Oscar data help - CAs

[CalAB61]

Hello,

I am new to CPAP therapy, and so far, it has been going pretty well. The first week was a learning curve regarding mask leaks. I believe I have figured that out; at least the leaks don't wake me up. I have uploaded the data into OSCAR and have been trying to understand it. As a newbie, I would put my understanding of the data on the low end, hoping that someone can help me. 

Background: I was diagnosed with Sleep Apnea late last fall with an AHI count of just over 36. I had an ABG test done, which came back normal, and pulmonary tests, which also came back normal. I have an Airsense 10 Autoset, and its current settings are below. I do have elevated blood pressure; however, it is not considered chronic to warrant medication.

Device Settings
Mode  APAP
Pressure Min  8.00 cmH2O
Pressure Max 12.00 cmH2O
Antibacterial Filter No
Climate Control Auto
EPR Off
Essentials Plus
Humidifier Status On
Humidity Level 4 
Mask Full Face
Ramp On
Ramp Pressure 7 cmH2O
Ramp Time 10.00 Minutes
Response Soft
Smart Start Off
Temperature 27 ºC
Temperature Enable Auto

My AHI dropped below 15 in the first week, but once I figured out how to keep the mask from leaking and got a contour pillow, my AHI count was below four for the past 5 days. My concern is the CAs, which range from 1.15 to 2.72 during the last 5 days. This is where being new to sleep apnea diagnosis and having a low understanding of the data can send me down rabbit holes where I may be making a mountain out of nothing. 

The following is the Daily chart for last night, Feb 22.

   

[Deborah K.]

I have a few suggestions based on your chart.  Your median pressure is over 10 and you are bumping up against your upper limit.  You'd do well to raise your pressure range to 10 to 15.

You are using soft response.  Most people feel better using standard response.  I'd do that if I were you.

You've been at this long enough that you don't need ramp.  Please turn it off.

Your CAs are not too bad.  I think they are treatment-emergent and will lessen as time passes unless you had many of them in your sleep study.  Did you?

Your flow limits are very high.  They are short apneas that don't get reported because they are short, but they can disrupt your sleep.  I suggest that you turn on EPR full-time set at 3.  This will probably raise your AHI, but I would do it anyway, as it is best to keep the flow limits low.

Best wishes for improving your therapy and comfort!  

[CalAB61]

Thank you for reviewing my information and chart. Your feedback is greatly appreciated. 

I'll adjust the Airsense settings tonight. You inquired whether my sleep apnea study had CAs recorded, and yes, CA=1.7. I have attached the sleep study analysis in case I didn't interpret it correctly. When the respiratory therapist reviewed the results, they neglected to mention the CA count or even outline what CA was. I poked around online and on the Apnea Board to get an understanding of what it is and what it means. 

   

[CalAB61]

I adjusted the settings as discussed. I didn't sleep well, but I suspect that is because I am getting used to the new pressure settings. My CA and OA events went up, but the changes did seem to reduce Flow Limitations. 

               


Will the CA events go back down, or will that require more tweaking? From 12:49 a.m. to 1:00 a.m.,, I appear to have had 18 CA events. I'm thinking this is not good.

I appreciate your help. 

[SarcasticDave94]

The CA should diminish in time, assuming you didn't have a lot during the sleep study.

[CalAB61]

Thanks for commenting. My CA event count during the sleep study was  1.7. 

The CA events had been between 1.89 to 2.54 over the last 10 days leading up to the pressure adjustment. Through the fabulous posting within the Apnea board forum, I had expected that changes could be treatment-emergent. It was just a bit of a surprise to look at the data and see 18 in an 11-minute timeframe.  

I am looking forward to finding that sweet spot for settings. 

[Deborah K.]

I think you would do well to stay with your present settings for now and give yourself time to adjust. If you don't feel better after a few days, we can try some changes, but I think you will feel better.

Don't worry about the higher CAs. They were low in your sleep study and will lessen as time passes. Lots of folks here always have some.

[CalAB61]

@Deborah K.

Thank you for responding. I admit my eyes widened when I zoomed in and counted the CAs in that 11-minute timeframe. 

I'll post an update in a few days.