Little Olive - Therapy Adventure

[Little Olive]

Notes:  Yes I wore the collar all night .  50 minutes in I was still unable to sleep or breathe properly, the air I was receiving felt cold and forceful, plus mask felt it was being puffed off my face and leaking, so  I changed mask size, in the hope of feeling more comfortable.  The night was patchy and I def did not sleep the usage time stated.  Fibit says 5 1/2 hrs.  

The last 2 hours I was AWAKE.  I was lying quietly, relaxed, sort of dozing, hoping to sleep, but unable to breathe properly.  I was aware of my beathing becoming smaller and smaller and more shallow, then big breath, over and over.  I I have often had that breathing while conscious, and I now know it's CSB. It's a weird feeling, like being hyperventilated and hypoventilated at the same time.  If I do some breathing exercises, it stops then immediately starts again as soon as I relax.

[Little Olive]

BTW  l don't think l have any followups with the sleep clinic  because  I received a letter from them last week telling me that they are unable to resolve my issues and have referred me to the local hospital physicians for cardiac assessment and  further referral on to Respiratory and Sleep  Services at a bigger hospital in another city.  This is all in the national health services  public health arena, so there will likely be a wait of several months to be seen by the Respiratory doctors.

[jcp519]

Could you post a zoomed screenshot of the flow rate during the last part of the session that is labelled CSR? Also, take a few screenshots of various points that have lots of apnea. If it is true CSR there is a specific pattern of breathing to look for on the breath by breath basis. Your flow limits are still pretty high too. I'm starting to believe that you might need a more advanced machine to help you.

I also wanted to mention that central sleep apnea is consistently inconsistent. There may be a night or two where is completely disappears, only to return just as bad as before. My AHI would vary on CPAP from down to 2, all the way up to 8+ night to night.

[Little Olive]

Hi, thanks for that, l will find out how to zoom, as you have asked for this previously but l haven't figured out how to do it yet. Just a matter of asking Google ....

Ps the different settings just felt aggressive, and it was impossible to fall asleep with that level of presssure even though it was only 7, . I am a very light sleeper, easily disturbed. That's probably why they originally set soft response and auto ramp for me. I understand that the softly softly therapy approach is probably not in the therapeutic range l need but l can't face another night like last night. I just wanted to rip off the mask, stamp on it and throw the whole kaboodle out the window. OK l will go and work out zooming now.

[UnicornRider]

If you review the links in post #39, you will find CPAP FRIEND demonstrates zoom and navigating the features of OSCAR, The other two links in that post will take you into the ApneaBoard Wiki and will also provide insight into the workings of OSCAR.

  The follow-up with the Physicians is a good idea, It will put your mind at ease with concerns of CSR. We will get you as much assistance as possible before the Respiratory and Sleep evaluation.

  Are you able to get practice sessions in with the mask under pressure as described in post #34? Every hour of practice outside of your sleep sessions will greatly enhance your acclimation to the fit and feel of the mask under therapy pressure?

You are doing well with your hours of sleep session, Keep it up.   

[stevew168]

Based on the number of CAs you often have, EPR set to 3 is doing you no favors. AirSense apaps usually mark CSRs properly; actually they tend to be rather conservative. I would try setting EPR to 1 and lowering your minimum pressure to 5 or 6.

I believe what you really need is an ASV, unless you have serious heart failure. Maybe you can convince your current physician to write you a prescription since your apap is showing CSRs, as well as your sleep study. Maybe you can present them with a screenshot from OSCAR showing CSRs. That is what I did with my sleep specialist who worked for the sleep clinic, he wrote one, and I had an ASV within a few days, completely covered by insurance. Sometime it really helps to be proactive. BTW, last night my AHI was 0.24, with only one hypopnea in 8.5 hours!

[Little Olive]

0.24  Wow!  That's a happy place to be Hope I make it there someday.  Thanks for the advice, all noted, and I appreciate it.  

I had a comfortable night, the collar did its job, the pressure was comfortable, the air was warmer,  and  the mask behaved itself.  I see minimal obstructive events, and no CSB (YAY!) but still getting the CSA,. I guess I need to live with that.  I had 2.50 at 5am, then I went back to sleep for a couple of ours and ended up with 3.50. This is good, right?!

The sleep clinic nurse told me on day one that it's "all about how you feel", ie if I feel OK, the numbers are of less importance.  She told me I was being hypervigilant when I was asking about the AHI numbers and requesting detailed data.  I guess she is busy, and I was making a pest of myself.  Now I have Oscar I don't need to keep asking her questions.

So someday if I start feeling OK, and AHI start staying under 5,  but I still keep getting the centrals, is that something I should still try to eliminate?

PS jcp519, I did my best to do the zoom, watched the guy on utube, and did it but I kept losing it, when I had to slide it over and mark it up, it kept disappearing. Sorry for being inept ! Will try again.

[jcp519]

The AHI looks good, but your flow limitations are still pretty high which is probably why you still aren't feeling great yet. I have a feeling that the CSA is going to remain and vary quite a bit, night to night. Consistently inconsistent. It definitely looks to me that you need some more pressure support to help with those flow limits.

And no worries about having computer issues! So to zoom in on OSCAR itself, you'll just click and drag across the area of the night that you want focus on. So just hover your most over the flow rate chart, click and hold, and then drag it right to cover the length of time you want to zoom in on.

[UnicornRider]

Not knowing the requirements of New Zealand's National Health Care System to upgrade to a different machine, I am trying to exhaust the features of the ResMed AirSense 10. While not stressing you by Jacking Settings too erratically and drastically, rather by logically progressively eliminating features of the AirSense 10 that do not benefit you.  At the same time I am trying to provide you with the knowledge and skills necessary to navigate and capture the information from OSCAR that will enable the forum members to provide the best assessment of your needs and suggest further course of action. This forum exists as an Educational Platform to enlighten individuals so they may better understand and control their own therapy.

Before I forget, I noted you mentioned you wore a FitBit, do you happen to wear a Pulse/Oximeter? With your desaturations listed on your Sleep Report, and other comments you have made it might be a useful tool to add to your kit. Our household was hit by a respiratory illness last September, all four of us tested negative for Covid & Flu. It took a couple of months recovery and we ordered a Wellue Checkme O2 Max, Pulse/Oximeter for my mother as her lips kept turning blue and other symptoms of low SpO2. Long story short we ended up with 4 each of the Checkme O2 Max as all of us were having desaturation issues. My Mother ended up on supplemental O2, the rest of us because we could respond to the audible and vibratory alarms of the Pulse/Oximeter, to prompt us to breath, did not get supplemental O2. We are getting better, but still wear the Pulse/Oximeter as we still experience SpO2 drops.

Please review the Post #39 links to "Introduction to OSCAR parts 1 & 2" and the other links also. In Post #34 I mention acclimating to the fit and feel of the mask under pressure it would be good to review that also. Remember you can combine the activities of Posts #34 & #39 to make the most of your time investment,

There is a lot to learn, key words, tricky phrases, reviewing this information often, especially when new to this adventure you are beginning, will make it easier to understand.




  

OSCAR Chart Organization

[Little Olive]

Gah!  The events graph is blank.     I downloaded it from oscar a second time, still blank.   Searched for clues and found the drop down in the bottom R corner, they were all ticked green.  I even unticked them all, and reticked them and refreshed etc but graph still blank.  And ALL the days now have a blank events graph, so it not just today's that is missing but every other day's events graph has also disappeared. Any ideas???  TIA