Finally giving OSCAR a shot after 4 months of CPAP with no results

[SleeepyPuck]

    Is this ok?

[SarcasticDave94]

First, this was the sleep study, no CPAP segment, correct? If so, the following applies.

60 Obstructive
127 Central
2 Mixed
1 Hypopnea
9 RERA

Yes, this info was exactly what I wanted.

You need to have a talk with your doctor. This CA count makes more than half you events, same CA/Central Apnea present in that test. This indicates you need to treat the Central Apnea with a specialized machine, in this case specifically ResMed AirCurve 10 ASV. That very high Central count will probably not be treatable without the ASV.

Make an appointment soon. How to address? Show the doctor that page you attached. If that doctor will not order an ASV, you need to address it with one of your other doctors that will listen, maybe starting with your Primary. CPAP doesn't require sleep specialist doctor to order CPAP equipment.

PS your OSCAR seems fairly OK currently. If you see random levels of CA, that's to be expected. CA are consistently inconsistent, up then down random, with no settings changed. If you see that random up down CA, this makes ASV more likely to be necessary for more consistent treatment..

[SleeepyPuck]

Small issue with that. I tried to do a titration sleep study on an ASV and no matter what setting the technician put me on, I was uncomfortable. I think it was because of my tongue getting in the way. That’s the whole reason I’m on CPAP, and not ASV.

[SarcasticDave94]

OK. Historically how bad are your CA events with the AutoSet? Do most look similar to the OSCAR from beginning of this thread? If so maybe ASV isn't required, or at least until the other issue is addressed.

Additional info

Titration isn't required by insurance to issue ASV. Medicals may require echocardiogram to pass usage of ASV from a flawed SERVE-HF indicating ASV promoting heart failure. It doesn't, the test subjects already had HF. That's the flawed part more or less.

You can set the ASV pressures as easily as the AutoSet yourself with coaching here. Day 1 I had to self adjust the ASV I had.

Addition 2

To avoid CA with an AutoSet, no Ramp, and you may need to use less EPR, maybe minimize pressure swings. But this is the avoid CA plan only. To treat CA it requires ASV.

[SleeepyPuck]

For the most part my central apnea count is in the 2-3 range, although there are some days where it’s higher.

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I don’t have EPR on at all, should I keep it that way?

[SarcasticDave94]

Your choice to leave it off or see if it helps or hinders. If you have an experimental spirit, maybe try it, but with those CA in that report, it may make them worse by a little or a whole lot.

If you do try it, you'll find out very quick what happens if you anger the CA. That 2-3 AHI may will multiply. However CA are always unpredictable to the max.

[SleeepyPuck]

Great, thanks for your help!

[Rickyricardo]

Sorry I keep replying lol there’s a lot to take in and I’m going to bed in an hour or so: for the EPR, what level should I put it at? And should I have it in ramp mode?

Put it at 3 full time and turn off ramping so the pressure gets up to 8 quickly vs. starving you of air for 5, 10, 20 minutes.