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New member, help analyzing SS and Oscar
#11
RE: New member, help analyzing SS and Oscar
        Thanks Gideon

I have been using the notes section in OSCAR to keep notes and try and see any patterns. I know its early days as I have only used for 8 nights and been trying different masks. I cant say i have noticed feeling any better, I thought i might notice something given the low AHI compared tot eh sleep study AHI of 38/hr.

attached is last nights summary which is about as good a result as i have had, but to me it still seems like too many APNEA events.

I will try the setting changes by sleeprider of fixed pressure of 6 and ERP on 1. 

did you have any suggestions for setting changes? or suggest try this (I was thinking or trialing for two nights) and post an update and see from there.  Sleep tech might be P*ssed but that's what the trial is for, to play around with the setting and see if we can improve results.
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#12
RE: New member, help analyzing SS and Oscar
       

Hi Sleeprider

last night I tried the updated settings, see OSCAR summary attached.

very similar results to the previous night in my post above. Centrals still present throughout the night with a lot more at the end of the night.

there seems to be a correspondence with tidal volume, resp rate and minute vent. these all fluctuate when or around a CA event. any ideas on these?

still feeling about the same which isn't rested or recovered. i have been exercising a bit more (from none for the last few months) and it would be nice to recover better. 

Ill try again tonight, but open to suggestions/feedback.
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#13
RE: New member, help analyzing SS and Oscar
Of the results posted previously, this result shows events at the low-end of your normal CAI and events are spaced out rather than clustered. This steady low pressure of 6.0/5.0 controlled obstructive events well. There is a slight increase in flow limitation as expected with less EPR. You say you don't feel much different or better with these settings, but then again, not worse. The problem with trying to treat CA with a CPAP is the events are consistently inconsistent, so we really need to look at more than one night to see if the results represent a trend. At this point I'd like to continue with these settings, then we might want to look at EPR 2 with the same fixed pressure of 6.0. I'm not expecting perfection in treating sleep disordered breathing that is predominately central in nature. Given what we're working with this looks pretty good so far.
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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#14
RE: New member, help analyzing SS and Oscar
What you have above is a success as defined by your medical team. Your play is to counter with symptoms. So record them, write them down EVERY day. Do this before you read your results. I just don't want your numbers coloring how you feel. By all means review your numbers after this.

Do you NEED an ASV? Honestly, I don't know, at least yet. Let's, for the moment try and experiment. Turn EPR OFF! Going from 3 to 1 does seem to provide you with some benefit so a trial at EPR=0/OFF.

It is very important that you tell us how you feel, are you having any difficulty breathing, is it "hard". How you feel will guide us to the best settings on this machine.
And realize that a little CSA is not bad.
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#15
RE: New member, help analyzing SS and Oscar
A 2.05 CAI is very good considering the machine used here. Agreed with the trend building strategy. See how next session compares to this one.
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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#16
RE: New member, help analyzing SS and Oscar
Thanks Sleeprider

that makes sense, will see what tonight looks like. Maybe aiming for 0 as that what seems like would be the best outcome for sleep quality isn't right and some CA events spaced out are acceptable. will keep trying to eliminate though and work through a few options. 

My main consideration is to try and sort out while I'm on my three week trial before I buy a machine.

I haven't felt more tired than normal. Breathing wad a bit harder last nigh. similar to the first night i used CPAP a week ago. what i noticed the most was a pain in the belly which I had after the first night. I think I swallowed air overnight. I have been taping my mouth fully at night as I'm using nasal pillows as I'm a mouth breather. I noticed last night and the first night of CPAP every now and then my mouth/cheeks would inflate with air. this went away so maybe its just a process of my body getting used to it and higher pressure. exhaling was slightly more difficult as well but manageable. it maybe just made it harder.. mentally I have been clear today so less brain fog but that has been improving over the last week that i have been trialing CPAP.

I'm also interested to know, is having around 20 CA events a night totaling around 4-5 minutes in total bad? I've been interpreting that as bad and that it should be 0 as it would provide the best quality of sleep and not disturb sleep stages. Also how many CA events would you need to to get an ASV, a lot higher for example? I understand comments about it being based on symptoms but I feel like that might be hard to measure unless I significantly start feeling like I have more energy and it becomes clear I am much better.

thanks Gideon

i have started the diary and I am also seeing my GP Friday and will discuss results with him and symptoms. Still confused if having around 20 CA events is like you say deemed a medical success or if 0 is what i should be aiming for. I understand this should be based on how i feel as well.

Ill keep the same settings tonight and then turn ERP off to see how that goes.

I have added a summary of how I feel in my previous post reply to Sleeprider.

appreciate the comments and checking in
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#17
RE: New member, help analyzing SS and Oscar
The numbers to concentrate on are events per hour, not events.

Those 20 events occurring in 20 minutes is very significant, an AHI of 60. The same 20 events over 10 hours is an AHI of 2, a level we attack symptoms, not numbers.

Chasing zero is going down the proverbial rabbit hole for minimal to no gain. This is where your symptom history comes in play
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#18
RE: New member, help analyzing SS and Oscar
My opinion on what it would need to be to get ASV is you're unable to get a consistent, well rested status and there'd be a consistent Central overload, a trainwreck looking mess. Very helpful to getting an ASV would be 50% or more CA on the PSG diagnostic study. However if you're gaining rest and reasonable comfort as is on a different PAP like the AutoSet, then you likely won't qualify.

I'll attach what my therapy looked like on an AutoSet session and you'll see the trainwreck look.

   
Dave

OSCAR
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Dealing With A DME
Soft Cervical Collar Wiki
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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#19
RE: New member, help analyzing SS and Oscar
       

Thanks Gideon

that is helpful to know and my AHI events have been separated over the last few nights with low AHI/hr.

last night was the best  result so far with AHI/hr of 1.52.

writing down how i felt before looking at OSCAR was as follows

Noticed more difficulty breathing when going to sleep, especially the end of my inhale and exhale. it felt like they were both being cut short and my breath was shallower because of the pressure. woke at 5am with the same feeling and slight pain in the belly (its deep so it could also be my diaphragm). also had a few instances of air in my mouth. I feel tired but had less sleep last night, time in bed 7hrs 15min. usually aiming for over 8 so that might be why. feel tired in my face and eyes.

overall my last three nights numbers have been good and two were with the fixed pressure and low ERP, it has been noticeably more difficult to breath going to sleep and when waking and certainly not easy to go back to sleep when I wake early i think due tot eh pressure and slight discomfort with my stomach

suggestion for turning ERP off or going back to original settings to see what that looks like and how it feels.

Thanks SarcasticDave94

that is very helpful to see what a night on PAP looked like for you. wow, that is a big difference.

will keep monitoring how I'm feeling and discuss with my GP and sleep tech when I have an appointment next week.
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#20
RE: New member, help analyzing SS and Oscar
Welcome. That's what pre-dominant Central looks like. Nevertheless, Apnea of any sort can be a real bother. Best wishes for your success.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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