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Interpretation Questions - My OSCAR Data
#1
Interpretation Questions - My OSCAR Data
I am starting to try to understand how best to interpret Oscar data.

The time stamps are 2 hours offset due to incorrect clock setting on the machine, but that shouldn't affect the interpretation.

I wonder if anyone is willing to give first impressions without me saying anything to sway your analysis.

I don't know when I was awake and when I was asleep but my sleep is fragmented as I try to get used to the mask etc.

I am showing data for one night at 3 zoom levels.

I zoomed in on the clustered CAs and then even closer on a piece of the cluster. I'm not sure if that helps.

I have a few thoughts and observations but I'd prefer to hear your unprompted opinions.

Thanks in advance.

PS - I didn't turn the event marks on each subplot.  I'll do that for future snapshots.


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#2
RE: Interpretation Questions - My Oscar Data
Why do you have an ASV? Do you have a diagnosis of central apnea (without CPAP)? I'm surprised you only had one OA with min pressure 4.

If you don't have central apnea without CPAP, this is likely treatment-induced central apnea. It only occurs only in NREM sleep, mostly S1 and S2. That first big pressure bump you have is likely REM sleep, where your machine detected flow limitations and increased pressure in response and prevented any obstructive events (impressive). After you cycle back out of REM, CAs are massively increased, particularly in the second part of the night with increased pressure.

If you reduced EPR to 0 and saw a significant improvement in CAs, that would pretty much confirm it.

Edit: I saw you asking why attachments in my thread were deleted. I haven't deleted any attachments, I think the forum had a glitch and deleted some attachments.

The attachments on the first page were my sleep study results which I posted again here. http://www.apneaboard.com/forums/Thread-...#pid320868
Nothing I post is medical advice and should not be taken as such, always consult a medical professional for guidance.
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#3
RE: Interpretation Questions - My Oscar Data
My first thought is why aren’t you using the ASV machine that you list in your profile.
An auto Cpap cannot treat those central apnea’s.

Before going there, you can do one thing tonight, and that is turn the EPR setting to off, and see what this shows in the morning.

Did you have a sleep study done?  We’re you diagnosed with Central Sleep Apnea?  

Can you turn on the flag in the events graph for Periodic Breathing (may be labeled Cheyenne Stokes Respiration or CSR).

Edit: I see I’m on the same thought process as JoeyW.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Interpretation Questions - My Oscar Data
Welcome to the forum.  Thanks for the charts.

The end goal of many with that many centrals is frequently to get an ASV so why do you have an ASV and why are you not using it.

Please make sure that all your events are enabled at the bottom of the charts.


Flow limits, snores, and possibly Obstructive Apneas are driving your pressure changes but it is the Central Apneas that need to be immediately addressed.

Set your EPR= 0 so we can see how your central apnea responds to that change.  I expect a substantial change but I don't know because I know nothing about them.  I would like to see a full copy of your diagnostic sleep study to determine if you had any pre-CPAP.  Your titration study also, the full study.  Summaries tend to be focused on OSA often not, mentioning the occurrence or absence of other than obstructive events.  Seeing your central apnea it will help to know the history of your central apnea.  

You do not have CSR, just periodic breathing.

The impression I have is that your obstructive apnea is not all that bad.  Again if you find event flags disabled it could show some more detail. 
What is not uncommon is to see treatment-emergent central apnea in new users to CPAP.  What happens is your CPAP has you breathing more efficiently.  Sounds good right?  Well as you are increasing the Oxygen absorption you are also flushing out a greater amount of CO2.  Unfortunately in the unlucky few this decreases the CO2 in your blood to the point where your body fails to send a signal to breathe thus a central apnea.   When we have more data we will know if I am right or not.

That said, do you know why you have central apnea?
Any cardiac issues?
Breathing issues other than sleep apnea?
neuro-muscular disorders?
Strokes or Seizures?
Brain injuries?
Drugs, either prescription or recreational?
The goal here is to eliminate possible causes.
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#5
RE: Interpretation Questions - My Oscar Data
(12-08-2019, 05:34 PM)JoeyWallaby Wrote: Why do you have an ASV? Do you have a diagnosis of central apnea (without CPAP)? I'm surprised you only had one OA with min pressure 4.

If you don't have central apnea without CPAP, this is likely treatment-induced central apnea. It only occurs only in NREM sleep, mostly S1 and S2. That first big pressure bump you have is likely REM sleep, where your machine detected flow limitations and increased pressure in response and prevented any obstructive events (impressive). After you cycle back out of REM, CAs are massively increased, particularly in the second part of the night with increased pressure.

If you reduced EPR to 0 and saw a significant improvement in CAs, that would pretty much confirm it.
Thanks for the rapid reply.   If it's ok with you I will wait for a few hours and see if I have any other "takers" before answering all your questions.
I am impressed by your comments and will give lots more information (probably too much information) shortly. 
I guess I'm wondering if others will agree or give alternative interpretations simply by looking at the data "cold" (ie with no narrative from me).
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#6
RE: Interpretation Questions - My Oscar Data
(12-08-2019, 05:37 PM)OpalRose Wrote: ...Can you turn on the flag in the events graph for Periodic Breathing (may be labeled Cheyenne Stokes Respiration or CSR)....

Thanks for your reply
All your questions (and more) will soon be answered after the initial responses have trickled in.

I'm struggling to find anything in the OSCAR UI to turn on flags for Periodic Breathing aka Cheyne Stokes.
I'm scanning OSCAR docs as we speak.. but if you can get me there faster I'd appreciate any hints.
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#7
RE: Interpretation Questions - My Oscar Data
(12-08-2019, 05:42 PM)bonjour Wrote: ...Please make sure that all your events are enabled at the bottom of the charts...
Thanks for the reply.
All your other questions will be answered soon after the replies have trickled in.

I am not sure I understood what you were suggesting in the above quote.
What I DID do was to make sure that each sub-graph had all the overlays turned on (as mentioned in my P.S. in post #1) (see attached graph)

If that's not what you meant... can you rephrase please and I'll do my best


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#8
RE: Interpretation Questions - My Oscar Data
(12-08-2019, 06:38 PM)ApneaQuestions Wrote:
(12-08-2019, 05:37 PM)OpalRose Wrote: ...Can you turn on the flag in the events graph for Periodic Breathing (may be labeled Cheyenne Stokes Respiration or CSR)....
All your questions (and more) will soon be answered after the initial responses have trickled in.

I'm struggling to find anything in the OSCAR UI to turn on flags for Periodic Breathing aka Cheyne Stokes.
I'm scanning OSCAR docs as we speak.. but if you can get me there faster I'd appreciate any hints.

Go to the bottom of the daily page, left side.  There you will see a drop down box.  Click on it and turn on the flags for Obstructives, Hypopneas and Periodic Breathing.   They will then show up in the events graph. The bars should be green/black if turned on.
See example below with arrow.

[attachment=17842]
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
RE: Interpretation Questions - My Oscar Data
The fact that you have no obstructive events is unusual, wanted to make sure that obstructive events are enabled. this is the drop down in the lower left of the charts.
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#10
RE: Interpretation Questions - My Oscar Data
OK, I'm done playing games here
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