Interpretation Questions - My OSCAR Data

[Sleeprider]

I don't see a central. I see increasing flow limitation leading to a RERA with an open-airway apnea that looks for all the world obstructive based on what is around it. I completely agree with the direction from Bonjour to start treating flow limitation and not be concerned about what is flagged as a CA.

[ApneaQuestions]

I don't see a central. I see increasing flow limitation leading to a RERA with an open-airway apnea that looks for all the world obstructive based on what is around it.  I completely agree with the direction from Bonjour to start treating flow limitation and not be concerned about what is flagged as a CA.

Yes that's what we are doing (flow limitation and RERAs et al). 

You'd need to go back to the chart (attached) to see why we are being cautious about the possibility of re-triggering CAs.

I am hoping (and starting to believe) that I may have crossed the acclimatization threshold and that treatment-emergent CAs may now be a thing of the past. If true.. that's a fairly recent transition.

The centrals were previously triggering with EPR 3  (worst-case nightly CAI 32.7 and worst hour clustered CAI rate of approx 94.0 per hour)

In the past couple of days we stepped back to EPR 0 to fix the CAs ...then creeping back up to give RERA support with EPR 1 last night .... EPR 2 tonight ... tomorrow (maybe) back into the EPR 3 realm

We are going slow to try to avoid repeating the treatment-emergent CAs that were seen previously in the attached chart on Nov 28th when EPR was 3.

If I'm hearing you correctly... It's interesting to hear you say that you disagree with the CA flag...is that what you are saying?

I previously asked my Sleep Doc if she had seen any peer-reviewed papers she could point me to that measure how RELIABLE those CA flags are.  Sending ripples or pulses down the pipe to try to guess is a cute idea but I've not seen any papers measuring just how ACCURATE these flags are.  We can't know for certain unless we have a study that compares the flags against readings from chest bands to truly measure if the muscles are working or not.  Unfortunately she did not know of any such studies and just believes the flags because Resmed marketing tells her to.  I am a more skeptical audience... maybe you are too (if I'm reading your response correctly).

[Gideon]

I too agree with SR in that those in the detail graph are not Centrals.  On the whole the events tagged as a CA are usually centrals.

[ApneaQuestions]

Last night's data...

What changed?:   EPR bumped 1 to 2
What's next?: Guessing EPR bump 2 to 3

Symptoms/Subjective:
Sleep: Some full-conscious awakenings.
Sleep: Not enough - Waking too early and too alert.
Sleep: Not refreshing - Too fragmented
Daytime: "chronic jetlag" and "fogginess"
Morning: Mouth: completely dry
Morning: Nose: dry and congested (non-optimal Turbinate reduction surgery. Septum fixed)
Morning: Eyes: Puffy, baggy, slitty

My Impressions: 
CAs not re-triggering.  Maybe now acclimatized CO2 preventing treatment-emergent CAs

Zoomed plots showing:
Poor waveforms (RERA flat-tops) ?
Apnea-like breathing stop but less than 10 seconds so no event reported
Pseudo-CA ? Real-CA ?

My user-defined flags
Trying to get better RERA insight.
UF1: Triggered if Flow Limitation 80% for 10 seconds
UF2: Triggered if Flow Limitation 80% for 5 seconds

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[ApneaQuestions]

CA zoom

[ApneaQuestions]

Maybe I should have put this in its own thread... we'll see

I was intrigued to see this in an OSCAR plot

Does this mean that the user has a personal EEG hood/cap/headband?

If so... are they gimmicks?
Does anyone have recommendations on things that are reliable and comfortable and integrate well into OSCAR at a reasonable price?

I'm assuming this data would give a better feel for true arousals and fragmented sleep.  Nice to have.. but only if it's accurate and reasonable cost.

[Gideon]

I would try EPR=3 tonight.

[ApneaQuestions]

Last night..

No data.  Only one hour with PAP machine.

Hose was banging and knocking due to water condensation build up then squirted water at me.
Took off the mask to clear the water but fell asleep.  Didn't seem to wake up again until it was too late to put it back on.

Although no data was generated, it confirmed for me that I still sleep "better" without PAP. Ironic.

Try again tomorrow.

[ApneaQuestions]

This might be interesting for anyone getting up the learning curve on interpretation (like myself).

I made this collage of images showing classic inhalation waveforms that can indicate RERA-like flow limitation.

   

This google search may help track down the paper containing that table.
It will find a lot of deep-dive ventilator theory papers too if you have the interest and the time.
https://www.google.com/search?client=fir...+waveforms

Also, here is @Bonjour's answer to a question I asked related to another thread.
http://www.apneaboard.com/forums/Thread-...#pid323345

   

[sheepless]

nice!