Interpretation Questions - My OSCAR Data

[ApneaQuestions]

Go to the bottom of the daily page, left side.  There you will see a drop down box.  Click on it and turn on the flags for Obstructives, Hypopneas and Periodic Breathing.   They will then show up in the events graph. The bars should be green/black if turned on.
See example below with arrow.

I don't have the Periodic Breathing aka Cheynes Stokes option in that drop-down
All I have are the ones in the attached image and they are all turned ON

I don't know if that option is machine-dependent or if I have to turn on some other flag elsewhere to make it available in that dropdown.
I did go to File->Preferences->Events and turned Chenes Stokes on (both check-boxes) ..  but it had no discernible effect

The image attached  is my best-guess at turning on all the options I can find

Let me know if you need or want the zoomed versions too

[OpalRose]

Ok, the OA’s and H weren’t showing on your event graph in the first chart you posted. But I see they are now.

And, PB isn’t available on ResMed machines graph? Maybe someone can verify this?

[ApneaQuestions]

I'm going to stick my neck out and try my own version of an interpretation.
I love to learn and I love to be corrected when wrong... so don't hold back the punches.

For some reason I got out of bed for an hour between 5:40 and 6:40 (or maybe slipped the mask off?)
Once the mask was back on, the machine began gently due to the ramp option.
Shortly after 7:00 I started snoring
At about 7:10 those snores turned into OAs
The machine cranked up the pressures to stop the OAs and (as a consequence?) I started to get unstable as the CO2 dropped and the CAs kicked in
The machine backed off the pressures to try to resolve the CAs
At 8am the pressures were lower and the CAs resolved
between 7:57 and 8:03 my flow rate dropped in amplitude so the pressure cranked up again (?)
The higher pressures triggered more CAs at 8:20 and they never fully resolved
Although the CAs did not fully resolve, they reduced in number (less frequent)
I finally woke up... feeling bad

It's a great story.... but is it sensible? reasonable? fictional? delusional?

[JoeyWallaby]

No comment. Please post your sleep study with personal information removed and share why you have an ASV machine.

[Gideon]

PB is avail OPAL, though it may be called CSR

[SarcasticDave94]

Why do you have an ASV? Do you have a diagnosis of central apnea (without CPAP)? I'm surprised you only had one OA with min pressure 4.

If you don't have central apnea without CPAP, this is likely treatment-induced central apnea. It only occurs only in NREM sleep, mostly S1 and S2. That first big pressure bump you have is likely REM sleep, where your machine detected flow limitations and increased pressure in response and prevented any obstructive events (impressive). After you cycle back out of REM, CAs are massively increased, particularly in the second part of the night with increased pressure.

If you reduced EPR to 0 and saw a significant improvement in CAs, that would pretty much confirm it.

Edit: I saw you asking why attachments in my thread were deleted. I haven't deleted any attachments, I think the forum had a glitch and deleted some attachments.

The attachments on the first page were my sleep study results which I posted again here. http://www.apneaboard.com/forums/Thread-...#pid320868

You did notice the OSCAR data was created on an APAP?

[ApneaQuestions]

It looks like the "cold" interpretations are mostly in so let me give you lots of information.  I'll do it in two posts.

This first post puts that bad night into perspective.  It was "atypical". However, I'm struggling to get a feel for what "typical" is for me.
The data seems to be all over the map.

The second post will give the full story over the past decade but may have more info than we need.

The attached summary shows my PAP adventure to date over the last few months. 
Although I've had apnea for years and possibly decades, it was untreated until recently. The second post will explain why that is.

The summary graphs consist of three different time periods.

1) I started on a prescribed Resmed 10 Autoset (but lost the detailed data due to swapping the card into an ASV machine which essentially reformatted it).
2) Had a one week trial in the middle with a loaner ASV just to see how that would behave in fixing CAs - It worked and the AHI dropped to essentially zero. I started using Oscar so that the data could not be lost. I also backed up the SDcard to a hardrive to be double-safe.
3) ASV trial ended so back to my prescribed Resmed 10 Autoset - CAs returned but sometimes hardly any and sometimes many

The night we've been looking at was the worst night ( I  am trying to understand why that night was so bad).
I am also wondering why things seem fairly random from night to night.

I need to grab some food so the full story may be delayed a little.

[SarcasticDave94]

I would say info from the sleep study is needed as well in a full detailed redacted form. I see lots of central flagged events on an APAP set to wide open 4-20. The sleep study would tell us if those type of centrals were pre-existing or CPAP/APAP therapy induced.

[SarcasticDave94]

It looks like the "cold" interpretations are mostly in so let me give you lots of information.  I'll do it in two posts.

This first post puts that bad night into perspective.  It was "atypical". However, I'm struggling to get a feel for what "typical" is for me.
The data seems to be all over the map.

The second post will give the full story over the past decade but may have more info than we need.

The attached summary shows my PAP adventure to date over the last few months. 
Although I've had apnea for years and possibly decades, it was untreated until recently. The second post will explain why that is.

The summary graphs consist of three different time periods.

1) I started on a prescribed Resmed 10 Autoset (but lost the detailed data due to swapping the card into an ASV machine which essentially reformatted it).
2) Had a one week trial in the middle with a loaner ASV just to see how that would behave in fixing CAs - It worked and the AHI dropped to essentially zero
3) ASV trial ended so back to my prescribed Resmed 10 Autoset - CAs returned but sometimes hardly any and sometimes many

The night we've been looking at was the worst night ( I  am trying to understand why that night was so bad).
I am also wondering why things seem fairly random from night to night.

Why the randomness? Apnea in general can be inconsistent. Central Apnea are "consistently inconsistent". IF you're dealing with centrals, ASV is my go-to therapy suggestion.

[JoeyWallaby]

The appearance of central apnea is related to a patient's "apneic threshold." The hypocapnia-induced apneic threshold is a physiological state-dependent, nonconstant numerical value resulting from a drop in end-tidal PaCO2 (usually 3-4 mm Hg) below the eupneic PaCO2.

https://www.ncbi.nlm.nih.gov/pubmed/26653197

Overtime the apneic threshold which is a fluctuating value readjusts and resets itself making TECSA a transient process. The vast majority of patients will demonstrate the resolution of TECSA with continued CPAP or adaptive servoventilation use within few weeks to few months. While most patients demonstrate gradual resolution of central apneas over weeks to months, 1.5–3% of patients with TECSA may continue to exhibit central apneas on a chronic basis.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4966223/

It is the difference between the prevailing Pco2 and apneic threshold Pco2 that is important

https://www.atsjournals.org/doi/full/10....507-1035OC

You likely have a small range between your usual sleep PaCO2 and your apneic threshold which explains the inconsistency.