Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

OSCAR data - CA and overall help
#1
Sad 
OSCAR data - CA and overall help
Backstory: I've been using CPAP for about 3+ years now, originally diagnosed with severe sleep apnea at about 50AHI, and 10-15% of that was/is central.  I'm a 37 year old male weighing about 140lbs.  My initial year and half was a fun journey of trying nasal pillows -> full face mask -> nasal mask, and at this point, I believe the nasal mask (AirFit N20) has worked the best for me overall.  Before CPAP, I was a pretty consistent stomach sleeper, but since have moved to sleeping exclusively on my left side. My original pressure RX was something in the realm of 9-14, but I've since tweaked those settings down pretty heavily to about 6-10 to account for a significant gas/bloating/air swallowing.  I had/have a lot of trouble initially falling asleep with any mask on with a side of insomnia, so I have run the gambit of trying a bunch of different medications to help get me to sleep (Lunesta -> gabapentin -> trazadone -> Ambien -> back to lunesta -> settled on Ambien with a side of THC... for now[thanks California])

The reason for my post:  With pretty consistent usage, I still feel like a complete zombie everyday; I feel like my cognitive ability has decreased significantly over the years, to the point I'm having pretty bad short-mid term memory loss.  I'm not sure if the memory loss/zombie feeling is related to the sleep meds, but without them, I can't use my CPAP at all, so I feel like I'm between a rock and a hard place.  Looking at my OSCAR data, I feel like my OSA is pretty much fully handled by the CPAP, but I'm noticing pretty consistent 2-4 AHI from CA events, and am wondering if it's feasible those are still accounting for my zombie feeling and if different settings could be used to alleviate them without increasing my aerophagia.

I have 0 faith in my current sleep doctor.  I was seeing him every 2-3 months to get a new sleep med Rx, he would look over what I think was just the insurance compliance report and congratulate me on my consistent usage, and was impressed I was making my own adjustments to pressures to help with my aerophagia while still monitoring my AHI.   I have an appointment with a new sleep specialist in the coming weeks.

Any extra insight would be helpful here, I'm really not sure what I should be correlating with the OSCAR data, and what conclusions or adjustments I can/should make based on it.


Attached Files Thumbnail(s)
       
Post Reply Post Reply






Donate to Apnea Board  
#2
RE: OSCAR data - CA and overall help
Welcome to the Apnea Board.

OK what I'd like to find out is whether or not you have your copies of the diagnosic sleep study. Specifically the stat that has the event type and count. You can request and obtain as HIPAA law permits you to get it. You'll need this for your personal health file and you can post a copy here in redacted form.

For now I'd suggest you turn off the Ramp and either lower EPR or turn it off too. Try it and see how the Central events respond. And if you do get your sleep study posted, this helps us identify CA type. Let us know if it helps with the CA and how you're comfort level changes.
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.
Post Reply Post Reply
#3
RE: OSCAR data - CA and overall help
The obvious is to dial back EPR. The waveform around the CA you have highlighted is a bit irregular making it more of an awake breathing. They are not showing the waxing and waning of a CO2 induced breathing pattern. Therefore I question if this will work. As a test set EPR=1 for a night, The other fact that makes this less likely is your 3+ years of CPAP use. This may result in obstructive events. Remember this is a test.

Try this reduction of EPR to 1. Worst case is we will learn from it.

The option that is more likely to work is ASV. By your numbers you do not "qualify" for an ASV so you would have to either self pay or argue that your symptoms alone should qualify you.
Post Reply Post Reply
#4
RE: OSCAR data - CA and overall help
Here is the event data from my original sleep study.


I believe I tolerate the lower pressure well enough, so disabling ramp shouldn't be a problem, but out of curiosity, what is the purpose of disabling the ramp?  

Would be it acceptable to just limit EPR to only during ramp time (I believe that is a feature in the Airsense10)?


Attached Files Thumbnail(s)
   
Post Reply Post Reply






Donate to Apnea Board  
#5
RE: OSCAR data - CA and overall help
Ramp minimizes therapy during the ramp. If you can tolerate it turn it off or decrease the ramp time. If you wake up 3 times before you get up for good you lose 3 hrs of therapy. Fortunately, you don't seem to wake that often.. FYI most, not all, of the 'Pros' do not use a ramp.

EPR can have a major impact CA events, it is not uncommon to see more EPR = more CA events.

Your sleep study shows the half of your apneas are central which strengthens my thoughts that you will see little to no impact from the EPR decrease.
EPR is the magic that is in ResMed machines. It effectively treats Flow Limits, hypopneas, UARS, and even snores. No other CPAP/APAP class machine comes close in this regard. EPR is very likely a very important part of the effectiveness of managing your obstructive events. So you want EPR = on and Fulltime, not Ramp only.
Post Reply Post Reply
#6
RE: OSCAR data - CA and overall help
I too see the 26 CA to 26 Obstructive. Sooner or later you're going to need an ASV, preferably the ResMed AirCurve 10 ASV. Begin to document your failing therapy now, including things like not well rested, uncomfortable, and so on. Tell the doc the CPAP therapy isn't working well and that due to pre-existing/predominant CA existing on the diagnostic, you're needing the diagnosis and scripts to change to Central Apnea. The treatment is ASV, avoidance of CA of this type doesn't always work well.

If me I'd tell the doc about this sooner to begin the ASV acquisition process. You're likely to need a new titration with ASV and a test called echocardiogram to find your LVEF percentage. Request it soon.

The reason I mentioned Ramp was that it diminishes therapy time and in some with CA it adds to the variable pressures that increase Central events.
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.
Post Reply Post Reply
#7
RE: OSCAR data - CA and overall help
I think the sleep study indicates that ALL apneas were central: CA+OA+MA=Apnea
Post Reply Post Reply






Donate to Apnea Board  
#8
RE: OSCAR data - CA and overall help
Thanks for the quick replies folks!

I've gone ahead and disabled ramp since my min pressure was so close to the ramp pressure anyway. Though it's worth mentioning I'm not sure OSCAR interprets the ramp time correctly, since mine was set to Auto and it looks like it was showing 45min in the OSCAR report.

I've also set the EPR to "Full Time" but reduced it down to 1 for testing. I'll give this a few days and report back. I have an appointment next week with a new sleep doctor, I'll push for ASV and a proper central diagnoses.
Post Reply Post Reply
#9
RE: OSCAR data - CA and overall help
My Sleep Study Clinic just got back to me with my results from during the titration study, so I'll go ahead and add those here for more info.


Attached Files Thumbnail(s)
   
Post Reply Post Reply
#10
RE: OSCAR data - CA and overall help
Kappa was correct, the diagnostic had 26 CA which equaled all the Apnea. The titration changed this to 10 CA to 2 Obstructive. So from this I'm pretty sure you'll not get successful treatment with anything other than ASV. I still say get the ResMed brand.
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.
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  Help Please, with Oscar Data MikeE3 10 179 11 minutes ago
Last Post: MikeE3
  DreamStation 2 data - non OSCAR Ponydriver 3 144 07-25-2021, 10:49 AM
Last Post: Gideon
  [Treatment] Koala1 - oscar data, first impressions koala1 83 1,564 07-23-2021, 10:52 PM
Last Post: SarcasticDave94
  Check Oscar Data Please.... Ryd4Life 3 108 07-22-2021, 10:42 PM
Last Post: SarcasticDave94
  How does my OSCAR data look? accetableplaintain 8 212 07-10-2021, 10:36 PM
Last Post: notam2
  F&P Sleepstyle and OSCAR - sample data needed GuyScharf 0 114 07-10-2021, 03:50 PM
Last Post: GuyScharf
  Large Leaks - Please Explain My Oscar Leak Data Attached Sleeper396 3 178 07-06-2021, 04:03 PM
Last Post: Sleeper396


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.