Central Sleep Apnea, confused about Oscar readings

[kps619]

Hi! I was diagnosed with central sleep apnea this past December, which was completely unexpected. I went in thinking maybe I had some type of issue with my sleep stages, or maybe mild narcolepsy or something. 

I'm supposed to be getting an asv or bipap in the next few weeks, but I've been using a CPAP machine I got from someone who is no longer using it, trying to improve my sleep even a little bit if possible. 

It's a ResMed S9 Autoset and I'm using in on Autoset mode, with the range from 4-9 because after my second sleep study, I asked the tech what was the highest pressure he has to use for me and he said 9. 

I've been uploading the sd card to Oscar and I'm a little confused because it looks like for a lot of my events the pressure doesn't go up, and it goes up sometimes in between. 

If I post some of my charts/graphs, would someone with more experience be willing to look at them and tell me what I'm looking at, maybe give me some ideas about what's happening in my sleep? I know it can't be taken as medical advice, and I will be getting that soon, whenever they get me set up with a machine that's actually monitored by a doctor, but I'd like to have some clues in the meantime. I've read through the wiki as well as I can but between sleep deprivation and ADHD it's not easy to retain all of that, or even understand some of it.

 

I'm trying to get back on my feet before my daughter and I (and our dog and cat) lose our home (again) and time is quickly running out. Thank you for reading, and for anyone willing to help me understand some of this. 

[OpalRose]

If you have a copy of your last sleep study, you can post it here.

Also, post a couple of your graphs here. Look over the link in my signature line to guide you on Organization of your graphs.

Use the F12 key to take a Screenshot of the Daily Page in OSCAR, then use the Attachment Feature to post them here.

Someone will gladly take a look and advise.

I have a feeling though if you were titrated at a pressure of 9cm, then your minimum pressure should start there. But let's look at your charts first. As you know, Central Sleep Apnea can't be treated with the AutoSet you are using, but maybe we can offer some settings for comfort until you're on the correct machine.

[SarcasticDave94]

Welcome to Apnea Board,

When we see the OSCAR charts, we'd be able to help much better. However, your title says you're concerned with Central Apnea. The ASV is the correct treatment device for those that have pre-dominant CA. This means it's not treatment emergent CA caused by being on CPAP. Specifically, the best choice is the ResMed AirCurve 10 ASV. I've used it myself and it does very well.

When you can, post the redacted sleep study, detailed version with charts and graphs. And add some representative OSCAR daily detail charts as well.

[Rich66]

I know it can't be taken as medical advice, and I will be getting that soon, whenever they get me set up with a machine that's actually monitored by a doctor,

Sorry to say, but don't over-estimate the "monitoring" aspect.  I've been a hoser for over 4 years.  I have never received any monitoring from the DME,  and the doctor has only once made a comment about my settings (and that was just a week ago).  I'm on my second machine, Phillips Respironics System One was the first one and no one was monitoring me on it (it took me over two years to find out).  You'll get more help from the people on this site than you'll get from the people that you'd think would monitor you.  Those people seem to be only concerned about "compliance", and their profit lines.  Your health is not their priority.

[kps619]

Thank you all for the replies so far! 

I couldn't get the screenshot to work with F12, ctrl + F12, or even by going up to "view" then "take screenshot", so I just took window screenshots as best I could. Please let me know if there's any problem with them.

Should I attach all ofl the pages from the sleep studies, or are there certain parts that would be more helpful? I had my first one in December 2021, then another in March that was done with cpap only for some reason, and then a third one a few weeks ago with ASV. 

Also, I was just about to go ahead and attach one of them but it said that type of file isn't allowed, so do I need to take a screenshot of the sleep study as well? 

   

   

   

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Here's one more OSCAR screenshot. It would only let me attach 3 but this one looks interesting to me.

   

[SarcasticDave94]

OK, the charts are helpful. For your comfort, you may want to add a bit of air by editing min pressure to 5 or 6. Again it's for comfort only. Most adults feel better starting off with 5 to 6 as a minimum, but quite a few need more to start with. And this may help CA by reducing the pressure changes somewhat.

Second thing is for trying to reduce the Central Apnea. If you have EPR on, it needs to be turned down. So if it's at 3, go to 2, try it, then if needed to reduce CA further, go down again to 1, then if you must, go to EPR off. This is to help make PAP therapy a bit more tolerable until you're on ASV.

Attachments and OSCAR screenshots: the method is partially dependant on your computer type, as in Windows or Mac. I had scanned my test result pages onto my PC thus creating data files of them. I then used the New Attachment: Choose File button. If you can get all to attach, that's best. If not, for myself especially the page from the first test, the one without PAP, with event type and count chart is helpful. As is, with this OSCAR info, I'm pretty sure you are rightfully headed to ASV. I would request the ResMed AirCurve 10 ASV by name. It is best in class and works with OSCAR.

[kps619]

Dave, you are awesome! I will try the adjustments you suggested, and I'll call the DME company and request the ResMed AirCurve S10 ASV. 

I downloaded my sleep study reports as pdf files so I'm not sure why they're not working, but I'll just take screenshots once I'm at my computer. 

Thank you SO much for taking the time to look at my information and replying so thoroughly!

[SarcasticDave94]

You're welcome. There may be some file attachment limitation due to your new member status. Hopefully that's making sense (and that the expected results follow) about those pressure edits. Let us know how it's going.

[Geer1]

It is probably possible to improve results with this machine. I would try min 6, epr 2, can leave max at 9. Same reasons Dave gave.

[kps619]

Sorry for taking so long to get back here! The last few days have been chaotic for me. I'm attaching the pages of my first sleep study, the one with no treatment. Well, it says to control server storage costs, posts are limited to 3 attachments, so i'll attach the first 2 pages here and the other 2 in another reply. 

I called the DME supplier and requested the ResMed AirCurve 10 ASV and they said that's exactly what they've ordered for me! ?

I tried adjusting the settings on my machine but that didn't go so well... The first time I used this machine, I had the pressure up super high and woke up with a very painful stomach full of air. Since I've had it on Autoset from 4-9, that hasn't been a big issue, I just notice a tiny bit of stomach pressure right after waking up, until I burp a couple of times. But after I moved the minimum pressure up to 6 and turned the EPR off (I figured I might as well go all the way with it if the goal is more pressure consistency), I woke up with a lot of air in my stomach, not as painful as that first time but very uncomfortable. Not sure if it was from the changes I made or I just coincidentally happened to swallow more air that time for some other reason.

Any ideas on how to prevent aerophagia? If it was worse because of the change in settings, should I turn the EPR back on, or lower the minimum pressure back down some? Or would a nose mask possibly help? 

I do have a nose mask, and the first time I used it, I actually liked it much better than the full face mask. I did have to put a little piece of medical tape over my mouth, because I'm used to breathing through my mouth at night. I have a deviated septum and my turbinates swell at night, so it's harder to breathe through my nose. I was hoping that using the nose mask and taping my mouth, I would breathe in enough air (because of the machine pressure) and avoid the extremely dry mouth I usually get at night. That seemed to work pretty well the first night with the nose mask, but the next night, I woke up with a very painful burning sensation in my nose.  

I don't know if that's because of the narrowed passage or maybe I'm not getting the right level of humidity... The hose I'm using is for the newer ResMed machines, so the chip thingy at the end of it doesn't fit into this machine. But I can't afford to get the other hose, so this one is it until I get the ASV machine. 
 
Okay I think that's everything I needed to add. I hope so. If I forgot something, I'll remember it as soon as I submit my reply lol. 

   

   

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Okay, here are the other 2 pages.