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Woofer777 - OSCAR Analysis
#41
RE: First Post, requesting Oscar review assistance
Yeah collect some nights at this setting and then try Pressure = 7 and EPR = 0 for a few nights.

You can't draw any conclusions from this yet because as noted at previous settings night to night variation can be 4.5 to 13 AHI.

Your sleep tech is assuming these are treatment emergent central apnea. If that is the case then lowering the EPR should help. With all the other variables removed (pressure fluctuations) we can see if that is the case. Then we can try a higher pressure using whichever EPR setting was best to see if pressure is beneficial or not. This process is slower but it is the only way when there are such large variations day to day.

Other than seeing how this pans out the main thing I am curious about is your heart rate and trying to determine if it is actually fluctuating like that and if it is correlated to the apnea or acts independently.
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#42
RE: First Post, requesting Oscar review assistance
IIWM I'd go over the data with a fine toothed comb before I did any dial wingin'.  This would entail looking at 90 to 120 second windows.  SkyLab view can be helpful, but IMO only as a map to go find out where the problem(s) is (or are).

If so inclined, load your data up to a third party server like DropBox et al and I would be happy (and eager) to help browse.

Pulse oximetry results can be (and often are) tainted by artifact, so I would not necessarily commit to a lifetime of oxygen based on three 88s.  I'd put those under the microscope too.
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#43
RE: First Post, requesting Oscar review assistance
BTW do you live at altitude (Denver, Salt Lake City, etc.)?
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#44
RE: First Post, requesting Oscar review assistance
Rubicon - Where I live in TN elevation is around 1100 ft..   I will send you a PM regarding your other suggestions/offer. 

Night 2  (last night) with 9 fixed EPR 2 , 9.95 AHI (consistent with high centrals).  One occurrence of O2 at 87%.  

Will try a few more nights at same settings.
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#45
RE: First Post, requesting Oscar review assistance
I wonder "what-if" you could try ASV. Price of entry to try is $550 for a used S9 VPAP Adapt, and of course that is an out-of-pocket experiment that might resolve over 90% of your events and variable breathing.
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#46
RE: Woofer777 - OSCAR Analysis
Since I'm only a few months away from full insurance coverage I'm inclined to hold off on buying a used ASV.   I realize it will be a slow process to get the overnight testing and other reviews completed before eventually its concluded an ASV is needed and approved by insurance.   It would be nice though to jump straight to the finish with an ASV test.
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#47
RE: Woofer777 - OSCAR Analysis
2 quick points:

In re: oxygen level, are you short of breath under normal exertion? Climb up a flight of stairs or 2 while monitoring your O2 sat.

In re: ASV IMO you have to closely analyze their origin. If you're a bad sleeper and those are all post-arousal or sleep onset CAs an ASV could probably get them removed from the AHI list but you really haven't done anything. Those types of centrals are supposed to happen.
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#48
RE: Woofer777 - OSCAR Analysis
On O2, I'm not finding myself short of breath under normal exertion or daily awake activity.  I haven't been wearing the O2 ring except for sleeping.  I'll try a week wearing 24/7...except for charging...lol...  O2 levels surfaced as an issue with the HST and confirmed with my data collection with the O2 ring.  Typical night now with supplemental O2, is 3 to 4 drops per night still above 90% , and an occasional (once a night, not every night)  88% that wakes me up from the  O2 Ring alert that's set at 88%.   Until my nights are more consistent its difficult to correlate yet to events.

I understand the point on the root cause of the centrals.  My short term goal is to reach a consistent AHI level ( even if numbers aren't great).  Reaching that plateau should then allow a deeper dive into flagged events to better analyze cause or if any may have been falsely triggered, or should be ignored.

Testing various fixed pressure settings /EPR is the action suggested (to reach the short term goal). I am at the beginning phase of that testing still using fixed 9 EPR 2.
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#49
RE: Woofer777 - OSCAR Analysis
Just a few runs up the staircase will be fine.  See if you desat.  Or if you can bike, run, swim without shortness of breath then IIWY I'd rethink the whole oxygen thing.  Motion or displaced unit can result in artifact that may be misinterpreted as being valid data.
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#50
RE: Woofer777 - OSCAR Analysis
Even if these are sleep onset arousals or something along those lines they are significant as they are affecting 10-25% of the sleep period. These results are too consistently poor to be nights of bad sleep etc. This appears to be a real central apnea issue and goal now is to try and figure out if we can treat it with current equipment as well as gain an idea of whether or not they may be treatment emergent (in which case they may eventually go away on their own).
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