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Need Assistance with Oscar and Cpap
#1
Need Assistance with Oscar and Cpap
Hello I recently got diagnosed with UARS and been using my apap for about two weeks now on and off and I use the p10 Nasal mask
For the last week I've been waking up in the middle of the night often at 2 am or 3am to use the restroom when I am using my Apap, Where as nights when I don't use my Apap I sleep throughout the night and don't wake up.


When I wake up at night I take off the mask and just sleep without it since it would be a lot harder to fall back asleep with it on, so I am only getting about 4 hours of compliance a night.

But Nonetheless I am still pretty tired and exhausted whether I am using the Apap or not 


As for Oscar it says im having Clear way apneas even when my sleep study said I had no issues with central apneas .Maybe my pressures wrong? I don't know maybe someone can see something I cant, Thanks

   
   
   
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#2
RE: Need Assistance with Oscar and Cpap
If you had no centrals in your study you have treatment emergents. They come on when you first start therapy and go away when your body gets used to the therapy.

EPR can cause more centrals when you first start. I would suggest you turn off
EPR for a while and add it back in a few weeks.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Need Assistance with Oscar and Cpap
Welcome to the forum.

Which sleep study or both, Diagnostic, first without CPAP, or Titration with CPAP?
Any Mixed or Complex Apnea on either. Please post your sleep studies and there are other terms for Central Sleep Apnea.

Fairly common is Treatment-Emergent Central Apnea. This occurs because all flavors of CPAP improve your breathing and in a (un)lucky few they flush too much CO2 out of their systems to below their apneic threshold resulting in a Central Apnea. Many don't know it but having a higher CO2 level, and the need to clear the CO2 provides our primary need to breathe. It is NOT the need to breathe oxygen, low oxygen actually makes us breathe faster but it does not trigger the initiation of a breath. This happens gradually both decreasing then increasing our depth of breathing resulting in its typical waxing and waning appearance in the flow rate chart.

I don't know if this is what you have or not. It is possible that this is idiopathic, or of unknown cause. A ten-minute zoomed view including the CA events should help us evaluate as well as reading your sleep studies, full study, including the charts and tables.
This is not severe enough to worry about. It is likely to decrease over time, 2-3 months, as your body adjusts.
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#4
RE: Need Assistance with Oscar and Cpap
Other than a few CA events your numbers are good. I like to leave some there if they are treatment-emergent and let your body adapt. I would not turn EPR off. If they are really bothering you reduce EPR to 1.

While Stacey said Increasing EPR can, not always, increase CA events, lowering it has the opposite effect, lowering can, not always, increase obstructive events. It becomes a balancing act between the two.
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#5
RE: Need Assistance with Oscar and Cpap
A few additional thoughts.  

You are still early in your adaptation to using your machine.  You can speed the process up by using the machine outside your bedroom during the day or evening while you watch TV or read.  

During sleep, you may be having a fair number of arousals, again due to the newness of the experience.  Arousal breathing tends to be deeper than asleep breathing and thus can wash out more CO2.  That in turn can cause a pause in your breathing of 10 seconds or more, i.e., a CA.  But if this follows an arousal, you're more or less awake and so that isn't a SLEEP (central) apnea.  In this scenario, the root problem is the arousal, not the CA.

I'm attaching an example of arousal breathing followed by a CA.  You can zoom in to see whether there's something similar going on with you.  Besides the deeper breathing, arousal breathing will also look irregular by comparison with asleep breathing.


Attached Files Thumbnail(s)
   
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#6
RE: Need Assistance with Oscar and Cpap
So like this?

   
   
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#7
RE: Need Assistance with Oscar and Cpap
I am going to give you my sleep study on a drop box since I cannot post it here sadly, https://www.dropbox.com/sh/lsw7p0yvuupf2...ZzjIa?dl=0



Heres some closeups of the Central Apneas aswell
   
   
   
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#8
RE: Need Assistance with Oscar and Cpap
Your sleep test indicates UARS as indicated by RDI 9 and AHI 4.7

All the CA events are preceded by arousals and are likely you holding your breathe after tossing a bit. The arousals are significant, the CA's are not.
You also have a fair amount of flow limits on those closeups.

Increase your PS to 3 toneyter manage those closeups.
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#9
RE: Need Assistance with Oscar and Cpap
Can you repeat the last part? Got me confused sorry Smile

By PS You mean EPR Right?
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#10
RE: Need Assistance with Oscar and Cpap
Yes, he means EPR. The idea is that the EPR might reduce the flow limitations and help you sleep with fewer arousals. I'm betting you'll also just find EPR comfortable, which is likewise a plus. Do try it out during the day or evening, outside your bedroom.
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