wanted to clarify everything, as I felt you thought my personal Dr. ignored the CA, as opposed to the Dr. who wrote the report. 
I’m just really curious about the “mild” CSA vs. Severe OSA designation by the report Dr. as I can assume it’s a clinical diagnosis based on math. That’s all. Doesn’t make logical sense to me so I wanted to know if there was an official calculation/reason. 
I will definitely post some charts in a few days/week once my little “experiment” is over. Instead of using a pressure range, I’ve been slowly adjusting min/max pressure on a fixed level, attempting to locate the best pressure that is low enough to prevent treatment induced CA’s from appearing, and high enough to eliminate OA’s and Hypopneas, all the while reducing flow limitations the best I can. Been noticing that a fixed min/max “may” work best for me. TBD! I only use EPR on Auto-Ramp as I’m aware that EPR can unfortunately increase CAs.
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#16
RE: First Night on AirSense 10 - New Member
Just so you aware Code G47.33 is the diagnosis code used for Obstructive Sleep Apnea nothing to do with quantity G47.31 is the code for central sleep apnoea (CA’s)
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#17
RE: First Night on AirSense 10 - New Member
(11-16-2020, 02:28 AM)jaswilliams Wrote: Just so you aware Code G47.33 is the diagnosis code used for Obstructive Sleep Apnea nothing to do with quantity G47.31 is the code for central sleep apnoea (CA’s)

Ha! Awesome. Thanks! Makes sense. I was wondering how those “figures” were calculated Wink Well, at least that clarifies a part of my question!
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#18
RE: First Night on AirSense 10 - New Member
Yep those G codes are for diagnosis. This G code is an ICD-10 style. G47.31 diagnosed as Central Apnea, and G47.33 for Obstructive Apnea. The moderate diagnosis for OA and mild diagnosis for CA is a bit slanted wrongly, unless the doc has included Hypopnea and Obstructives are together, and yes they may well be. I suppose what may be best is to sit down and really consider which apnea hinders your sleep, OA, H, CA, all. Make some kind of notation that you feel these events disrupt sleep. Even though the doc may be doing everything well, he isn't the one suffering from the apnea. Convey the apnea events are disruptive, describe it in as detailed fashion as possible.
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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#19
RE: First Night on AirSense 10 - New Member
Thanks again Dave! Yeah, the report had me at Severe OSA and mild CSA.  Just strange overall.  I guess next visit to my personal sleep Dr. i'll ask about it.  He'll probably think the report Dr. was half asleep when he wrote it. Ha!  

Overall, I think i'm doing pretty solid.  I'll update more soon, but below are a few charts as I know those are the key contributors to a more detailed discussion.  I think my only real issue is going to bed earlier.  I average around 6-6.5 hours of sleep per night.  Could probably use a little more like most of us! 

I've successfully killed off (for the most part) OAs, Hypopneas, RERA's, Unclassified, Leaks, etc. The OA's/Hypopneas & flow limitations were still there to a tiny degree until I recently upped the min pressure a little.  The only events that remain are Centrals, which aren't much I guess when compared to many others here, so i'm not complaining in the least.  I guess I'll discuss ASV with ya'll in a bit, but i'm not sure if the juice is worth the squeeze as my numbers are pretty solid.  I know it's more about how I feel than the numbers and "not chasing numbers". Overall, I feel exponentially better than prior to starting therapy.  I just need more sleep Wink

Here's last night's default chart, last night's chart showing the events info, a close up of a few centrals along with the associated flow chart / waveform, and my stats page. 

I've been playing with a fixed pressure value, but just decided today to really just narrow down the APAP range after reviewing all my daily stats.  Currently set for 9-13.  The fixed amount of 8.8 last night worked great for the most part.  I just know APAP can adjust for weird situations, body position, etc. that I can't control.

I only use EPR for the ramp, which is set for Auto. I'm not sure why the machine settings say ramp time is "45 min" since it's set for Auto.

Any and all thoughts/suggestions are welcome.


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#20
RE: First Night on AirSense 10 - New Member
Looking at your latest graphs no need of an ASV the few CA’s could be as simple as holding your breath whilst rolling over great numbers.
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