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Interpreting OSCAR, Clusters of Central Apnea
#1
Interpreting OSCAR, Clusters of Central Apnea
   

I was diagnosed with moderate sleep APNEA over a month ago and finally got my machine (ResNed AirSense 10) and mask (Airfit F30i) last Monday. I have used it every night. Before I would wake up and have trouble getting back to sleep. Now I am waking more frequently because of new mask issues. After trying the medium and large masks, I eventually I settled on the medium wide, but I was still having issues with it. It seemed to leak a lot and I was sweating under the mask.

I contacted the vendor and asked them to send me a F20 size medium and tried it last night. It gave me fits and i never did get it to feel comfortable. I switched back to the F30i and was finally able to get a couple hours sleep. I haven't decided what I'll try tonight.

Here is a screenshot of last night's data. I started with the F20 until 2:30 AM. From about 2:30 AM to just before 4:00 AM I was awake. and that's when I switched back to the F30i.

I feel my AHI numbers are still quite high after almost two weeks 9-11-8-34-26-17-19-14 and last night 12. Please advise. Thank you.  
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#2
RE: Interpreting OSCAR
First I can see the Cheyne Stokes Respiration. That is not good for heart. I don't know how to make that situation better. Second your apneas are central apneas. Their causes can be different. Maybe someone can tell more about these.

With obstructive apneas increasing pressure could reduce amount of apnea. But not central apnea.
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#3
RE: Interpreting OSCAR
Letsrun100 try turning down EPR to 1 see if it helps any,



I am concerned with the amount of Central Apnoea, do you have a copy of your full sleep study can you post a redacted copy here with all personal information removed. I would like to try and understand if there was any central apnoea on your study as the numbers look too high to be treatment emergent.
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#4
RE: Interpreting OSCAR
Welcome to the forum.

First CSR with ResMed means Periodic Breathing, not CSR until it is verified to be that. AQctual CSR is rare, periodic breathing is not rare.
Post a zoomed view, 5 minutes of data.  That will let us evaluate what is labeled as CSR.
Do you have any breathing or heart issues other than apnea?

Sleep studies, please post full, redacted copies of your sleep studies.  This should include the charts and tables in addition to the summary portion.  The summaries frequently do not include details that are very important.

All that said,
Set your min pressure = 6 for comfort.
Set your EPR to OFF or 0.  This is to manage your central apnea.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
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Dealing with a DME
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Optimizing Therapy
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#5
RE: Interpreting OSCAR
Like others have said, let's see the data on the sleep study. It's possible that info there will show a high ratio of CA vs OA. We need a redacted of personal info multi-paged sleep study report. You need it for your own personal health file regardless.
Dave

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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.
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#6
RE: Interpreting OSCAR
Yes, the number of CSRs and CAs have me a little concerned.

I have included two screen shots. The first shows increased CSRs and CAs and only one OA. I used F20 mask sleeping with the usual two pillows.

The second shows decreased CSR, but still many CAs and increased OAs.  I used F20 mask and slept with my head almost flat with no pillow to eliminate OA due to jaw drop. The 6.56 AHI is the lowest I’ve seen in two weeks.

Tonight I plan to sleep with my head flat and use no pillows, F30i mask, and try to sleep more on my side. The F30i has been more tolerable than the F20 mask.

I am not seeing any improvement in my sleep in the two weeks since I started, and I will not be seeing my doctor for another two weeks. I feel I am on my own to try and figure this all out, but I don’t want to adjust the machine without my doctor’s approval. I know how to adjust it, but I’m hesitant to do so.

Amy suggestions to get AHI down even more? Thank you for your help.

       
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#7
RE: Interpreting OSCAR
Not wanting to adjust it without your doctor, OK, in that case I would not use the machine.
The minimum change would be to turn the "Comfort" setting EPR off, as it theoretically does not impact your therapy.

This one change could have a major change in your therapy, worst case, it will change nothing, maybe a small increase in obstructive events.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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#8
RE: Interpreting OSCAR
Thank you for the responses. I do not have a copy of my sleep study. BTW, i had a home sleep study.

I will make suggested adjustments.

   
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#9
RE: Interpreting OSCAR
I'm sorry my response was rather short. I do not have a copy of my sleep study, but now that you all mention it, I should have and will endeavor to get a copy.

I have no serious medical conditions. My calcium score is pretty low, no heart conditions. No drug use. I am however kinda old, 72 but in pretty good physical condition and exercise every day by walking 4 - 12 miles per day.

I have changed the min pressure = 6.

And set EPR = 0.

Funny how I look forward to my nightly therapy, hoping to get a good nights rest, only to wake several times for various reasons. Finally, at daylight, rushing to the computer with SD card in hand. What do all these numbers and squiggly lines men?
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#10
RE: Interpreting OSCAR
That pattern of periodic breathing is CSR. The duration and frequency needs to be made known to your GP and cardiologist if you have one. The issue is that CHF, Congestive Heart Failure, is closely linked to CSR so that is something to be checked for and eliminated which is what usually happens. You need to see if all of the periodic breathing maintains that pattern of waxing and waning with a CA event between.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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