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Interpreting OSCAR, Clusters of Central Apnea
#21
RE: Interpreting OSCAR
You need an Adaptive Servo Ventilator (ASV) which will resolve all of this. Show your results to your doctor and ask for a titration that evaluates ASV. You have a somewhat urgent need to get this evaluation. If your pre-CPAP AHI was less than 20/hour, then discontinuing therapy is a reasonable temporary solution. This kind of central apnea will not resolve with more time. If your insurance is not adequate or your doctor not responsive to your needs, we will help direct you to the therapy you need at the lowest possible price. Don't waste time. We can't help you with your current machine, and you need to resolve this central apnea problem.
Sleeprider
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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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#22
RE: Interpreting OSCAR
Okay, I will call my doc tomorrow and insist on an office visit to discuss the issues. I believe you all are correct, but I was told the sleep lab is not doing any tests right now, so my options are limited. I have Medicare, so I don't believe cost is an issue.

Attached is a screenshot from my Garmin 245. I'm sure it's not as good as a true oximeter, but it consitantly shows my SPo2 levels too be low over night.

   

Thank you all for your responses.
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#23
RE: Interpreting OSCAR
Your words on the Garmin are that "you know that the results are not likely accurate, but can we follow up an get good overnight numbers. "


Those numbers do need to be investigated.
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#24
RE: Interpreting OSCAR
FYI, your Garmin numbers indicate a need for supplemental oxygen during sleep. I'm assuming that that was with CPAP?

Please action on this ASAP!!!
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#25
RE: Interpreting OSCAR
Since medical necessity for supplemental oxygen is 89% and you are showing a lowest of 77%, this says to me you need to get something done ASAP not soon. Tell the jokers that are supposed to be your medical care team they have work to do to help you now not sometime soon. They need to be made to pay attention to this data.
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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#26
RE: Interpreting OSCAR
Yes, with CPAP, but before I got CPAP it was low then too. The lowest I've seen (during sleep) is 72% and the highest was 90%.

I will call my doctor tomorrow morning.
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#27
RE: Interpreting OSCAR
To be clear, supplemental oxygen while using CPAP is under their watch, your sleep medicine doctor/team is responsible to do this. Without CPAP it would be your PCP.
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#28
RE: Interpreting OSCAR
I talked to my doctor today, he wants to change my pressure to a constant 10 instead of the variable pressure which is now set 5-18. The highest my pressure has gone since I started therapy is 7 or 8. We will try this and on Monday, 4 days from now he will call me back. If this helps, we will leave it there and monitor until my May 28 follow-up visit. If there is no change, he will order an in-lab sleep study, which he thinks I will probably need. He has called the DME provider and they will make the change today.

The next step would be a bipap machine, this will depend on the changes we see come Monday.

In order for there to be justification for ASV my AHI numbers must be at least 50% of the apneas.

As far as the low O2 levels, we will see what Monday's data looks like. The low numbers I have seen are not constant, they are brief periods during the night. He said brief periods are acceptable, but extended periods of low O2 are not.
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#29
RE: Interpreting OSCAR
(05-14-2020, 01:57 PM)letsrun100 Wrote: I talked to my doctor today, he wants to change my pressure to a constant 10 instead of the variable pressure which is now set 5-18. The highest my pressure has gone since I started therapy is 7 or 8. We will try this and on Monday, 4 days from now he will call me back. If this helps, we will leave it there and monitor until my May 28 follow-up visit. If there is no change, he will order an in-lab sleep study, which he thinks I will probably need. He has called the DME provider and they will make the change today.

The next step would be a bipap machine, this will depend on the changes we see come Monday.

In order for there to be justification for ASV my AHI numbers must be at least 50% of the apneas.

As far as the low O2 levels, we will see what Monday's data looks like. The low numbers I have seen are not constant, they are brief periods during the night. He said brief periods are acceptable, but extended periods of low O2 are not.

Your doctor is correct, brief periods of low O2 levels are not a concern.  Eyeballing your Garmin data said about 50% is below 90%, minutes below 88% is justification, IMHO per your Garmin data you are there, the question is how reliable is that data?  Thus the need to measure with the doctor's equipment.

Prepare a bunch of screen prints to take in with you.  You want to show that you frequently have CA events in excess of 5 CAI and frequently have CSR with 10 minute views of the flow rate during the CSR so he can see the pattern.

Here is a wiki to read on ASV http://www.apneaboard.com/wiki/index.php...P_Machines
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#30
RE: Interpreting OSCAR
Justifying Advanced PAP Machines” and “Sleep Lab Titration Guide” previously sent by Sleeprider, are interesting reading. Depending on my data findings on Monday and during my follow-up visit, I may need to discuss these items further.

So, last night I taped my mouth while using my F30i. I woke a few times noticing the tape, but went right back to sleep. I didn’t wake up a much as I usually do because of leaks. Hopefully, I won’t have any trouble with my new nasal mask when it arrives tomorrow. I find it hard to sleep with all the junk on my face.
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