Titration Study Results

[hookedonstitch]

I could use some more assistance reading my last 2 night OSCAR data please

I've been taking 300 mg Gabapentin for PLMD and I feel like I am sleeping better but last night's data has me really concerned.  I will attach some closeups as well of all the events.  As far as I can remember I didn't wake up once last night.

Are all of the CA's, actual Central apneas?  

Pressure is set to 5.0-8.0 at the Dr's request and EPR is set to 3.

[hookedonstitch]

These are the attachments for Apr 20th

[hookedonstitch]

I am not surprised to hear you have PLM.  It is probably what is waking you up as well as making you so tired.  APAP can only help the breathing issues unfortunately.   You have three sleep issues ... sleep apnea, PLM, and sleep onset insomnia  .... and each one has their own solution.

My sleep doctor had me taking iron and 250 vitamin C to increase my stored iron.  He said the stored iron is a different blood test, but I assume your GP can order it to monitor your iron on an ongoing basis. If you get your blood tests at a LifeLabs you can see blood work results the next day.

Let's hope the iron and Gabapentin do their work and give you a good night's sleep.

The Dr. has me taking 2 Iron tablets along with Vitamin C but my Ferritin is going up very slowly so that is why I am taking Gabapentin until the Iron levels rise.  

I'm starting to understand that I have 3 separate sleep issues that are each being affected by the other.

I thought I was sleeping better the past 2 nights but looking at last nights data has me a bit concerned.

[Gideon]

!. on central apneas you don't have enough of them to be concerned.
2. of the centrals you highlighted only the last one may be an actual central but I'm leaning against it. Thus all of your centrals are the result of an small arousal and you settling back down, most likely briefly holding your breath, again not a concern.

[sheepless]

at a minimum, plm is likely to disturb sleep. it's also likely to occasionally fully wake you. the same might be said about flow limitations.

the good news is no apparent plm in your screenshots and an entirely acceptable ahi.

the bad news is ongoing flow limitations & pressure wanting to go higher than settings allow (suggesting plm isnt the source of the flow limitations). if you're not feeling too awful you might stick with this to see how you acclimate. or try incrementally raising pressure, especially min pressure, to see if it knocks down some of the flow limitations while watching for increasing ca.

[hookedonstitch]

!. on central apneas you don't have enough of them to be concerned.  
2. of the centrals you highlighted only the last one may be an actual central but I'm leaning against it.  Thus all of your centrals are the result of an small arousal and you settling back down, most likely briefly holding your breath, again not a concern.

Thank you for putting my mind to rest : That's the most centrals I have reported to date so it sort of shocked me.

[hookedonstitch]

at a minimum, plm is likely to disturb sleep. it's also likely to occasionally fully wake you. the same might be said about flow limitations.

the good news is no apparent plm in your screenshots and an entirely acceptable ahi.

the bad news is ongoing flow limitations & pressure wanting to go higher than settings allow (suggesting plm isnt the source of the flow limitations). if you're not feeling too awful you might stick with this to see how you acclimate. or try incrementally raising pressure, especially min pressure, to see if it knocks down some of the flow limitations while watching for increasing ca.

I will try it at this pressure for another week and if I'm still feeling tired then I will adjust my minimum pressure.  I had a feeling the Dr. set them too low.

[hookedonstitch]

How can I understand the OSCAR data to know if my flow limitations are getting better?  Is there a number I should be looking at or how do I read this on my chart?  I am really curious!

[staceyburke]

You just do it by comparing the different days graph.  One easy way to look at more than one is go to the day you want and right click next to "flow Limit." and pick popout, then go to the next day and do the same thing, and the next.  You can get 3 or 4 depending on your screens res and compare them for how many and size....

[Geer1]

How can I understand the OSCAR data to know if my flow limitations are getting better?  Is there a number I should be looking at or how do I read this on my chart?  I am really curious!

The only number that has an iota of value is 95% flow limitation, lower is better. Learning what a flow limited breath looks like and reviewing your breathing in detail is more valuable. Look for worsening flow limitations that are followed by large deep breaths (arousal breathing), these are RERA's.

Some info available here. http://www.apneaboard.com/wiki/index.php...limitation

A lot of necessary sleep study/titration data is missing. How many arousals did you have? How many were related to PLM? How many were related to breathing (RERAs)? Did they even score RERA's (not all do)?

Your pressure is being maxed at 8 cm almost all the time and flow limitations are driving that pressure increase. Treating flow limitations can be tricky. Increased pressure sometimes helps, sometimes does nothing, and sometimes makes it worse. The easiest way to tell this is for you to increase max pressure and let the machine work (I would do first jump by setting max pressure to 12 cm if minor improvement could then try 15 cm). If flow limitations reduce the higher pressure is helping you, if pressure maxes at 12 cm like it currently does at 8 then it isn't helping you and it would be best to return back to 8 cm max (and at that point consideration of using a different machine may be warranted).