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First day results (OSCAR) - Printable Version

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First day results (OSCAR) - chrisiscitrus - 08-13-2020

Hi everyone,

I just got myairsense 10 autoset! The therapist at my DME was sure to warn me not to change anything (I think she got a sense of the type of consumer I am), because my settings have to be as prescribed (I think only the pressure is actually on the prescription) and she warned me that she could see everything I do and even tried to talk me out of using an autoset.  

Anyway, first night with it, I think it went well comfort-wise but my AHI was high with a ton of CA events.  I spent the first bit of the night fiddling with the mask to make sure it was correct and then had to do the same thing after waking up around 3:40 before trying to go back to sleep after 4:00.  That brief period was my only conscious time being awake.  Any thoughts on my results?  

Thanks in advance,

Chris


RE: First day results (OSCAR) - staceyburke - 08-13-2020

Looks like your settings are fine but the ca isn’t. It appears to be positional, chin tuck. It is cutting off your breathing. A collar is used by many to keep the chin up. http://www.apneaboard.com/wiki/index.php?search=Collar

Also your min was at about 8 so put it at 7. That would stop wide swings in support.


RE: First day results (OSCAR) - jaswilliams - 08-13-2020

Chrisiscitrus,


Can you upload a redacted copy of Sleep study, I would like to see if you had CA’s during the study.


I don’t think your issue is positional as CA’s are not positional in nature. Maybe you could reduce EPR down to see if this helps. But at a high levels the amount of CA’s is not normal. Do you have any other medical conditions or live at altitude ?


RE: First day results (OSCAR) - Gideon - 08-13-2020

Welcome to the forum.

We do need to see a copy of your sleep studies, a full copy including the charts and tables with personal info redacted.  This is to see if Central Apneas showed up in any of your Sleep tests.  We need to see if Central Apnea shows up anywhere in those reports possibly Mixed or Complex Apnea.  This is to determine if your centrals are treatment emergent or not.

Changes:  EPR often increases central apneas, fo I'd like you turn EPR off.  Since you are essentially obstructive free we are going to maintain the same therapeutic value so decrease your pressure to 8.

edit
I'll add that central events are not positional.  A positional blockage would tend to increase CO2 concentration which would tend to suppress central apneas.


RE: First day results (OSCAR) - chrisiscitrus - 08-13-2020

Hi everyone,

Thanks for your help thus far.  Here's the redacted sleep studies (full study and titration study).

Chris


RE: First day results (OSCAR) - Gideon - 08-13-2020

I cant eliminate the hypopneas being central in nature.
Your pressure was set to 10 because that is the only pressure that had enough time to draw a conclusion and the index was lower.

Post a zoomed chart, 10 minutes during a 'cluster' of central events, let's see what it looks like.


RE: First day results (OSCAR) - chrisiscitrus - 08-13-2020

Okay, here's the period with the most CA's zoomed in.  I can zoom in more if need be.

Chris

Oops...I just realized you asked for a 10 minute zoom.  Here's that. 

And to answer JAS, I don't have any other medical conditions of note. I'd consider myself to be in good shape. I have inherited alpha thalassemia trait, but that just makes my red blood cells smaller than normal. I'm healthy otherwise, as far as I know! I live in a city around 300 feet above sea level, so not at altitude.

Chris


RE: First day results (OSCAR) - Gideon - 08-13-2020

the only chart we need is the first one. we will ask if we need more.


RE: First day results (OSCAR) - jaswilliams - 08-13-2020

Thanks for all the information there is no CA’s on your initial sleep study the Hypopneas do not seem to be central as there is a Central Hypo column in the first study. Based on the information we have it seems like the events are treatment emergent and may reduce over time. As Bonjour says turning off EPR may help reduce the CA’s lets see how things go


RE: First day results (OSCAR) - chrisiscitrus - 09-20-2020

Hi everyone,

I just wanted to post a quick update.  I've been sticking with it and even found a mask that is better for me (the dream wear nasal cradle fits me like a glove!) and grabbed a chin strap for leaks.  I didn't change many settings (just decreased the EPR to 1) because I was wary to change too much prior to my first follow up appointment since my DME therapist made it seem like she knew I was "the type" to know how to change settings and would be watching me like a hawk (though, about 40 days in without her ever contacting me, I'm beginning to think she was bluffing haha).  

With that being said, I just had my best night yet and wanted to post the results.  The clear airway events are still the highest in quantity on a nightly basis, but they've decreased enough that my AHI is typically around 2 to 2.5 per night and last night I had a 1.04 with a full night of usage.  I feel better than I've felt in many years.  After my follow up, I'll probably fiddle with some settings and possibly try autoset mode, though if I keep getting results like 1.04, I probably won't even bother.  

I want to thank everyone for their support.  It's mentally helpful to know that there are a bunch of strangers who want to help out.