Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

[Diagnosis] OSCAR: TECSA, CSR, or something else?
#11
RE: OSCAR: TECSA, CSR, or something else?
Attached is the summary. I'll see about getting the old machine set up again today and go from there.


Attached Files Thumbnail(s)
   
Post Reply Post Reply






Donate to Apnea Board  
#12
RE: OSCAR: TECSA, CSR, or something else?
My opinion is that if you want to reduce and also avoid some Central Apnea of any flavor (in your case these are TECA), reduce EPR and turn off Ramp. This reduces some of the variables in pressure that CA don't like.
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.
Post Reply Post Reply
#13
RE: OSCAR: TECSA, CSR, or something else?
We often see these CSR flags in TECSA and other central apnea cases. Imo these machines are not capable of distinguishing CSR from other central apnea breathing and I think they just flag CSR when there are longer periods of continuous apnea like this.

Imo this is qlmost guaranteed to be TECSA as your doctor diagnosed. The only thing that would make me think otherwise is if you are also having other symptoms of heart failure in which case yes go see a cardiologist.

Imo you need ASV and your doctor has been right on the money so far. Sounds like it should be easy for you to get the titration although you could see if doctor will just trial asv instead.
Post Reply Post Reply
#14
RE: OSCAR: TECSA, CSR, or something else?
(01-08-2022, 04:38 PM)SarcasticDave94 Wrote: My opinion is that if you want to reduce and also avoid some Central Apnea of any flavor (in your case these are TECA), reduce EPR and turn off Ramp. This reduces some of the variables in pressure that CA don't like.

Oh interesting. I've never heard about ramp having an impact. I'll give these both a shot tonight and see if it gets me anywhere.

(01-08-2022, 04:53 PM)Geer1 Wrote: We often see these CSR flags in TECSA and other central apnea cases. Imo these machines are not capable of distinguishing CSR from other central apnea breathing and I think they just flag CSR when there are longer periods of continuous apnea like this.

Yeah, I'm beginning to get a sense it's... not great. It's diagnosed this same exact breathing pattern as OSA a couple nights, plain CSA some nights, and CSA-CSR on other nights.

Quote:Imo this is qlmost guaranteed to be TECSA as your doctor diagnosed. The only thing that would make me think otherwise is if you are also having other symptoms of heart failure in which case yes go see a cardiologist.

Well I've got four different congenital heart defects, but no heart failure as of yet (knock on wood), at least per my tests last March. I'm reaaaaaaally hoping to keep it that way, and was primarily concerned this night be a sign things were going south on that front, moreso than I'm even directly worried about the apnea in a lot of ways, although obviously I want to sort that out too. But yeah, no obvious physical symptoms anything had changed.

Quote:Imo you need ASV and your doctor has been right on the money so far. Sounds like it should be easy for you to get the titration although you could see if doctor will just trial asv instead.

So the good news was we already did the ASV titration. That was the in person I did in December. Still some RERAs with that, but the apneas all went away. Can always refine from there once I actually have a machine. Gonna try some of the suggestions from here with the old CPAP and see if it gets me anywhere in the mean time. If not, I'll just wait I guess. Hopefully not too long. He's written out the order, as of about a week ago. Last time it was 10 days from that to getting my machine, but given I haven't had anyone contact me about setting up an appointment as of yet, I suspect this one is going to be a bit longer. I know supply is in the toilet right now, and there's also the chance my insurance is gonna take a while, guess we'll see.
Post Reply Post Reply






Donate to Apnea Board  
#15
RE: OSCAR: TECSA, CSR, or something else?
The advanced machines such as the ASV are minimally affected by the shortage simply because there are very few of them, The shortages are hitting CPAP/APAP hard and BiLevel without backup quite a bit less.
Post Reply Post Reply
#16
RE: OSCAR: TECSA, CSR, or something else?
That is good news the ASV helped. Especially for the first night I wouldn't be surprised to have some remnant reras as ASV can take a while for the body to get used to.
Post Reply Post Reply
#17
RE: OSCAR: TECSA, CSR, or something else?
I have also had a whole night determined to be OAs by the CPAP when I absolutely do NOT have OSA, I have pretty much as pure CSA as you can get (as in 80+CAHI vs 5 OAs total on sleep study). It's an unfortunate side effect of the machine not being able to measure respiratory effort and taking a guess via FOT - it basically uses "echolocation" to check if your airway seems obstructed, and if so, tags it as an OA - but even if your airway is completely blocked, if you aren't even trying to breathe, then the event is a central apnea.

Glad to see ASV is helping. Smile
Post Reply Post Reply






Donate to Apnea Board  
#18
RE: OSCAR: TECSA, CSR, or something else?
Get your personal copy of all the detailed versions of the diagnostic and Titration results. You can post a redacted copy of it here and we can comment.
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.
Post Reply Post Reply
#19
RE: OSCAR: TECSA, CSR, or something else?
So... update:

1. Talked with the pulmonologist, and they aren't terribly concerned, said I'd have other symptoms if it were heart problems.
2. Pinged the cardiologist just in case because I'm paranoid. Cardiologist out till next week, but the nurses suggested it's probably a nothingburger.

In the meantime:
1. Should get my ASV next week.
2. Turned off all the things and dropped the pressure to six, then four, with significant improvements each time. Periodic breathing is still there a bit, but less, and very few actual apneas. Surprisingly I'm not seeing a ton in the way of obstructive apneas either. Is it possible the initial study is just completely borked and this machine is simply what's causing my sleep apnea to begin with? That said, I also see some significant variability in the flow limit graph. I assume that's a measure of obstruction in the airway? Would that suggest the diagnosis is correct, but just being at least somewhat contained even at an extremely low pressure?

Looking into getting the original full results instead of just the report, but may not be a simple process unfortunately.


Attached Files Thumbnail(s)
           
Post Reply Post Reply
#20
RE: OSCAR: TECSA, CSR, or something else?
I do see some clusters of Apnea, Hypopnea events indicating chin tuck. Was Positional Apnea and a soft cervical collar mentioned yet?

To clarify, this Positional Apnea is not what doctors talk about, like in sleep studies, where they refer to supine, prone, side sleeping body positions. This is rather referring to a head, neck position that tucks your chin towards your chest. This position kinks your airway much like kinking the garden hose restricts water. The solution is the soft cervical collar.

The clustering of events can be seen where you'll have a series of event flags, one after another in a cluster pattern. See the first most recent chart, the CSR area? There's a big possible Positional Apnea cluster. Next chart, 1/11, time 0710-0730 another likely. Chart 1/12 light clusters as early as 0511 but more defined at 0550-0640.

To allow more details to show, collapse the calendar with the black triangle in the date area, far left.
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.
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  I like Oscar 1.2.0. Can I turn off Oscar New Version Notifications E.W. 1 392 10-25-2021, 06:51 PM
Last Post: GuyScharf
  [CPAP] CPAP, BPAP, or ASV to start with eye towards TECSA Nohbotal 14 1,381 06-11-2020, 01:57 PM
Last Post: sheepless


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.