Help, please, for new AirCurve 10 and OSCAR user

[njf1525]

I could really do with some help. I am new to all this, having been diagnosed a few months ago at the age of 73, although I've probably had it for very many years without knowing.

As mentioned in my earlier thread, I now have my AirCurve 10 VAuto and I am very confused by the results.

Previously, I had a loan BMC Bilevel set at 10cm IPAP and 6cm EPAP. BMC provides quite a good report and I can attach a copy if anyone wants to see it. During the 67 days I had it, my AI was an average of 0.7, my HI average 0.2 and my CAI was 0.0 every night. (The BMC report does not show UAs.)

The BMC showed an average leak rate of 15.1 L/min, 95% was 38.1 L/min and large leak (>90 L/min) 00hr 01min, % large leak (>90 L/min) 21%.

I have used the AirCurve for three nights. It is mostly all set to auto with a pressure support of 4cm. I am particularly worried about my CAI figures. (Am I right that the CAI is the worst kind because the brain does not even know that you've stopped breathing?) From the BMC saying it was negligible, OSCAR is now showing much higher levels. Why would that be?

Also, my AHI is jumping about a lot. NB. On the second night I was only asleep about 4 hours.

I am not sure how I should be posting the report so forgive me if I am doing it wrong. I have looked at the Chart Organisation Wiki. I have done one for each of the three days. I hope that was right.

Thanks in advance for any advice. It is very early days with my new machine but I would like to get it right and, particularly, try and solve the problem of my CAI.

[Sleeprider]

Except for the last night, the results look pretty good, and the CAI is not a major concern here. You seem to do pretty well at low pressure and I'm going to suggest a lower maximum pressure and some other changes. Lets use Vauto mode with EPAP min 4.0, Max IPAP 12.0 and PS 3.4 with trigger sensitivity set at High. This should resolve the centrals and be more comfortable, but you will have to deal with the leaks.

[njf1525]

Thank you, Sleeprider. I've changed the settings ready for tonight. I will have to work on the leaks. I am already mouth-taping and will have to see what I can do about the fitting of the mask. I tried a P30i pillow cushion and didn't like it as much. Let's see what tonight brings.

Thanks again.

[njf1525]

I've been away for quite some time but I would like some more help, please. Being able to view Oscar properly on my 4k screen has made a 100% improvement in my using it.

I am still worried about my central apneas.

I could not get on with mouth taping but I found the mask for me at last a couple of weeks ago - the F&P Vitera. I thought it might feel too big and uncomfortable but, together with the Lunderg CPAP pillow, I am finding it fine. The only downside is that I have to keep my dentures in at night as otherwise the leaks increase too much. I think my leaks are now under control?

I have been using my AirCurve 10 VAuto for a while in S (bilevel) mode, mostly set at 10cm IPAP and 6cm EPAP. Last night, I increased my EPAP to 7cm to see if that would help with my centrals. The AirCurve 10 VAuto does not have an ST mode which I would otherwise have tried.

My total AHIs are sometimes below 5 but can go up to near 10 but, as you can see my centrals are 75% or more of the totals.

Should I be worried and what can I do to reduce the centrals, if I need to? Anything else I should be trying?

Thanks in advance for any advice.

           

[Sleeprider]

Try changing Trigger Sensitivity from Medium to High and watch the centrals go away. You don't have a high event rate, and by making this simple change, you can resolve most of it. With high trigger sensitivity, the machine will trigger IPAP with less spontaneous effort, and this usually stimulates a spontaneous breath. Other options is trigger sensitivity on very-high or reduction of the pressure support to 3.6, 3.4 or something a bit less than 4.0.

[njf1525]

Thanks, Sleeprider. I changed the Trigger to Very High as it was already on High. The IPAP I left at 10cm but I changed the EPAP to 6.6cm. I slept well and my AHI was better than most days at just 0.45. However, the centrals were still two thirds of the total. See attachment. I still don't know if I should be worried or not.

I intend the leave the same settings for tonight to see if the total stays low, unless you want to suggest I change the PS again? 

   

[Sleepster]

I slept well and my AHI was better than most days at just 0.45. However, the centrals were still two thirds of the total. See attachment. I still don't know if I should be worried or not.

I intend the leave the same settings for tonight to see if the total stays low, unless you want to suggest I change the PS again? 

Definitely leave the settings alone for several nights. Let your body adapt.

There is nothing to worry about with a AHI of 0.45. It doesn't matter if they're all centrals, your apnea is controlled better than could be accepted. Many people would kill for a AHI that low.

If you want, you can check to see how long each central event lasts. It shouldn't be much more than 10 seconds. If it's much longer, like say a minute, then I would get an oximeter to see if your oxygen levels drop significantly during those central events.

[njf1525]

Thanks, Sleepster. I will leave things as they are for at least a couple of days, although I doubt my AHIs will stay that good. My centrals seem to last up to around 25 seconds and there do seem to be quite a lot of them.