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Trying To Interpret Periodic Breathing In Oscar
#1
Trying To Interpret Periodic Breathing In Oscar
I was diagnosed with complex sleep apnea and given a prescription for an ASV  machine.  I first downloaded Oscar around April 18th and had one episode of Periodic Breathing (PB) around April 26th.  Then for some reason, Oscar would not upload most of my data from around May 16th until it resumed uploading all of the data around May 30th, so there are some gaps in the reported data.  However, I have noticed a persistent pattern of PB in my reports since they started reloading.   

My machine shows a pressure setting of 25, minimum epap of 4.0,  max epap of 15.0, ramp at 4.0 and flex at 1.  However, the left-sidebar statistical data shows the machine settings at minimum epap at 8.0 and maximum epap at 20.  I'm not sure why there's a discrepancy.  Also, is there a way to include the left-sidebar in the report printing or screen shots?

I have switched masks several times during the reporting period.  I received a Resmed Airfit N30i nasal cradle cushion, size medium, with the machine.  I liked the mask fit with the hose on top and the cushion, however, I have a left deviated septum problem, in which my left nostril feels as if it deflates towards the center while lying down, and noticed that the cradle mask did not help with that.  The sleep center had given me the Resmed Swift FX mask with a size large nasal pillow cushion, which I had used there, so i switched to it and noticed an improvement.  I believe that's because a nasal pillow cushion directly delivers equal pressure to each nostril.  However, I preferred the N30i mask setup with the hose located on top of your head and that there was an Airfit P30i nasal pillow cushion available for it, so I purchased one.  I didn't know whether to purchase a medium size since that was the size of the N30i nasal cushion, or a large size which was the same as the Swift FX nasal pillow cushion.  I opted for the large size thinking that it would be a better fit for a nasal pillow cushion.  I'm not sure I made the right decision on size.  Since then I have switched back and forth between the two nasal pillow cushions.  For the past week I have been using the Swift FX large nasal pillow cushion.

I though an ASV machine was supposed to alleviate any PB issues, so I'm surprised by my report results.  Could it be a pressure problem?  Can the masks be part of the problem, and if so, why?  Or is there a more fundamental problem with the machine itself.  I could use some advice in understanding why my PB has steadily increased, as well as an assessment of my overall reports.


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#2
RE: Trying To Interpret Periodic Breathing In Oscar
The presence of the DS ASV is one of the reasons we chose the version of SH to base OSCAR on. We are aware of an issue with reporting settings and will address it. The charts are good though.

On PB, from a point of view of duration, it is insignificant, we would need to see a zoomed view of about 5 min possibly 10 to see if a reason becomes apparent. Screen prints should include the sidebars, what is your operating system and how are you taking the screenprint?
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#3
RE: Trying To Interpret Periodic Breathing In Oscar
I would also suggest you google and download the Philips titration protocol guide. It will help you see what the settings do and how they suggest to titrate it from default. It may give you a better understanding to the advice you are given here
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#4
RE: Trying To Interpret Periodic Breathing In Oscar
Thanks for the very helpful replies.  I understand PB a little better now and am not as concerned about it as before.  I also downloaded the PR Titration Protocol Guide and it has really helped in understanding my machine settings.
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