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Does this oscar report make sense?
#1
Does this oscar report make sense?
To me it looks like the air pressure is going up to the full setting for no reason.  My hubs has lowered his central apneas from 47 down to this, but cpap keeps picking up disordered breathing on waking as central apneas.  Any thoughts on this?

Sorry first attachment didnt work.


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#2
RE: Does this oscar report make sense?
Resmed uses the flow limit to determine a pressure increase. Yours is high enough that it will keep increasing the pressure until it either clears the flow limitation, or it hits its upper set pressure limit.

- Red
Crimson Nape
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#3
RE: Does this oscar report make sense?
Thats only about an hour and 15 min time. Hard to make an assessment. I think you probably have some chin tucking going on or leaks. That’s where your chin is almost touching your sternum and you close your airway. Try a flatter pillow, adjust min. pressure to 7 , max 15 , EPR 3. report back in a few days with a new chart. I think this will give you a good solid baseline and future adjustments should be minimal.
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#4
RE: Does this oscar report make sense?
hey, when the max pressure is 7, you can get it to peg out pretty easily.  having central apnea is not an obstructive issue, so the pressure is not raised for any of the CA events.  CA scores can be elevated when the EPR is high, or when the pressure is needlessly high.  Both cause more carbon dioxide to be swept out of the lungs (than the patient's central nervous system is used to maintaining and controlling.)  The secret is that the exchange of gas in the lungs is aided when the lungs are allowed to maintain a small amount of CO2.  When there is too little, the lungs just stop signaling the breath, and the central nervous system follows instruction (does not signal the brain to induce a breath that it was not asked for).  The CA is not a failure to act, or a broken respiratory part, it is a properly working feature.  

All this to suggest that reducing the EPR to 2 or to 1 will reduce some of the CA artifacts.

Consider setting pressure min of 6 cmh2o and the EPR = 1, and you can retain the max pressure at 7.  If we see obstruction in the way of OA count or worse flow limitations, we can make other small adjustments.

QAL
Dedicated to QALity sleep.
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#5
RE: Does this oscar report make sense?
I don't see 4-7 as a useful CPAP pressure. I do see minimum 7.0, maximum 12. 0 and EPR 2 as something worth considering. No sleep doctor would have put these settings in. Are you self-treating?
Sleeprider
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#6
RE: Does this oscar report make sense?
He had a sleep study 2 months ago that concluded he had an inadequate response to cpap from 5-15 with no snoring and continuous central apneas and cheynes stokes respiration with ahi over 60/hr.

We changed one of his heart medications to get where we are now with central apneas much much lower, sometimes in the single digits.

He had 2 previous sleep studies, one 20 yrs ago, his prescription was 6 for obstructive apnea which was increased to 11 (6-11 it turned out).  He did very well till his heart attack
In August 2022 when his 2 to 5 obstructive apneas changed overnight to 50 central apneas.

We’ve had oscar one week or so & trying to get some baseline info at different settings.


Thanks all for advice.
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#7
RE: Does this oscar report make sense?
Ivy, it's simple...he is on the wrong device and should be using an adaptive servo ventilator (ASV) which specifically treats CSR and central apnea. Why didn't that happen? If he has left ventricular ejection fraction greater than 45%, he should be titrated or just prescribed ASV. The medical history of CA and CSR over 60/hour would have been useful information up-front.
Sleeprider
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Does this oscar report make sense?
Thankyou.
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#9
RE: Does this oscar report make sense?
(02-22-2023, 10:49 AM)Ivy woods Wrote: Thankyou.

Ivy, it sounds like you are a caretaker, so I'm gong to link the Resmed Clinical Titration Protocol for you to look at, hopefully to be enabled to better discuss this with the medical team.  You should know first that any time central apnea is involved, the recommendation is to consider ASV.  The ASV titration protocol, and the conditions it is intended for, and how it works is discussed starting on page 28. https://document.resmed.com/en-us/docume...er_eng.pdf  Please read this information so you can waggle your finger in front of his doctor and ask good questions.
Sleeprider
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____________________________________________
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Does this oscar report make sense?
Great info there - thankyou!  Sleep dr mentioned bi pap and asv were being considered. Husband is of course at risk of heart failure as he had infarct (mid august) with revascularization and stents in both right and left coronary arteries.  Infarct was nstemi in right inferior descending and ejection fraction was preserved both left (49) and right (50).
Other than only getting 4 hrs of sleep or less per night, he feels good.  He’s 72 and does brisk 20 min daily walk ( much faster than i can walk).  He is 5’8”, 160 lbs ( down from 180)in august.  With cardiac involvement the asv may be contraindicated, so we are motivated to get the central apneas reduced by finding the best setting on current autosense 11.

Central apneas started immediately post infarct.  Possibly due to medication Ticagrelor which was switched Jan 13, or due  possibly to bradycardia & other minor arrythmias which are ongoing but may also resolve after cessation of ticagrelor.  Lots of unknowns.

Have attached records from old airsense 10 for her machine ( found the sd card today) and replacement airsense 11.  

Thanks for your help.


Attached Files
.pdf   Oscar Statistics Feb 22, 2023.pdf (Size: 148.79 KB / Downloads: 8)
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