How to find Central Apnea events in OSCAR? [Treatment of central apnea]

[GaspForAir]

Sleeprider, I understand now about keeping my thread together so you have my permission to move the other thread posts into this one.

To answer some questions posed by bonjour, I don't have any cardiac issues, but I am at risk for things like cholesterol and calcium CT, so I see a cardiologist and she has me on atorvastatin, low dose aspirin and folic acid. I also take pepcid. I don't have a history of stroke or seizures, and no known breathing issues. I am 70 yo.

I have had a total of 7 events like this that I can recognize from the beginning of November.

Here they are:

   
   
   

well I guess I can only add three. So thank you for your generous help and please let me know if I can provide more information.

[GaspForAir]

Had some more events reported as CSR night of Dec 26. My last night like this was Dec 22. Can someone help me analyze this please?

   

[Gideon]

I am a bit concerned with the duration, but would like to see a couple of 5 min segments to see if this is CSR or something else.

[GaspForAir]

   
   
   
Thanks for looking at this. I think this is what you want...

[Gideon]

The first 2 example are not obviously CSR, but the 3rd example is a classical CSR waveform.

Have you consulted your doctor about this?
In your history
Any Heart conditions, especially CHF?
Any Strokes or Seizure issues?
Traumatic Brain injury?
Med use, especially pain meds or recreational drugs?

[Sleeprider]

GFA, I think it's time to talk to the doctor and get a screening for left ventricular ejection fraction to verify it is greater than 45% in preparation for ASV. Adaptive servo ventilation can treat the hypopnea and central apnea you are experiencing, but it is going to take some work to get you into the right therapy from where you are now. The doctor may need to use bilevel therapy first to satisfy insurance or medicare requirements that you first fail CPAP then BiPAP before being eligible for bilevel with a backup rate (ASV), which can resolve central events and periodic breathing or CSR. Before we go there, remind me if we have ever used the EPR feature on your CPAP. EPR acts like bilevel and can reduce the flow limits and hypopnea we see in your charts. It's not so much I think it is ideal, but we need to at least know how you respond to bilevel pressure or EPR (exhale pressure relief).

One other minor thing...if you can please change your avatar. We use that one in Moderator an Monitor training as "Horrible Henry". As cute as he is, it's hard not to see HH when you post.

[GaspForAir]

Thank you bonjour and Sleeprider. I don't have any of the medical conditions that bonjour references. As far as I know I'm a fairly healthy 70 year old (except for my sleep problems). And for Sleeprider, I have never used EPR.

One problem I think I have is with my doc. He runs a solo sleep practice and having him respond to my concerns is difficult. I've already told his RT about my central apnea concerns and got nowhere. I'll push some more and if that doesn't work see what I can do about finding a new doc. My plan now is to print out some of the images above and bring those along with my SD card to another visit.

[Gideon]

SleepRider, CSR, and I believe GFA's centrals, should respond to EERS, What do you think?

[GaspForAir]

Most of my CSR events reported by OSCAR occur in the last 2 hours of sleep when I am frequently not asleep but in and out of a light sleep. Here's a good example from last night

   

Is this typical or does it shed any light on why I am having these events?

Here is another question I have. I know we're supposed to keep our posts together in one thread, but what if we want to change the topic significantly? I want to seek advice on why my doc is so difficult to deal with and what happens when I might change to a new doc.

Thanks!

[Osiris357]

My mom is a retired nurse and from what she tells me it is because doctors think that you couldn’t possibly know what you’re talking about because you haven’t gone to medical school. And because the medical world is still learning about SA so how could you know better then them. They treats nurses the same way as the rest of us also.