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I'm afraid I don't understand the picture here. How many times during, say, the past month have you seen "drift"? If it has been very frequent, then perhaps you should get in touch with your DME about repair or replacement for your machine.
I'm also concerned about the CAs, but I can tell you are reluctant to make adjustments that might address them. I hope you will change your mind about that.
At this point, I'm uncertain what any of us can contribute, but please let us know if there's an area in which you would welcome advice.
I think it is fair to judge therapy effectiveness on how you feel. If you feel the therapy is what it should be, then maybe ignore the charts or don't read them at all. Those of us that armchair quarterback therapy suggestions, have only what we see, and what we're told to go on. Right now it seems, you are satisfied with therapy and are concerned about things other than events you are seeing in the charts. Quit looking at charts.
If you want to keep some pressure support and resolve the central apnea, then ASV is the only device that can do all that You seem to heve enough events that it could be justified if you want to push it with your doctor, or especially if you're ready to self-finance a new or used machine. Either way, let's define the goal, and then move that way.
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On the June 6th data zoom in to show a time period of 2:40 to 4:00. Rearrange the graphs so that mask pressure and snore are also visible(can bump resp rate, flow limitations and leak rate for now). Scale mask pressure to the same as the pressure graph (4-9). Before taking your screen shot also scroll down on left scroll bar so other machine settings are visible.
I agree the pressure graph looks strange and also strange that no flow limitations are recorded during the same period. Hard to diagnose without more details. though and very strange/unlikely that two different machines would have same issue.
I agree with your advice and, for the most part, I do ignore the charts (except for leak rate and flow limit). However, my previous work (35+ years as a research scientist) has taught me that to get the most out of your machines you have to ensure all aspects are working properly and I simply could not ignore the pressure drifts. That was the motivation for this thread.
Geer1,
I think you have made the right suggestion. I have never paid much attention to the mask pressure as I was under the impression that it pretty much mirrored the results of the pressure (modified by the addition of respiration). In this case it does not! In fact it reflects no drift upward only the increase due to the hypopnea followed by a slow decay as expected from the settings. It appears that either the pressure or mask pressure is reported incorrectly.
Mask pressure is always more detailed and I have noticed this the odd time in other data. I've wondered if it is just the odd bit of data messed up when saving on the sd card or something like that but shouldn't be occuring regularly if so. What is strange in your case is like I said before it looks like it is in ramp mode, pressure graph doesnt respond as expected and flow limitations aren't being reported either.
Since you have tried tso machines I wonder if it isn't something on the OSCAR side of things. Maybe try uninstalling OSCAR and installing the newest version, no idea if that might help but who knows.
Only other thing maybe worth trying is turning off smart start unless you use that functionality. If you do use that functionality maybe try not using it for a bit and see if it fixes the reporting issue.
06-10-2020, 09:42 AM (This post was last modified: 06-10-2020, 09:43 AM by jaswilliams.)
RE: Did my machine malfunction?
The upward drift of the pressure line may be an artefact in the way OSCAR draws the pressure line if over an extended period of time the pressure remains constant then raises by a small amount Oscar plots the pressure between the start out of low pressure and the start of the higher pressure rather than a stepped line so the graph looks like a gradual uptick in pressure. In this instance the bottom of the mask pressure line is a better representation of the pressure changes.
Your issues are not caused by this pressure increase and I don’t believe there is an issue with your machine
jaswilliams,
I do not think it has anything to do with Oscar. Why do both June 7 (and June 8) display correctly. The only change is on June 6 I used the P30i and on subsequent days I switched to P10i. On the June 7 chart it is clear the observed increase in pressure is due to flow limit.
That June 7th data looks the same to me minus the obvious pressure drift. The pressure graph starts out flat lining although there were minor fluctuations as visible in the mask pressure graph (more so than later in the night when the pressure line does shows some minor fluctuations). There were also no flow limitations recorded until 21:17 although it looks like you may have had some flow limited breaths before that point.
I still wonder about smartstart, it may do something similar to ramp which does pretty much this exact thing (ignores flow limitations and pressure graph sometimes acts weird). Turning it off would be my first test.
Your machine is working fine as is obvious by the mask pressure graph. All the data just isn't being recorded or displayed properly for some reason.
