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Why are my CA same as OA in flow rate graphs?
#1
Question 
Why are my CA same as OA in flow rate graphs?
New member on 14th day of APAP. Review of data with Sleepyhead shows CA(1.17) and OA (0.02) for the last week statistical average. Obviously few events flagged as OA. Flow Rate waveforms for most CA look the same as OA. Is the ResMed device just miss-flagging OA as CA?

My flow rate waveforms seem to be somewhat different than I see on the forum posts ... much more variable in shape and amplitude. Is this normal?

The ResMed device seems to miss some events. Limit on new member so cannot attach the chart. Does this happen often with the APAP machines?

I suppose what is normal for one person is abnormal for another ...
It does not matter how slowly you go as long as you do not stop. --Confucius
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#2
RE: Why are my CA same as OA in flow rate graphs?
Your pressure is staying very close to the minimum of 15.0 all night. Your 95% is only 15.8. I would be inclined to lower minimum APAP pressure to about 12 and get a better picture of the machine titration. There is only 2 CA all night, and the machines are not infallible in identifying CA vs OA, especially in the presence of leaks. A lower minimum APAP pressure may allow some more OA to become apparent, but it may be more comfortable and reduce leaks.

If you're feeling good, there is not much reason to change anything, but if the CA is bothering you, there is probably some room to reduce pressure.
Sleeprider
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#3
RE: Why are my CA same as OA in flow rate graphs?
Sleeprider: You notice that Ed1101 has Itime > Etime. And, low tidal volume?
Plus fast median resp rate.
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#4
RE: Why are my CA same as OA in flow rate graphs?
Jm, I missed it. It's not as extreme as some recent cases we've seen, and I don't know if it's even significant. Tidal volume seems okay if this is not a large person, but the respiratory rate is 24 bpm, which is on the high side. Hard to say without more information. The waveform looks pretty good other than the apnea. To be honest, I don't know of any spontaneous PAP therapy that targets those parameters.

tom
Sleeprider
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____________________________________________
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Why are my CA same as OA in flow rate graphs?
Sleeprider: The chart is expanded to show the three types of events. I count 11 CA and 2 OA and 22 H all night. The Resmed AirSence 10 Autoset shows excessive leak rate not total leak rate. Is that correct? Is the ~15 leak rate excessive in this expanded section and causes the device to flag CA vs OA? Does the CA waveform show no flow the same as the OA? It seems the H flag is usually delayed as shown in the expanded graph. My data shows mostly CA and very few OA.

justMongo: "You notice that Ed1101 has Itime > Etime. And, low tidal volume?
Plus fast median resp rate." What does that mean/indicate? What is typical?
It does not matter how slowly you go as long as you do not stop. --Confucius
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#6
RE: Why are my CA same as OA in flow rate graphs?
(02-22-2016, 06:44 PM)justMongo Wrote: Sleeprider: You notice that Ed1101 has Itime > Etime. And, low tidal volume?
Plus fast median resp rate.

(02-22-2016, 09:24 PM)Sleeprider Wrote: Jm, I missed it. It's not as extreme as some recent cases we've seen, and I don't know if it's even significant. Tidal volume seems okay if this is not a large person, but the respiratory rate is 24 bpm, which is on the high side. Hard to say without more information. The waveform looks pretty good other than the apnea. To be honest, I don't know of any spontaneous PAP therapy that targets those parameters.

tom
I am 6' 1" and weight is ~250. I am seeing a Pulmonologist about reduce lung capacity.
It does not matter how slowly you go as long as you do not stop. --Confucius
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#7
RE: Why are my CA same as OA in flow rate graphs?
(02-22-2016, 05:59 PM)Sleeprider Wrote: Your pressure is staying very close to the minimum of 15.0 all night. Your 95% is only 15.8. I would be inclined to lower minimum APAP pressure to about 12 and get a better picture of the machine titration. There is only 2 CA all night, and the machines are not infallible in identifying CA vs OA, especially in the presence of leaks. A lower minimum APAP pressure may allow some more OA to become apparent, but it may be more comfortable and reduce leaks.

If you're feeling good, there is not much reason to change anything, but if the CA is bothering you, there is probably some room to reduce pressure.

SR
I think you meant 2 OAs all night. I like your idea of the lower pressures.

Rich
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#8
RE: Why are my CA same as OA in flow rate graphs?
Another factor to consider when comparing the waveform of CA's versus OA's is the Flow Limitation graph. You would expect the CA's to occur when no significant FL is present and the OA's to occur when a fairly large FL is occurring.

Dude
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#9
RE: Why are my CA same as OA in flow rate graphs?
The night I picked to upload is not very typical for Itime & Etime. All other nights (13 of 14) Have Itime < Etime. Tidal volume max range is 1530-2600 w/1620 average. FL is 0.01 at the CA before the OA and is 0.00 at the OA shown on the chart.
It does not matter how slowly you go as long as you do not stop. --Confucius
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#10
RE: Why are my CA same as OA in flow rate graphs?
(02-22-2016, 10:13 PM)Ed1101 Wrote: FL is 0.01 at the CA before the OA and is 0.00 at the OA shown on the chart.

That suggests that you may have been awake or partially so when those events occurred and they were both CA's that were caused by irregular breathing that can happen when moving or sometimes for no apparent reason. I wouldn't give much credence to them, especially when they occur in clusters like the graph shows.

Dude

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