How am I doing?

[JBSLEEPZZZ]

           

Hello all, first time poster. 

I would appreciate any feedback as getting answers/explanations from my doctors is difficult.

Background:
56 y/o male
Recently dx with OSA, CSA, CSR

Home study 28 AHI, results attached, 2X CA vs OA. Huge difference between sleeping on my back vs side. 
In Lab overnight AHI 9.7 all Centrals but said I had 10 minutes of CSA. 



Eco: normal LV EF60%, RV is borderline dilated, normal function. LA is moderately dilated. Normal valve function. 
48 Hr Holter Monitor: 3 afib events, under 6 minutes in total, short PSVT events 110, longest 10 beats.
Resting HR while sleeping 40. (I have always had a low resting HR, I run 10-12 miles per week).
Cardiologist wasn't concerned, CHAD score was 1. I asked if this could cause CSR and he wasn't concerned. 

Should I be concerned about CSR? My Pulmonologist and Cardiologist didn't seem to be to concerned. 

Can a very low resting heart rate cause CA and CSR? 

Been on Aircurve 11 ASV for two weeks and my results have been decent thus far. I attached the last two nights Oscar reports. How does it look? 

Thank you!!

[Deborah K.]

I know nothing about ASVs, but I can see that your flow limits are high.  Someone with ASV knowledge can tell you how to fix that.

Also, we could better help you if you changed your Oscar chart just a little.  We need to be able to read to the very bottom of the flow limits section.

[JBSLEEPZZZ]

Hi Deborah, thank you for responding. I will make the adjustment and repost later when I’m back to my computer. 

Thanks again

[JBSLEEPZZZ]

   


Good morning, I added last nights info with full view of the grafts. 

How does this look?  Should I be happy with my results? 

Anyone have any thoughts regarding CA and CSR per my original post above? 

Any feedback would be greatly appreciated. 

Thank you.

[Jay51]

What are you settings?  EPAP and PS and IPAP max?   Just curious.  

Your leaks are not going over the threshold of 24L/min.  That is good.  Your pressure stays pretty low (about 5/10).  That is good.   

You could try increasing both your EPAP max and PS (since you seem to be getting good therapy at relatively low pressures for someone using ASV).

[JBSLEEPZZZ]

           

Jay51 pid='530583' dateline='1726937698']What are you settings?  EPAP and PS and IPAP max?   Just curious.  

Your leaks are not going over the threshold of 24L/min.  That is good.  Your pressure stays pretty low (about 5/10).  That is good.   

You could try increasing both your EPAP max and PS (since you seem to be getting good therapy at relatively low pressures for someone using ASV).

Hi Jay51,

Thank you for responding. 

EPAP Max 5.  I have been looking for the IPAP and PS settings but not sure what that is?  I have been playing around with the ASV machine but I didn't see a way to make any pressure changes. I actually didn't see anything noted PS and IPAP. 

Can I change settings on my own or do I need to call my sleep doc to make the change?

I attached my settings page

[Jay51]

I am trying to figure out if you are in ASV mode or ASV Auto mode.  I am trying to find a manual for the 11 series online.  

Your machine is not reporting the mode it is in with OSCAR (most likely because it is the new 11 series).

[JBSLEEPZZZ]

Ok I see it now when I turned on the machine.

Mode ASVAUTO
EPAP 4-5
PS 1-6
Still don’t see IPAP

I believe this is the new 11 unit. That is what they said when I picked it up.

[Jay51]

Thank you very much for that.  

You have very low pressures.  That is good.  About the only major thing I see in your charts is a lot of H's (hypopneas).  Usually, more pressure support gets rid of flow limitations, H's, etc.   It may even take raising your EPAP a little bit.  

A good experiment may be to raise your EPAP by.  So it would now be:  4-6.  

You can also raise your PS by 1.  So it would now be:  1-7.   

By raising these pressures, you may be able to get rid of the H's in your OSCAR charts.

[JBSLEEPZZZ]

Good afternoon Jay51, thank you for your feedback, I really appreciate it.

So I guess I am doing ok lol. I really have no idea, getting any feedback from my doctor’s office has been challenging. I’m just trying to figure everything out on my own.

Can I make the changes or do I need to have my sleep doc do it?

I am a bit reluctant to make changes on my own, but will give it a shot. I don’t know how to do it but will do some research.

Thank you again!!!