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First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
#11
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
Your centrals there are looking ideopathic, that means of unknown cause. In your case it means that they are unlikely to go away. The EPR lowering, and possibly turning it off I now expect to have very little effect on your central.

Your Actions: Talk to your doc about scheduling an ASV Titration, remember, if your Centrals go away it can be canceled, but by scheduling it now you will minimize delays in getting it and an ASV. The ability to cancel will give your doc the 3 months he is looking for to establish this is treatment-emergent. The goal is to get the ASV titration scheduled.
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#12
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
(04-07-2021, 12:07 PM)Gideon Wrote: Your centrals there are looking ideopathic, that means of unknown cause.  In your case it means that they are unlikely to go away.  The EPR lowering, and possibly turning it off I now expect to have very little effect on your central.

Your Actions:  Talk to your doc about scheduling an ASV Titration, remember, if your Centrals go away it can be canceled, but by scheduling it now you will minimize delays in getting it and an ASV.  The ability to cancel will give your doc the 3 months he is looking for to establish this is treatment-emergent.  The goal is to get the ASV titration scheduled.

Thanks for your help. 

Still a bit confused.  Initially I thought "CA" was central apnea.  Now I see it says "clear airway" 

How can I tell by looking at Oscar data how many central apneas Im having. 

Regarding EPR - I see that on my resmed air sense 10 I can either turn it off or leave it on.  Which should I do?

Regarding my doctor and an ASV titration - I used Lofta for my at home sleep study so I don't think they do Titrations.  I should go see an actual sleep study doctor right?  Thanks again for your help
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#13
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
On my machine under clinical settings it says my avg AhI is 9 obstructive and 5 centrals per hour
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#14
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
(04-07-2021, 11:42 AM)fikus56 Wrote:
(04-07-2021, 11:03 AM)Gideon Wrote: I would like to see your diagnodtic sleep study, redact your personal data please.
I would like to see 5 minute view of a couple of your ca events to judge their 'character'.
and I would like you to reduce your EPR to 1 as higher EPR tends to lead to higher ca in a few 'lucky' people,

All this will tell us more about your apnea.

You are 2 months into CPAP, treatment-emergent apnea tends to diminish after 2-3 months as your body adapts to treatment.  At this time, while I suspect, I don't know if this is you.

Ok here is a 5 minute view of a few of my CA events

1 more

(04-07-2021, 11:29 AM)Gideon Wrote: That is a summary, It doesn't even mention central apnea.  You were having a lot of flow limitations as evidence by detected RERAs and your AHI.  RERAs = RDI - AHI

unfortunately, this is the only data I have.

I was able to get them to send me the clinical data - see attached


Attached Files Thumbnail(s)
       
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#15
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
CA = Clear Airway (there was no obstruction) = Central Apnea. Technically an xPAP cannot identify a CA because it has no way of knowing that you have not attempted to breathe, that you had no chest movement, and no belly movement to correspond with your breathing. The CA events are considered an acceptable indication of central apnea.

In OSCAR we call them what the manufacture calls them and do so simply because that is what they called them.

Decrease your EPR to 1, so we can have that data point.

Again

Your Actions: Talk to your doc about scheduling an ASV Titration, remember, if your Centrals go away it can be canceled, but by scheduling it now you will minimize delays in getting it and an ASV. The ability to cancel will give your doc the 3 months he is looking for to establish this is treatment-emergent. The goal is to get the ASV titration scheduled.
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#16
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
Thanks for explaining that piece

I’ve decreased EPR to 1.

Will see if my doc can refer me for an ASV titration.

Could you tell from my sleep study if there were centrals ?
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#17
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
There were NO recorded CA events. Since CA was not even mentioned I doubt they were tested for. I cannot tell you had centrals during your sleep study.

The appearance of the central apneas look idiopathic, on that basis I believe that they were present, but not recorded. during your sleep study.


With your doctor acknowledge that you know he can't do that immediately, but you want to be moving toward ASV under the assumption that since the centrals have been present for 2 months and will be there in the future. And You can always cancel if the centrals reduce significantly.
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#18
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
GideonThere were NO recorded CA events.  Since CA was not even mentioned I doubt they were tested for.  I cannot tell you had centrals during your sleep study.

The appearance of the central apneas look idiopathic, on that basis I believe that they were present, but not recorded. during your sleep study.


With your doctor acknowledge that you know he can't do that immediately, but you want to be moving toward ASV under the assumption that since the centrals have been present for 2 months and will be there in the future.  And You can always cancel if the centrals reduce significantly."

Ok thanks for reviewing this for more.  I requested the ASV titration study from my new doctor last night so I'm sure we will get the ball rolling. 

I am attaching another night's sleep.  Again, I was in bed for about 10 hours and mostly asleep.  Still had tons of CA's resulting in an avg AHI of 18....

Is it possible the machine is broken?


A few weeks ago I was getting AHI mostly under 10 and on good nights under 5.


Attached Files Thumbnail(s)
   
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#19
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
It also looks like my myAIR score is showing that im leaking a lot of air. I used to get like a 20/20 now its giving me a 10/20. I know this isnt as precise as the oscar data but is it possible that the leaking air is causing the machine to show more events than are actually happening?

I felt a lot better using the CPAP when I was getting an AHI of 5-10 and had much less of a leak going on.

I suspect the additional leaking started happening when the pressure settings were increased.

Im contemplating lowering the min pressure from 8 to 6 , no ramp, and then maybe lowering the max from 16 to 14. Sometimes when I wake up , i can tell it is on Max pressure and the mask is leaking.
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#20
RE: First Post - 60 days using CPAP - AHI still 10+ Oscar Data included
Ok - I would like to
Update everyone who helped me with this as to where I’m at.

I ended up getting a titration study in a lab after seeing a pulmonologist and he helped it
Get covered completely by insurance. 

The results were as you expected. I  am having central apnea’s as well as obstructive.

They prescribed me a Bipap ST with pressure set to 20/16

Thoughts on this ?
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