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[Treatment] New Member: Looking for some insight on OSCAR info.
#1
New Member: Looking for some insight on OSCAR info.
I have continued to have problems with sleep apnea after 5 years of inconsistent CPAP usage. My compliance has been a lot better over the last 12 months. I've been using an oral appliance with CPAP on and off for the last 12 months. the last 4 days I've gone back to CPAP only and now I am exhausted again! 

I'm envious of all you who get 0-5 AHI. I am regularly in the 10s. 

I'm not sure where to start to try and figure out why I can't get below 5. 

Can any of you take a look at my reports from OSCAR from last night and let me know what you think. Is there anything glaring to you guys? 

I increased my pressure from Dr. recommended 12 to 13 for last nights sleep. 

Cheers,

Frank

[attachment=27477]             [attachment=27479]
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#2
RE: New Member: Looking for some insight on OSCAR info.
Here is my Daily OSCAR info from the night before Oct 18. I've noticed no leak on that night but a big leak last night. Perhaps I took the mask off during that time, I cant remember!!

   
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#3
RE: New Member: Looking for some insight on OSCAR info.
Welcome to Apnea Board. A few suggestions and a question. Turn off Ramp and EPR, these are potentially increasing your bad Central Apnea/Clear Airway/CA flags. This is almost all your events, and needs reduced ASAP.

OK, the question: do you have a copy of your sleep study? If you don't, you need the full detailed report, and you should post a redacted version here. You have been on PAP therapy for 5 years, and this CA has yet to be addressed. Without seeing the sleep study, I am certain your CA and/or Mixed Apnea counts are higher than OA. You need to smack the doc and get his attention. DOC I have CA! Here are my symptoms and you need to help treat this now. You need to either buy a ResMed AirCurve 10 ASV or make the doc retest your sleep study including tests for ASV. You are on the wrong machine, and it won't get better till you are on ASV.
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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#4
RE: New Member: Looking for some insight on OSCAR info.
Thanks for the quick reply. I kepy my report until I got an oral appliance. They snagged the original copy. I've sent my docs office a request for a copy and will post an update. 

Thanks for telling me about ramp. I've always been confused about "Central Apnea." It's consistently at about 5 on my machine. Does that mean my brain stops signaling breathing 5xs per hour?
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#5
RE: New Member: Looking for some insight on OSCAR info.
That is a fine working definition. I have severe CA as well, so I try to keep myself up to date on info about CA. And I own the ASV I mentioned you're likely needing. It will combat all apnea and wins most of those battles. I think if you were on an ASV and it were on optimized for you pressure settings, your AHI is about 3, give or take a few ticks, but definitely below 5 almost always.

There are 3 kinds of CA. 1 is treatment emergent; this shows up right after you start PAP therapy. It's triggered by the PAP washing out CO2, meaning the carbon dioxide has a lower content in the bloodstream than where the brain signals a breath. TE/CA typically diminishes over the first 3 months of PAP therapy. Obviously, that's not yours.

Then there's CA type idiopathic, meaning unknown for medical cause. It still more or less is the same as treatment emergent, but it doesn't go away. Pre-existing CA is similar to idiopathic. I know my CA to OA was over 5X more and a BPAP made it even worse. So a warning, avoid the BPAP as it likely will increase your CA. Find a doc that can see your CA and is also willing to treat it with the ASV. ResMed describes their ASV as one that treats CA. No other can do as good against CA.

PS some homework besides those setting edits. Note all your symptoms of poor sleep. Mention how long it's not been doing well, probably back to the beginning 5 yrs ago. Take this to the doc and even take OSCAR charts. Say to doc, this is what I'm dealing with. Let's fix it, OK.
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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#6
RE: New Member: Looking for some insight on OSCAR info.
Thanks Dave. I've actually found a copy of my most recent sleep study from 2017. I had a tonsillectomy and septoplasty and that cut my untreated Sleep Apnea from 47 to about 30.  

Thanks for the low down on CA. I feel like that is something that regardless of what I achieve, I'll always have that and as a result I'll never be below 5 or where I wan't to be! 

here is my sleep report : https://drive.google.com/file/d/1aY86NNP...sp=sharing

Oh note, the sleep doctor hand written notes on the first page are comparisons to my AHI before surgery. Also, the technologist who monitored me made a comment at the bottom of the 4th page. "Most resp were hypsone CSA, most causing desats. " I think he was referring to Centra Sleep Apnea being a major cause???!?!?! 

Thanks again for your input, 
 
Frank
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#7
RE: New Member: Looking for some insight on OSCAR info.
I must admit the event/numbers weren't how I thought they'd have fallen. Then again, that was in '17. I think given what is shown then to now, most of the Hypopnea on the test may have been Central based. I still say doc needs to know you're not treated as is, and it's not going to solve itself. And yes, I still say CA is your issue, at least now.
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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#8
RE: New Member: Looking for some insight on OSCAR info.
One of the things we need to do is see, try, to improve your CAI on this machine.
If we cannot bring it down we do have other options
1. ASV. This machine is designed specifically to treat Central/Mixed/Complex apnea. With it your AHI WILL approach zero, it is that good, but it is the most expensive of "CPAPs" and the least understood by the medical community. Why? Because the Medical community is set up to treat OSA, not CSA.
2. EERS, a methodology of slightly increasing the rebreathing of CO2 to above the apneic threshold thus resolving CSA that is driven by your body's CO2 levels.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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#9
RE: New Member: Looking for some insight on OSCAR info.
Thanks for the feedback. Here is my Daily Analysis from last night. I;'ll look into ASV today. I'm in Ontario, generally we haven't had to pay out of pocket for CPAP but I'm concerned that for ASV I'll be on the hook. Initial prices seem to be extremely expensive. like $4000 Canadian. Hopefully I am wrong.
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#10
RE: New Member: Looking for some insight on OSCAR info.
Here is a listing from Supplier #2 on the suppliers list at the top of the page.


Attached Files Thumbnail(s)
   
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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