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+--- Thread: [CPAP] New Resmed 10 Autoset user showing CSA / CSR (/Thread-CPAP-New-Resmed-10-Autoset-user-showing-CSA-CSR)
New Resmed 10 Autoset user showing CSA / CSR - KCAB1313 - 05-27-2020
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I'm a 58 yo male that started CPAP therapy in March and has been compliant with usage of a Resmed Airsense 10 Autoset device. Have been using OSCAR to review my detail data and have been logging about a 1:2 ratio of CSA to AHI, as well as periods of CSR each evening. My Dr had me perform a WatchPat One home sleep study to evaluate need for ASV. The WatchPat One report indicated AHI of 7.9 with "NO" CSA / CSR events, while for the same day my Resmed Airsense 10 Autoset indicated AHI 14.31, CSA 9.44, CSR 14.4%. My Dr was working on COVID19 patients, so a backup shared the report information with me. When I questioned the discrepancies between the two devices, I was advised the WatchPat One was better technology and more accurate and that I should disregard the Resmed data. I have contacted both Itamar and Resmed and awaiting responses on their levels of accuracy. Not holding my breath for responses. I have also contacted the hospital that has the WatchPat One data from my study and have requested they use the ZzzPat software to export the study channels to .edf and .csv files and send them to me. In the mean time, from what I can tell, the CSA / CSR event indicated by my Resmed Airsense 10 Autoset appear to be real. Can you please look at my OSCAR images and give your opinion. Thanks.
RE: New Resmed 10 Autoset user showing CSA / CSR - Sleeprider - 05-27-2020
The centrals and breathing pattern meet all the classic criteria of CSR for me. These events may be very different from what was indicated by the WatchPat One diagnostic evaluation due to the addition of CPAP and 3-cm EPR (aka pressure support). It would be an error for a technician or sleep clinician to assume your Resmed data is unreliable or to simply deny you have a moderate central sleep apnea disorder, because this may be therapy onset if not a component of your diagnostic test.
My suggestion is for you to turn off the EPR and see what affect that has on your results. We should see a significant reduction of at least 50% with EPR off. The obstructive apnea are occurring in clusters, and appear to be a positional issue. We describe our interpretation of positional obstructive apnea in this wiki article http://www.apneaboard.com/wiki/index.php/Optimizing_therapy#Positional_Apnea and suggest the use of a soft cervical collar as a solution here. http://www.apneaboard.com/wiki/index.php?title=Soft_Cervical_Collar
RE: New Resmed 10 Autoset user showing CSA / CSR - KCAB1313 - 05-27-2020
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Thanks for the review. I felt like the backup Dr was giving me the brush off when I questioned him. I'll hold out for my original Dr to pursue further. Last evening I had adjusted my EPR down from 3 to 2 and increased my MIN from 7 to 8. At first glance things looked better, but then I noticed that my CSA events had become UA events. Still had large period of CSR. I'll try your recommendations for a while.
RE: New Resmed 10 Autoset user showing CSA / CSR - Gideon - 05-27-2020
I completely agree with Sleeprider. Based on the info you provided this would be Treatment-Emergent Central Apnea.
Ask for a full copy of your WatchPat One study, including the charts and tables in addition to the summary. All too often we that the summary does not tell the whole story.
RE: New Resmed 10 Autoset user showing CSA / CSR - jaswilliams - 05-28-2020
You had large periods of Major mask leaks last night that is why your events were not Identified correctly, You need to work on your leaks as you had a huge amount of time last nigh in large leak