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OSA -> CSA?
#21
RE: OSA -> CSA?
You treat Flow Limitations by raising Pressure support. in this case you don't because of the Central Apnea.
I don't see the complaints from kuacc912 that would indicate an aggressive need to treat these flow limits.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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#22
RE: OSA -> CSA?
(04-14-2020, 07:10 PM)bonjour Wrote: You treat Flow Limitations by raising Pressure support. in this case you don't because of the Central Apnea.  
I don't see the complaints from kuacc912 that would indicate an aggressive need to treat these flow limits.

thanks for your input! can you explain why you don't because of the central apnea?
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#23
RE: OSA -> CSA?
(04-14-2020, 07:10 PM)bonjour Wrote: You treat Flow Limitations by raising Pressure support. in this case you don't because of the Central Apnea.  
I don't see the complaints from kuacc912 that would indicate an aggressive need to treat these flow limits.

Very true.

Kuacc912, is the quality of your sleep okay? Have you started feeling any better or noticed any changes? 

Basically, with EPR on you exhale too much CO2. CO2 is what signals your brain to breathe. If you exhale too much CO2, your brain is not getting that signal, and you lose the drive to breathe, which results in a central apnea.

There are also falsely flagged central apneas, which look like central apneas, but are actually "normal" breathing following arousals.

As far as I know, you can't 100% differentiate between true central apneas and arousal related "central apneas" without an actual PSG sleep study.

Bonjour, could you treat flow limits by raising the minimum pressure while keeping EPR at a minimum, provided it doesn't start causing aerophagia?
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#24
RE: OSA -> CSA?
Sleep quality, mood, and cognition have not changed noticeably over the past 2 weeks. I am hopeful though. 


Thanks for all the input and information. I appreciate it.
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#25
RE: OSA -> CSA?
Pressure support (PS) as in EPR or true PS on BPAPs are what I call pressure swings. They have a way of inducing CA.

Those that are proficient at reading OSCAR can see CA events if one presents a zoomed in to about 2 min. segment with a flagged CA within that segment. I can't say it's guaranteed, but there's tells that make it fairly high in accuracy. Obviously not the same level as on a PSG with wires all over. I think leading and trailing flow rate data help to ID these. Differing traces for events will look different somewhat based on cause.

An EPAP Min bump may be a way to address FL, but I don't know if the OP needs to chase those. That's his call IMO.
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: OSA -> CSA?
Felt compelled to attach some close-ups of flagged CA's from last night.

Thank you everyone!! Feels nice to not feel alone in this! Smile


Attached Files Thumbnail(s)
           
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#27
RE: OSA -> CSA?
With PR machines all we have is to increase pressure so yes, pressure increase may (not will) resolve flow limits and other obstructive events, but raising pressure also can (not will) increase central events, but it is nowhere near as effective as pressure support or ps.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
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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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#28
RE: OSA -> CSA?
heavily flow limited breathing, CAs are mostly idiopathic, the pattern at 319 has a slight indication of being CO2 driven.

long term I'd like to see you on a VAuto BiLevel to manage the Flow Limits. Have to know what will happen with your CA events though.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

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

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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#29
RE: OSA -> CSA?
Since I've mentioned so many things about the anatomy of mouth, I figure I should mention that one of my two tonsils is a size 3 while the other is a size 2 (based on some standard scoring system).

(04-14-2020, 08:11 PM)bonjour Wrote: heavily flow limited breathing, CAs are mostly idiopathic, the pattern at 319 has a slight indication of being CO2 driven.

long term I'd like to see you on a VAuto BiLevel to manage the Flow Limits.  Have to know what will happen with your CA events though.

Thank you so much for looking at the pics! Much appreciated Smile)
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#30
RE: OSA -> CSA?
Might want to keep track of this to see what trends of events you're likely to get.
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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