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+--- Thread: First Time User - Oscar Data - Looking for Guidance (/Thread-First-Time-User-Oscar-Data-Looking-for-Guidance)
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First Time User - Oscar Data - Looking for Guidance - Shenron - 08-20-2021
Hi there,
First I would like to say how appreciative I am that there is a place like this that I can come to for advice and support.
I just turned 40 and after 5 years of waking up gasping for air almost every night I finally decided it was time to try an xPAP machine. Two of my close family members are already on them and reporting good results. I am not overweight and consider myself in good shape as I jog regularly. Last night I used a machine for the first time. I have the ResMed AirCurve 10 Auto and my current prescription is for auto mode with 6 - 25 and PS 4.
I am a little confused because most of the events in OSCAR are clear airway events when I thought they would be obstructions. Does that mean I suffer from central apnea instead of obstructive apnea?
My AHI was in the 12s after the first night. Isn't that a little high while using the machine? Are there any settings I can try changing that might bring that number down when I try it again tonight? I have attached my OSCAR data.
I appreciate the help.
[attachment=34963]
RE: First Time User - Oscar Data - Looking for Guidance - GuyScharf - 08-20-2021
Welcome to apnea board.
Have you had a home or in-lab sleep test? If so, please post a redacted copy of the results.
If you are just starting CPAP treatment, then an initial number of CA's is common, and disappears after a few months as your body gets used to your better breathing. It would be useful to know whether CAs were reported in your sleep study.
If you don't need ramp to tolerate the CPAP, I suggest turning it off. While ramp does provide some comfort while going to sleep if you need it, no therapy adjustments occur during the ramp period.
It looks to me like a better minimum EPAP setting might be 7, or 6.4 if you want to make a more gradual change from the 6 you have it set at now.
Some of us have had success in reducing the number of CAs by changing the Trigger setting to High or Very High. But I would like to see the sleep study results to know whether we are chasing pre-existing CAs or whether these are just treatment-emergent CAs, which we could ignore until we see if they go away with time.
RE: First Time User - Oscar Data - Looking for Guidance - Gideon - 08-20-2021
I too would like to see your sleep studies.
In the meantime set PS=1 and let's see what happens to the CA events, they should go down significantly.
Why are you using a VAuto?
RE: First Time User - Oscar Data - Looking for Guidance - SarcasticDave94 - 08-20-2021
Agreed, we need to see a redacted detailed sleep study report. As was mentioned, edit the settings to try to get CA down.
RE: First Time User - Oscar Data - Looking for Guidance - Shenron - 08-20-2021
Thanks for the replies. I will try the settings mentioned tonight and see if they make a difference. I will also request my home sleep study results and post them here. This is all new to me and I appreciate the help.
RE: First Time User - Oscar Data - Looking for Guidance - SarcasticDave94 - 08-20-2021
If this helps, when requesting the report, if the doc's office balks at giving you a copy, mention HIPAA and that it permits you to successfully request and receive your own report.
RE: First Time User - Oscar Data - Looking for Guidance - Shenron - 08-31-2021
Hi again. I figured I would give an update on what is happening. After the first night I tried raising my minimum pressure to 7 and set the trigger to high. The next night I had an AHI of 10 which was better. Then I set the PS to 1 and my AHI has been between 0.5 to 3.5 every night which I think is good. I have kept the setting there.
I am still having trouble waking up gasping and I would like some help dealing with that if possible. I am attaching a zoomed in portion of last night where it happened and you can see my flow increase like crazy when it happens. Neither of those gasping events registered as events in OSCAR which seems odd to me because they were very severe for me. What can I try to stop these from happening? Should I increase my minimum pressure more?
I also included a zoomed in OSCAR shot of some centrals incase that is useful.
I have my sleep study data and I am really disappointed with the amount of data it gives. It tells almost nothing. I was hoping for data like OSCAR shows. Also during the test I think I only slept an hour or so because I was so anxious. Rather than trying to redact portions I'll just type out what it says:
Diagnosis: Obstructive Sleep Apnea (G47.33) Mild based on pAHI 12.8, pRDI 0.6, and O2 nadir 92%
Respiratory Disturbance Index: 12.7 per hour
AHI: 0.6 per hour
Oxygen sat: min: 92, avg: 95, max: 97
Sleep Pulse: min 47, avg 57, max 109
Snore duration: >40db: 9.8 mins, >50db 2mins (out of 8 hours)
Position: Back 62% of time: 15.3 RDI, Left side 38% of time: 8.9 RDI
Sleep Stage: Light 72%, Deep 18%, REM: 10%
This was the only information it gave....
Again, I would appreciate tips of settings I can try that will stop me from waking up gasping. Also, I am still not feeling well rested each day. Thanks for any help.
[attachment=35277][attachment=35278]
RE: First Time User - Oscar Data - Looking for Guidance - Gideon - 08-31-2021
Gasping implies not enough pressure (IPAP) set PS=2, cautious because of the centrals you presented w PS=4. We may try higher, if not we bump EPAP up
RE: First Time User - Oscar Data - Looking for Guidance - Shenron - 09-03-2021
Thanks Gideon. As suggested, I tried a night where I set PS=2 and my AHI was 7.5 for that night.
The next night I tried PS=1 and raised EPAP from 7 to 8. I couldn't tolerate it. It was too hard for me to breathe out and I woke up multiple times and ended up just taking the mask off and going back to sleep.
The next night, I thought I would try a smaller interval so I tried PS=1.2 and EPAP = 7.2 and I had a AHI of 2.7 for that. I was able to tolerate that.
Questions:
1) Why do my centrals increase when I increase my PS? I see most people are on PS 4. What is it about me that a lower PS reduces them? Is this something that will get better with time (is it related to me starting treatment recently)?
2) The smaller increments seem to work. Should I increase PS by .2 each night and see how much I can get away with before my AHI rises too much and then try increasing EPAP by .2 after that?
As always, I appreciate the help.
RE: First Time User - Oscar Data - Looking for Guidance - Gideon - 09-03-2021
Simple explanation: Our main drive to breathe is to get rid of CO2. It is not to get Oxygen. Increased PS/EPR/Flex increases the efficiency of our breathing y breathing deeper and exchanging more volume. This results in more CO2 being purged. In (un)lucky individuals this can reduce CO2 levels to below your apneic threshold where a central apnea occurs. When you stop breathing CO2 levels gradually build back up and you slowly start breathing with gradually larger breaths until you are once again breathing too deeply and your breaths start to diminish until once again you have gone below your apneic threshold in a repeating pattern.
In general these central Apneas will diminish over 2-3 months as your body adjusts. To aide this process IMHO you want a small number of these CA events to remain. You should be able to do this and be able to maintain well under AHI of 5