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I am a 40 y/o, female, BMI 19 with UARS. I got myself an at home sleep study due to high suspicion for sleep apnea based on my symptoms. The at home sleep study showed AHI of 0.9, but RDI of 5.1 per hour. Thus, I was approved for treatment based on the RDI. My O2 saturations never dropped below 92%. My doctors and nurses seem to look at the AHI on my CPAP machine and say no need to adjust anything for optimization. But if one uses that logic, I didn't need treatment either. Things are definitely better with CPAP/APAP but I'm wondering if it can be even better. Here are my questions:
1) Is the machine capturing all my events?
2) If it is not, how I can look at my Oscar data and manually score the events?
3) Can an event be defined as something that meets most of the criteria below?
increase in flow rate with
increase in mask pressure with
increase in flow limit with
decrease in tidal volume/minute ventilation (immediately followed by increase in these) with
decrease in O2 saturation with
increase in HR
Machine: Remediated Dreamstation APAP-CPAP Mode Mask Type: Full face mask Mask Make & Model: Airfit F20 Humidifier: Built In CPAP Pressure: CPAP 15cmH2O CPAP Software: OSCAR
Yes you can have events that are not flagged correctly, they typically happen around a flagged event so you can zoom in and check in Oscar and count the waveform variations that aren't flagged and tally them manually, the variance though I do not think is that high...
Also you need to raise your min pressure to at least 7cm with EPR on at 3. This could be some of the reason for your high leakrate as you are struggling to breath....
Short answer is no, longer answer is that your events are nearly all arousal-based from your study. The CPAP machine doesn't have an EEG channel so it's only guessing on RERA, but it does try to detect them. That you have none flagged in your chart is a good sign, but you might be able to find some few minor ones that didn't meet the criteria. The classic RERA is a series of flow-limited breaths (often flat topped inspiration shape rather than round top) followed by a recovery breath that indicates the body responding to the lack of breath with a mini wakeup or arousal.
Look, I'm an engineer, not a doctor! Please don't take my opinion as a substitute for medical advice.
Thanks for the pointers... bumped up to 6 last night and will go up to 7 tonight.
Okay, I took a look and rearranged my charts... looking for flow limitation and recovery breath. Am I on the right track here? Are those RERAs that I'm looking at?