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Please Take A Look At My Oscar Data
#1
Please Take A Look At My Oscar Data
Hi all,

33 year old male here. BMI is 21 (Very lean). Had a at home sleep test 1 year ago and and had a 11.4 AHI. Time below 90% was 31.7 minutes. Number of events was 90

Put off using the CPAP until about 2 months ago and since using the results have been pretty noticeable and good. However I still have an an AHI of somewhere between 3.5 - 4.5 most nights. Generally I'm able to be compliant about 4 hours a night. 

At first the machine was hard to use at all but since turning on the EPR setting to 3 it's been better. I also messed with the pressure a little. Currently its on a min of 6.8 and a max of 12. 

Thanks for any guidance or advice!!!!

   


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#2
RE: Please Take A Look At My Oscar Data
Here's another night where my AHI was at 6.57.

July 19th AHI: 1.83
July 20th AHI: 5.42
July 21st AHI: 2.34
July 23rd: 6.57


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#3
RE: Please Take A Look At My Oscar Data
The good news: Flow Limitations and Large Leaks seem well controlled.

The bad news: most of your events are Central Apneas, defined as when there is no attempt to breathe. No amount of pressure will treat central apneas. Some centrals are called "treatment emergent" and become much less numerous in a couple of months after your body adjusts to cpap therapy. But if Centrals are a the principal long term problem, your machine is not the right one; you would need an ASV machine.

Did you have a sleep study? Did it identify centrals as a problem?

Many people have a few centrals here and there, and it's no big deal. The question IMO is: when treatment emergent centrals are gone, is the remainder large enough to be a significant problem? One of the Apnea Board experts (I am not one) will be along soon to give you additional guidance.
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#4
RE: Please Take A Look At My Oscar Data
(07-25-2022, 09:06 PM)clownbell Wrote: The good news: Flow Limitations and Large Leaks seem well controlled.

The bad news: most of your events are Central Apneas, defined as when there is no attempt to breathe. No amount of pressure will treat central apneas. Some centrals are called "treatment emergent" and become much less numerous in a couple of months after your body adjusts to cpap therapy. But if Centrals are a the principal long term problem, your machine is not the right one; you would need an ASV machine.

Did you have a sleep study? Did it identify centrals as a problem?

Many people have a few centrals here and there, and it's no big deal. The question IMO is: when treatment emergent centrals are gone, is the remainder large enough to be a significant problem? One of the Apnea Board experts (I am not one) will be along soon to give you additional guidance.

Ouch, this is kind of rough to hear. I mean if my CPAP is keeping my AHI below 5 most nights doesn't that mean it's working?

I did have a sleep study and had 11.4 AHI's during the nights of the study. I'm not sure if it identified centrals as a problem. 

Thanks for your reply
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#5
RE: Please Take A Look At My Oscar Data
I should also emphasize, I have noticed some observed improvements in my energy level since using CPAP. Also began having dreams that I remember more often. Surely this means its working on some level? 

I guess the thought of potentially having to get a new machine and having Complex Apnea and stuff is just discouraging.
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#6
RE: Please Take A Look At My Oscar Data
Ok sorry for the many posts, but I just read through my sleep study report from 1 year ago and I guess I had 0 central apneas during it:

"A total of 52 Apnea events occured for an apnea index of 6.6/hour. 38 hypopnea eventws occured for a hypopnea index of 4.8/hour. 90 apnea and hypopnea events were observed during the analysis period as follows, 52 obstructive apneas, 0 CENTRAL APNEAS, 0 mixed apneas, and 38 hypopneas fpr am apnea/hypopnea index of 11.4/hour."
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#7
RE: Please Take A Look At My Oscar Data
I'm not an expert, but if you had zero centrals during your sleep study then the ones you show now are likely treatment-emergent and will go away on their own in time. Your present machine should be just fine. Don't be discouraged! All will be well.
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#8
RE: Please Take A Look At My Oscar Data
By age and physically, you match the profile of someone with central sleep apnea rather than obstructive. We will go with the test results and assume the CA are treatment emergent. Clearly, your CPAP is significantly reducing events of all types, and we actually have a number of tools at our disposal to help with the CA events. You say the EPR made your therapy more tolerable, and that is a very common reaction. Sometimes the use of EPR or pressure support can increase the number of central events as a result of the increased ventilation it provides, that reduces CO2 in your system. Sometimes a slight reduction of EPR can help reduce events, and trying an EPR of 2 may be worth trying. It is also possible to increase CO2 to compensate for the effect of improved ventilation by using "enhanced expiatory rebreathing space" (EERS) http://www.apneaboard.com/wiki/index.php...ace_(EERS) Also, Diamox (Acetazolamide) has shown effectiveness in reducing CA events. Your CA event rate is not particularly high or alarming, so I think we can try the reduced EPR with consideration of whether you can remain comfortable with the therapy, and see where that goes.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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#9
RE: Please Take A Look At My Oscar Data
(07-26-2022, 01:02 PM)Sleeprider Wrote: By age and physically, you match the profile of someone with central sleep apnea rather than obstructive.  We will go with the test results and assume the CA are treatment emergent.  Clearly, your CPAP is significantly reducing events of all types, and we actually have a number of tools at our disposal to help with the CA events.  You say the EPR made your therapy more tolerable, and that is a very common reaction.  Sometimes the use of EPR or pressure support can increase the number of central events as a result of the increased ventilation it provides, that reduces CO2 in your system.  Sometimes a slight reduction of EPR can help reduce events, and trying an EPR of 2 may be worth trying.  It is also possible to increase CO2 to compensate for the effect of improved ventilation by using "enhanced expiatory rebreathing space" (EERS) http://www.apneaboard.com/wiki/index.php...ace_(EERS)   Also, Diamox (Acetazolamide) has shown effectiveness in reducing CA events.  Your CA event rate is not particularly high or alarming, so I think we can try the reduced EPR with consideration of whether you can remain comfortable with the therapy, and see where that goes.

Thanks, what are the chances that the sleep study would've missed the centrals? This was an at home sleep study.
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#10
RE: Please Take A Look At My Oscar Data
If the sleep study didn't have an abdominal belt and a chest belt it's almost guaranteed to miss centrals - I think

You need both b/c some people are belly breathers and some are chest breathers
Apnea Board Monitors are members who help oversee the smooth functioning of the Board. They are also members of the Advisory Committee which helps shape Apnea Board's rules & policies. Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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