Any idea how to get rid of these central events? The pressure is already low, no EPR.

[resende]

I don't know what else I can do. I appreciate any suggestion. 

sleephqDOTcom/public/1ec416f0-a2af-44fa-87c5-bf78dcdad804

   

[SarcasticDave94]

What amount of Central Apnea showed on your sleep study? And how long have you been using the AutoSet?

Both answers will help to know more about the CA in the chart. Your settings are already set to avoid as many CA as possible. Possibly no Ramp, no EPR, static pressure.

It's possible for one of two things, either you have a higher likelihood for CA, which the test result will reveal. Or the CA in OSCAR are treatment emergent caused by the CPAP AutoSet. If the CA were very high on the test, you might need the ResMed ASV to treat CA directly. If however the CA were low on the test, you might wait for the treatment emergent Central Apnea to diminish over time, or get the ResMed VAuto where you can avoid more CA using high Trigger.

You'll want to show the pressure chart with these other 4 next time. Collapse the calendar too, to allow more left panel info be shown.

[resende]

Thanks for your response. This was my sleep study:

"During sleep, there were 10 obstructive apneas, 54 central apneas, 5 mixed apneas, and 25 hypopneas.
The apnea-hypopnea index (AHI) was 18.5 events per hour of sleep, consisting of 13.6 apneas/hour and 4.9 hypopneas/hour.
Oxygen saturation (SpO2) while awake was 93%, with an average saturation of 93% and a minimum of 86%.
The patient spent 0.4% of the total sleep time with SpO2 below 90%."

I'm using fixed pressure for 15 days. Same results

   

[SarcasticDave94]

You had 5.4 times the amount of Central Apnea versus the Obstructive Apnea. They're very likely not treatment emergent, and will probably not diminish without acting against them. You're going to get better therapy by treating the CA with a ResMed ASV, which is designed for CA treatment.

[2farfromshore]

I don't have a lot of confidence in how the software is categorizing apnea. I've noticed multiple occasions where I'm awake and breathing normally -- I know this because I'm concentrating on my breathing in order to illustrate this point -- and the graph indicates several Central events.

Here is one after I have woken up, gone to the bathroom, and come back to bed. I'm lying awake in bed during this segment of time ruminating and listening to my breathing. This leads me to think there are ample misreads and inflated AHI numbers, Central or whatever, appearning in CPAP software.

   

[super7pilot]

Looks like sleep wake junk to me 2far. My Dr. told me when I first started that I need to gauge my therapy on how i feel when I get out of bed and to not stare at the my air numbers.

It is not my intention to be mean in any way. However, spending time trying to show that the software is flaky is a fools errand unless you can fix the errors you have discovered. So it ends up being pointless if you can't reprogram it.
There have been many times when I swore that I was awake and I was actually falling in and out of sleep. And my machine showed this in the sleep wake junk CA's and messy breathing patterns. The same thing happens when a driver has a micro sleep and nearly has an accident. They didn't realize they feel asleep until they were headed for the ditch and needed a change of underwear.

Also be aware our little machines ARE NOT lab grade sleep diagnostic equipment. They are a guide to help the Dr. make adjustments to our therapy. And via OSCAR, we can ditch the Dr. and make those adjustments ourselves.

[2farfromshore]

A lot of software is flaky, so you get no argument from me there. I'm not on a "fools errand," I'm simply illustrating the point you made in reply about not getting too hung up on the numbers, which is very easy to do when you start out with this therapy. Back to the software, I think for the price Oscar is damn good; and, as you wrote, especially as a guide. I get next to nothing from my sleep specialist, even after fessing up to having installed Oscar and trying to get answers to questions about readings on the graphs. Now THAT'S a fools errand :-) On the bright side of things, I'm finally scheduled for an in-hospital overnight titration in the not too distant future. Honestly, I'm not expecting a whole lot from it at this point. I'm not an eternal pessimist, but I've lived long enough to have tempered expectations from America's medical system.

[SarcasticDave94]

FWIW the Titration should be considered optional. Your insurance probably has no requirement for it.

Have you set the machine yourself? That's good enough, probably making the Titration an expensive redundant act, one that doctors get wrong 90% + of the time.

And by the way, it's not the OSCAR software issue, it's directly reporting what your machine recorded. CPAP class machines have zero value for wake breathing, so saying there's errors during known being awake, certainly it'll be in error. Wake breathing is very unpredictable.

[resende]

Thank you for the responses!

Just an update: I am using a chin strap for 2 days, and  the centrals AHI went from 7 to 2. Unbelievable!

[SarcasticDave94]

Maybe some of your CA reported were disguised as such, but could have been Positional Apnea Obstruction based instead. We've seen it before with some others.