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What is a bad total for CA's?
#11
RE: What is a bad total for CA's?
(12-28-2017, 03:29 PM)Sleeprider Wrote: Alessio, It looks like your doctor wants a second diagnostic study to see if the first study had an error due to altitude.  Your CPAP shows that while your AHI is much better controlled, the events continue to be predominately central.  Your oximetry shows this has an impact on your oxygen levels.  I think the duration of CA events, how they line up with desaturations, and how you feel are important issues to get in front of your doctor as well.  If you are having long events, with significant oxygen desats, and you continue to be tired, then you should be arguing for a titration study on ASV not a second-guess diagnostic.  

If you have a titration study rather than diagnostic, the events and type will be evident on the study, and it can be determined if you benefit from ASV.  A diagnostic study is going to do nothing, but confirm or modify the original findings, putting no closer to a therapy alternative than you are today.  With an average event rate of less than 3 per hour, the challenge is going to be justifying ASV therapy.  That is why the numbers are incomplete without the duration and oxygen desat statistics, and how you "feel" in response to CPAP therapy.  A titration study at least moves the game forward.

If you are open to trying something different, then I still think a fixed trial at 7 cm or using a limited APAP range of 5-7 and turning off EPR would be useful.

I have noticed that the desats are pretty much concurrent with the CA's.

What would you say are the levels of desats and/or CA duration that are thresholds of concern? Am I at them now?
My big concern is that I have to wait to sometime at the end of FEB for the 'split study' at my residential altitude. That seems a long time to me if my currents levels of CA and Desats continue!! I am hoping at my Jan 10 appointment the doc will somehow expedite this process.

I will try you suggestion of setting my APAP between 5-7 and see what happens. Thanks for that suggestion.
Began APAP 11/28/17
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#12
RE: What is a bad total for CA's?
I don't know from what you have posted what the duration and extent of desats are. All we have is the number of events. In general, a significant event would be <88% for more than one minute (JMHO, not medical threshold). We have new members with desats down into the 60s and they are still here.
Sleeprider
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#13
RE: What is a bad total for CA's?
You have an appointment on Jan 10 and the doctor wants to retest. So you will have a proper answer to what is going on.

I know you are concerned and the forum can help you understand the data. You can contact the doctor or email your reports before the due appointment. If you are worried, it would be a good idea.

Without the sleepyhead chart with o2 or even just the pso2 chart to what it is actually reporting, I'm at a loss.
"67 desats for a total of 47.3 minutes" doesn't mean much by itself. what were the desats determined by and the number of times and duration under 90%? They may well just be out of the 4% swing and nothing to worry about.
"CA minutes were 6.68 minutes." it also depends how many there were and how long they lasted. 3 at 2 minutes is serious. 20 at 19 seconds is ok.

This was my sisters 108 desats and 88 minutes and the average event was 50 seconds
Now she does have apnea, but it isn't as severe as one would think by the numbers. Because the machine reads low, the basal or base o2 being 91%, even the below 88 doesn't mean much.
[Image: l8frd0d.jpg]
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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#14
RE: What is a bad total for CA's?
(12-28-2017, 04:29 PM)ajack Wrote: You have an appointment on Jan 10 and the doctor wants to retest. So you will have a proper answer to what is going on.

I know you are concerned and the forum can help you understand the data. You can contact the doctor or email your reports before the due appointment. If you are worried, it would be a good idea.

Without the sleepyhead chart with o2 or even just the pso2 chart to what it is actually reporting, I'm at a loss.
"67 desats for a total of 47.3 minutes" doesn't mean much by itself. what were the desats determined by and the number of times and duration under 90%? They may well just be out of the 4% swing and nothing to worry about.
"CA minutes were 6.68 minutes." it also depends how many there were and how long they lasted. 3 at 2 minutes is serious. 20 at 19 seconds is ok.

This was my sisters 108 desats and 88 minutes and the average event was 50 seconds
Now she does have apnea, but it isn't as severe as one would think by the numbers. Because the machine reads low, the basal or base o2 being 91%, even the below 88 doesn't mean much.
[Image: l8frd0d.jpg]

Here is an example of last nights. I use the same software as your Summary Report above, with the same Paramaters. (I don't know how to get that report exported)

Event Data SpO2
Total event       143
Time in Event      56.5
Ave Event Dur     23.7 sec
Index                   17.3/hr
Artifact                  46.8
Adjusted Index      32.6

SpO2 Data
Basel SpO2            89.9
time(min)               43.7
Events<88%         67
Ave Low SpO2(%) 87.5
Ave Low Spo2 <88 85.8
Began APAP 11/28/17
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#15
RE: What is a bad total for CA's?
Here is the graphs to go with the data

[Image: sEx3pU9.jpg]
Began APAP 11/28/17
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#16
RE: What is a bad total for CA's?
It really doesn't look that bad, I'll put the rest of my sisters up. Does the average 23 seconds agree with the side statistics bar, 'events' column, for CA duration times in sleepyhead?

By the chart, the 3:30 to 4:30 would be worth looking at, Zoom in and have a look. See if they go for a while or just single spikes.
I would match it to sleepyhead, my guess is the single 80 and 85% drops are glitches. If you start the machine and the o2 meter at the same time, they will line up in sleepyhead.

[Image: ASC5pHk.jpg]
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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#17
RE: What is a bad total for CA's?
(12-28-2017, 05:52 PM)ajack Wrote: It really doesn't look that bad, I'll put the rest of my sisters up. Does the average 23 seconds agree with the side statistics bar, 'events' column, for CA duration times in sleepyhead?

By the chart, the 3:30 to 4:30 would be worth looking at,  I would match it to sleepyhead, my guess is the single 80 and 85% drops are glitches. If you start the machine and the o2 meter at the same time, they will line up in sleepyhead.

Here is my SH Chart for the corresponding times of my SpO2:

[Image: IwQ7vKl.png]
Began APAP 11/28/17
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#18
RE: What is a bad total for CA's?
honestly, I'm not seeing much wrong, your longest CA was 17 seconds. Hold your breath for 17 seconds, it isn't that bad.
There are 2 clusters when you are waking up and stopped the machine. the rest of the night is ok enough.

turn off the EPR
As sleeprider said ...start with a fixed pressure of 5
then 6 then 7, see which one works best, if the OA/H and CA are about even, I'd call that fixed till you see the doctor.
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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#19
RE: What is a bad total for CA's?
OK Gentlemen, I will give it a try.
Began APAP 11/28/17
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