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Newbie - would appreciate review of Oscar data
#11
RE: Newbie - would appreciate review of Oscar data
If all of your CAs look like the ones you zoomed in on, they might be real. If you zoom out a little further, you might see a more obvious waxing and waning pattern, looking kind of like a string of beads shape but maybe more subtle than that.

If you see CAs around the time that you are falling asleep or waking up, those can usually be discarded as sleep-wake junk. And similarly, if you know that you woke up during the night, or you see your breathing go from a nice regular shape to suddenly bigger, more jagged breaths, that signals arousal. If that happens before the centrals, then they're probably a side effect of that.

I guess the real issue though is, how do you feel in yourself? The number of centrals is relatively low right now, and so at this level, it's mostly going to be about comfort. Just glancing over your settings, it does look like these centrals may be a little sensitive to EPR so you may want to consider which is better for you comfort-wise.
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#12
RE: Newbie - would appreciate review of Oscar data
Tyvm Ratchick

i have attached another slightly zoomed out the standard breathing patterns gets sill and then CA , nealry all event last night had the similar preceding patterns

FYI no CA at all on sleep tests results and i attached a stats page that showed the changes i have made over this period chasing my tail.

this leaking was a bit more than usual I have got that under control of late

Col


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#13
RE: Newbie - would appreciate review of Oscar data
Hmm. Actually that one, looks more like there was maybe some arousal before it. You can see that there's a change to slightly higher, more irregular breaths right before the CA, when compared to the breaths before it. So this particular one I would think looks more like a minor arousal perhaps.

So it may just be that the treatment has left you a little prone to centrals due to the increased ventilation... usually by 2 months we would expect that to improve, but if you're feeling okay and they remain low, then it's probably nothing to be concerned about.

And yes, I saw the stats page, which is why I suggested that maybe consider turning the EPR off if you want to reduce the numbers a little... but at the end of the day, if the EPR gives you better sleep overall than without it, then choose what makes you feel better overall. Your AHI is low enough to be "treated" at this point, so base it upon what feels better to you. Just remember that EPR on and increased pressure help with obstructive events, RERAS etc, but they potentially trigger more centrals and vice versa. Yours don't seem to be happening at particularly high pressures (and you're staying pretty stable with pressures). My doctor did recommend that I switch to a single fixed pressure CPAP rather than APAP as sometimes the changing pressure itself can trigger centrals too, even if that's because it rouses you very slightly when it shifts etc.

But that said, at this point, I don't really think you need to do a whole lot except keep an eye on things if you're feeling otherwise well-rested.
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#14
RE: Newbie - would appreciate review of Oscar data
Tx Ratchick 

I appreciate your advice, the CA arousals were evident in all but 1 CA

as you seen I have tried a number of other options but comfort was the issue.... will leave on here for a bit and see how I feel

Col
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#15
RE: Newbie - would appreciate review of Oscar data
This is where you've entered involuntarily into the teeter-totter dilemma zone. Your CA are a bit up, but if you change EPR down, then Flow Limits or Obstructive events go up. The equal yet opposite action thing. The question is are you comfortable as is? If so, just monitor the CA numbers.
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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#16
RE: Newbie - would appreciate review of Oscar data
Tx Dave and Ratchick

I can see that seems to be a common issue with trying to get the right setting, well last nights ca was even worse 37 ca events lol, I know I was awake around 3:30 I checked clock so it must have woken me, there were some nice clusters and after 0600 more clusters at that time I was just in and out of sleep pondering whether to get up or not.

I made some changes just now, min pressure back to 6.6 and max 10.6 epr 1 see how looks tonight

Does this look ok without dropping epr yet?

Tx 

Col


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#17
RE: Newbie - would appreciate review of Oscar data
You can try a decrease in EPR. Your choice on the EPR number. It's simple enough to change it down, see how things change and what of CA going down and Obstructive, Hypopnea events and the flow limits go up and by how much. Try it, decide what changed and determine if the result are acceptable. If it's good keep it and observe trends via OSCAR. If not ok, return to the prior EPR.

You'll then need to decide if the lower Centrals with probable increases elsewhere is worth it by determining if you feel better. This is very much the Apnea teeter-totter dilemma, to act against Centrals the Obstructive events and FL may go up. The opposite will also be true, acting on Obstructive or FL may make CA go up, due to the fact to diminish Central by action likely makes Obstructive and FL go up and then vice versa too.

Mark down that Central Apnea are consistently inconsistent, they roam up and down even if no setting changes. The CA can vary every night.

The CA at the end where you were debating on getting up, after 0600 you say, these alone can be ignored as they're what we call SWJ sleep wake junk. Your hovering between wake and sleep is why I say this is likely SWJ.
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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#18
RE: Newbie - would appreciate review of Oscar data
Excellent Tx Dave, 

will get back with some results tomorrow

Col
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#19
RE: Newbie - would appreciate review of Oscar data
Hi Guys

Just update on last nights settings, changed to 6.4 min 10.8 epr 1, epr was turned off at 0200.

heaps less CA however i checked them all against the preceding breathing pattern and all but 1 or 2 looked like real ones to my inexperienced eye

Sleep wasn't too bad, woke up for 2 x toilets, bit restless but felt ok today.

is it worth getting max down a bit more incremental to reduce ca or are they just swj issues will post  a couple of screenshots ( can only do 3)

1 x overview
1 x CA junky? 
1 x CA real

thoughts?

Tx in advance again, any help is appreciated

Col


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#20
RE: Newbie - would appreciate review of Oscar data
Whether or not these CA are real or not, I counted them at about 10 event flags the entire night, as they're spread across 7.x hours. I don't know that this amount of CA is really an issue. Leaks however are still up and likely a disturbance or possibly robbing some good therapy.
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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