[Equipment] High RDI low AHI. Overwhelmed with machine choices, OSCAR data, etc..

[ldinks]

Hi everyone,

I've had a watchPAT sleep study at home and I had an RDI of 8.5 (avg), with 13.5 RDI when on my side. I mostly sleep on my side on a typical night, and I felt like I had one of the best nights of my life by chance, so I think 13.5 is closer to a "typical" night than 8.5. Either way, over 5.0, and been told that treatment might help me with brain fog, tiredness, motivation issues, zoning out, typical "ADHD-like" symptoms. I also snore loudly and don't get restful sleep, wake up with a dry mouth, get sleep paralysis and EHS. Low AHI, so UARS instead of typical OSA.

I'm in the UK and looking to buy a machine online to use myself. I was going to go for the "S10 AirCurve VAuto BiLevel" but was told by someone online that the "Respironics System One DS950 BiPaP autosv" is better, if I've got the money.

Which machine, or if there's another, is going to be most likely to help treat my UARS?

Also, once I get the machine and use it, how can I learn to interpret the data in OSCARS, or is there a place I can upload my data to have some help with it?

Feeling pretty overwhelmed and alone with it all, would appreciate any guidance.

Thanks a lot,
ldinks

[OpalRose]

ldinks,
When you say your RDI was 13.5 on the WatchPAT test, do you know the breakdown?  Is this all Hypopneas? Did the test record RERA's?

Also, if you have a print out of the results from the WatchPAT test, you can post it here for review.

The AirCurve VAuto would be the better choice.  If you purchase a Respironics, it would be cheaper but harder to dial in.

Once you purchase a machine, you can upload your OSCAR data here and we would be able to help.

[SarcasticDave94]

Welcome to Apnea Board.

Of the 2 machines mentioned, the ResMed VAuto is more likely to fit your therapy needs. That is unless you have Central Apnea. The machines mentioned are apples and oranges in comparison. A VAuto is more for obstructive apnea on a bilevel without backup rate, and the AutoSV is to treat Central Apnea. And further, the Respironics mentioned is a previous generation machine whereas the ResMed is current generation. So it's really not a good comparison at all.

Most members of the Apnea Board get better, more comfortable therapy with the ResMed brand as a whole. The ResMed machines respond faster and don't need therapy pressures on top of needed pressure due to the faster response. Because pressures can be lower, you're more comfortable as pressures increase only as needed.

Unless you state you do have Centrals, I would say you're not going to go wrong getting the ResMed AirCurve VAuto. It's an auto bilevel with breath timing controls. Admitted I'm biased against Respironics, but for good reason. I am suggesting buying the Jaguar, BMW, Aston Martin instead of the Chevy, Ford, Toyota, if you get the meaning.

On OSCAR, you can download it via the link in the word OSCAR. It is free. You will need an SD card in your PAP machine to save data as it happens. The SD needs to be all this: SD standard physical size not Mini or Micro, SD or SDHC in 2-32GB, formatted FAT32, and must be unlocked while in the PAP. The SD can be any brand like SanDisk, Samsung, etc. and does not need to say ResMed, Respironics, etc.

Attach OSCAR Daily chart showing Events, Flow Rate, Pressure, Leak, Flow Limit, if you're using a Windows PC hit F12 to capture a screenshot. Make a post just like this one and use New Attachment/Choose File (this is the shot you just took). Once the file is found, click Add Attachment. Then finally, after Add Attachment, you'll see file info and Remove and Insert Into Post. Click the Insert Into Post button to add the data shot where the cursor is within the text box. AB members will see your post and will comment on it. That's how to get OSCAR feedback. Add the OSCAR shot as stated and include your feedback in answer to "how do you feel?". We aren't just greeting you with that, but are digging for your feedback on how you slept, what symptoms did therapy cause, etc.

[ldinks]

ldinks,
When you say your RDI was 13.5 on the WatchPAT test, do you know the breakdown?  Is this all Hypopneas? Did the test record RERA's?

Also, if you have a print out of the results from the WatchPAT test, you can post it here for review.

The AirCurve VAuto would be the better choice.  If you purchase a Respironics, it would be cheaper but harder to dial in.

Once you purchase a machine, you can upload your data here and we would be able to help.

Hi OpalRose,

I've attached my results - I'd like to point out again that I slept the best I had in a long time (my partner said I wasn't snoring much/having issues breathing like normal, my mouth wasn't as dry, and I mentally felt better. Happens a couple of times a year at most). 

What do you make of these results? I also have depression/anxiety (somewhat), and many ADHD symptoms (zoning out, brain fog, struggling with motivation / taking action), and general tiredness. I get a dry mouth on waking and suffer from sleep paralysis/EHS. Is there a possibility that these symptoms will improve with treating my UARS?

As far as I can tell, no OSA or CSA, just UARS.

The AirCurve VAuto is actually cheaper for me! $799 compared to $1199 for the respironics one.

Welcome to Apnea Board.

Of the 2 machines mentioned, the ResMed VAuto is more likely to fit your therapy needs. That is unless you have Central Apnea. The machines mentioned are apples and oranges in comparison. A VAuto is more for obstructive apnea on a bilevel without backup rate, and the AutoSV is to treat Central Apnea. And further, the Respironics mentioned is a previous generation machine whereas the ResMed is current generation. So it's really not a good comparison at all.

Most members of the Apnea Board get better, more comfortable therapy with the ResMed brand as a whole. The ResMed machines respond faster and don't need therapy pressures on top of needed pressure due to the faster response. Because pressures can be lower, you're more comfortable as pressures increase only as needed.

Unless you state you do have Centrals, I would say you're not going to go wrong getting the ResMed AirCurve VAuto. It's an auto bilevel with breath timing controls. Admitted I'm biased against Respironics, but for good reason. I am suggesting buying the Jaguar, BMW, Aston Martin instead of the Chevy, Ford, Toyota, if you get the meaning.

On OSCAR, you can download it via the link in the word OSCAR. It is free. You will need an SD card in your PAP machine to save data as it happens. The SD needs to be all this: SD standard physical size not Mini or Micro, SD or SDHC in 2-32GB, formatted FAT32, and must be unlocked while in the PAP. The SD can be any brand like SanDisk, Samsung, etc. and does not need to say ResMed, Respironics, etc.

Attach OSCAR Daily chart showing Events, Flow Rate, Pressure, Leak, Flow Limit, if you're using a Windows PC hit F12 to capture a screenshot. Make a post just like this one and use New Attachment/Choose File (this is the shot you just took). Once the file is found, click Add Attachment. Then finally, after Add Attachment, you'll see file info and Remove and Insert Into Post. Click the Insert Into Post button to add the data shot where the cursor is within the text box. AB members will see your post and will comment on it. That's how to get OSCAR feedback. Add the OSCAR shot as stated and include your feedback in answer to "how do you feel?". We aren't just greeting you with that, but are digging for your feedback on how you slept, what symptoms did therapy cause, etc.

Thanks Dave!

I actually have UARS, not CSA or OSA. I think it might be clearer with the results I've attached. Which machine would be best for that? A lot of people over at the UARS subreddit seem to believe that UARS requires different treatment to CSA/OSA.

I really appreciate you laying all of that information out, I'll get OSCAR as soon as I've ordered a machine.

Thank you both, I'm feeling a bit more at ease in general now.
- Ldinks

[SarcasticDave94]

Certainly cross off the ASV/AutoSV. I think the VAuto would be suitable, but see what others recommend with UARS being your highlighted need.

[OpalRose]

Hi OpalRose,

I've attached my results - I'd like to point out again that I slept the best I had in a long time (my partner said I wasn't snoring much/having issues breathing like normal, my mouth wasn't as dry, and I mentally felt better. Happens a couple of times a year at most). 

What do you make of these results? I also have depression/anxiety (somewhat), and many ADHD symptoms (zoning out, brain fog, struggling with motivation / taking action), and general tiredness. I get a dry mouth on waking and suffer from sleep paralysis/EHS. Is there a possibility that these symptoms will improve with treating my UARS?

As far as I can tell, no OSA or CSA, just UARS.

The AirCurve VAuto is actually cheaper for me! $799 compared to $1199 for the respironics one.
Ldinks

It appears from the test that you suffer with UARS and would more than likely benefit using a Cpap.  If you can acquire the VAuto, that would be your best bet.

You mention you have dry mouth upon waking, and that is usually a sign of mouth breathing.  When choosing a mask, you may have to use a full face mask if you can't overcome that.

Are you currently being treated by a physician for depression and anxiety?  Many medications can also affect sleep quality.  

Some of the things you mention... like brain fog, zoning out, low motivation and general tiredness are all symptoms of a sleep disorder.  I can relate to having sleep paralysis before being diagnosed with sleep apnea, but once treated, that stopped.

I can't see why you wouldn't benefit by using a VAuto.

[Gideon]

You have a small amount of OSA 1.6 pAHI
and about half of that is central apnea 0.9 pAHIc (the c means central)

What cannot be determined is the nature of the Central Apnea.
It is possible, not likely, that the higher levels of PS typically required to treat UARS MAY trigger CO2 induced Central Apneas, We do NOT know, it does happen in a few individuals.
The machine of choice is the VAuto at this time.

[marasmus]

I understand your point. I am a physician and suffering from UARS myself. I am one of the many patients who was failed by the healthcare system. After hustling with insurance company, I decided to pursue treatment out of pocket and grabbed a bilevel aircurve and currently running it on VAuto mode. 

So far I am impressed by the improvement it led to in my subjective sleep quality. I havent checked the Oscar data yet. However, I believe the most important part of the UARS treatment is the subjective sleep quality rather than the numbers so my initial goal is to sleep through the night with mask on my face. 

My observation is that the awakenings associated with UARS are RERA`s and for majority RERA`s happen during REM sleep ( For example in my case my REM RDI is 19.4 while NREM RDI is only 5.3). So that itself shows that flow limitations that lead to RERA`s are different in intensity during different stages of sleep. bilevel aircurve provides a set number PS ( in my case it is 3) and uses that PS throughout the entire sleep. What I observed is that I sleep quite well without PS during my NREM sleep but sleep poorly without PS support of 3 during the last 2 hours of sleep which is predominantly REM. 

Now the question is do I really need PS of 3 throughout the night? In my opinion, I would probably do well without any PS for good chunk of my sleep. However, I suspect that there are some REM periods where I need even more than PS 3 due to significant flow limitations. 

SO ASV`s algorithm adjusting the PS breath to breath basis makes sense to me for UARS. I have to say that I have been feeling better with aircurve bilevel. However, I am wondering now whether I would feel even better with ASV? 

But I have also been reading this forum for a while now and there are many members who are very experienced in respiratory mechanics. It seems like they are recommending bilevel for UARS so I will keep observing as I have just started treatment.

[Sleeprider]

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Moderator Action: Thread Split

A discussion of ASV vs bilevel therapies in the treatment of UARS has been split to a new thread http://www.apneaboard.com/forums/Thread-...RS-Therapy This was done to avoid disruption of the direct help intention with therapy threads and avoid confusion between the interesting debate of alternative therapy approaches, and help directly relevant to the thread author Idinks.

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