Interpretation Questions - My OSCAR Data

[ApneaQuestions]

I have no proof these fluctuations are from heart rate...

Yes I understand the caveat.. but your theory seemed the best available so far.
 
90 does sound high for someone asleep though doesn't it?

If anyone has any better theories or guesses we'd all love to hear them.

[ApneaQuestions]

Here's a nice image of a robot emulating flow limitations used to bench-test CPAP machines

Bench Test Study here:
https://openres.ersjournals.com/content/...5.full.pdf

[ApneaQuestions]

I got a loaner oximeter last night as part of the final "farewell" from my sleep doc.
These images might be interesting for the inquisitive types.

I managed to hack the data using SpO2 assistant.
Download here: http://www.contecmed.com/index.php?optio...Itemid=590

I posted a few images.

Note:
1) Yes my pulse really is sometimes 90 BPM (which nicely matches the analyses a few posts earlier looking at wiggles on the tail end of my exhalations).
2) Data integrates nicely into OSCAR
3) Take the relative positioning of O2/pulse data with a pinch of salt when zooming in closely.  The clocks on the PAP machine and the Oximeter are probably not synchronized. There can easily be a time shift between the oximeter data and the CPAP data.
4) Nevertheless, there are some interesting cyclic O2 swings that correlate with cyclic breathing anomalies

Maybe I'll buy an oximeter after all. I'll be looking to pay a little extra and get the same brand that I used last night. They should be fairly durable if the lab uses them as loaners on an ongoing basis.  There should be none of the disclaimers saying "Do not use this probe for more than 2 hours" as we see on cheaper models. It felt comfortable and  I forgot I had it on.
Oximeter was Virtuox Vpod Ultra

$64,000 question... what's going on with the cyclic CA breathing?

[ApneaQuestions]

Here's a cute animation I did on this other thread..
http://www.apneaboard.com/forums/Thread-...#pid325834

It shows "nice" waveforms versus "bad" waveforms resulting in a RERA event.

Hoping to get one with better axis exaggeration on the flow rate later tonight.

Here's how I did it... It's an animated "gif" file
Many programs can create them.. some are easier than others.
However I used "gimp" which is an opensource free image processing program (like a free version of Photoshop.. kinda)
I just imported the first image then imported the second image as an overlay and then exported the whole file as an animation with timestep 0.5 seconds looping forever
Here's how : https://itstillworks.com/animate-jpg-com...00984.html

[JoeyWallaby]

That oximeter looks like a rebranded contec cms50i.

[ApneaQuestions]

You are right!

Virtuox VPod Ultra is actually rebranded Contec CMS50I

For some reason the SAME oximeter was detected with two different "names" by SpO2Assistant.
I noticed a popup running Sp02Assistant saying that the name had changed.. I just ignored it.

Here's how it shows up in OSCAR (images)

The "I" version is $100 on Alibaba

The "F" version (not the "I") is $83 (US) today on Amazon
Check the one star and 2 star ratings
As I mentioned elsewhere people claim the F version is...

1) Inaccurate (calibrated against macihine at Doctor's office)
2) Tends to fail rapidly (screen stops working)
3) Docs say only use probe for 2 hours at a time
4) etc

These things are only accurate +/- 2% anyway and rely on being non-anemic.

[ApneaQuestions]

An annotated image showing the drop in O2 when breathing becomes periodic/cyclic

[ApneaQuestions]

Just because I can ;-)

VAuto mode

This may help to visualize the effects of changing PS, MinEPAP & MaxIPAP

The red pong is a small PS (say PS=4) cranking up from MinEPAP to MaxIPAP
The blue pong is a larger pong (say PS=6) doing the same

https://photos.app.goo.gl/gZibMihu9xr9GAB67

If it doesn't help... at least I had fun :-)

[ApneaQuestions]

So I'm now using my Titration machine as described here:ResMed S9 VPAP Tx

That thread will explain why I'm not showing OSCAR graphs

Determined to try to fix my flow limitations I just stepped straight into ASVAuto mode.

It was a perfect night of ZERO events and the waveforms are all fixed or significantly better.
(The "events" showing up in the "Annotations"  area are simply "start therapy" & "stop therapy")

Titration Settings were:
Mode:ASV_AUTO
ASVAuto_MaxEPAP:15
ASVAuto_MinEPAP:5
ASVAuto_MaxPS:15
ASVAuto_MinPS:3
Change Event:Manual

You can see the rapid changes in IPAP pressures (every breath) that fixed the waveforms

My conclusion: Everybody wins with ASV with or without centrals.

[sheepless]

"My conclusion: Everybody wins with ASV with or without centrals."

well, not quite everyone. I used asv for more than a year and gave it up for now in favor of vauto.

while the algorithms worked well to get my ahi down around 0.3, aggressive & ineffective swings of pressure support against my non-passive flow limitations induced by periodic limb movements wore me down. there's no way with the resmed asv to minimize ipap max enough to avoid this problem.

vauto is better in my case for now with steady epap & ipap, min ps to help with the passive flow limitations & a low-ish ipap max to avoid the swinging pressure support problem with non-passive flow limitations. I have more events now in response to plm but they seem to take less of a toll than the crazy asv ps swings.

I say 'for now' because the asv treats my mixed apnea better & I expect to try it again if as when I get some meds that are more effective at managing periodic leg movement than what I take for it now.