Newbie OSCAR Interpretation

[revoshift]

   
Hi, All

I'm new to the apnea, CPAP, OSCAR world and struggling to come up to speed. My OSCAR charts show lots of CA's, many of which have the signature on the attached screenshot. It looks to my simple mind like a period of normal breathing, then a deep sigh, followed by a pause before resuming normal breathing. Is that really abnormal? I recently heard a neurologist describe how a periodic deep sigh is a normal pattern of even awake breathing. I greatly appreciate this very caring and helpful community.

Thanks.

[Gideon]

Welcome to the forum.
First let's fix it so you are actually using EPR all the time which will help with hypopneas, flow limits, RERAS.

Set Min pressure=7
The example you cited I believe is an arousal, a sigh if you wish, followed by you holding your breath while "tossing" and as such not a true central apnea. The breathing following gives hints of central flow limits, not enough to worry about and not enough to call it either an apnea nor a hypopneas.

Because you have a few central Apneas
Set EPR=2, fulltime.
This may help with the centrals and will better support the obstructive events as noted above.

Then repost and re-evaluate.

Always post a full night's view, not zoomed so we have the context of the full night, almost zoomed images of any area you want comment on, if we see the need for additional charts we will ask. For example please post a redacted copy of your initial diagnostic study. It will provide detail on centrals without CPAP and can impact therapy choices. A full copy including charts and tables in addition to the summary.

[revoshift]

Thanks for the suggestion. I set the min pressure to 7 and EPR to 3. Lots of leaks to deal with. I cranked the mask pretty tight and still couldn't control them. Will keep trying. Here is the full night OSCAR. I note that the CA's during minimal leak periods seem to have the same pattern as before.
   

[Dormeo]

The zoomed-in view does indeed show a sigh, followed by a pause before you draw your next breath. The breath with a greater flow-rate amplitude washes out some CO2. CO2 is what tells your body when to breath. Once it builds back up, you resume breathing.

You seem to have had generally positive results from using the settings Gideon recommended. It's especially good to see that you didn't have more CAs with EPR in play during the whole night. I see that you still have a ramp pressure of 4. I recommend that you turn the ramp off, or at least set the ramp pressure to 7.

What mask do you use? Your profile says you're using a nasal pillow mask, but your machine is set for a full-face mask. If you could provide the maker and the model name that would help.

When you post your next chart, could you include these graphs:

Events
Flow rate
Pressure (not mask pressure)
Leaks
Flow limitations
Snores.

You can fit them all in by grabbing the gray bars that separate the graphs and pushing them up a bit.

[staceyburke]

The tight mask makes leaks worse

[clownbell]

Agree with Stacey - tight mask makes leaks worse. It seems counter-intuitive, one would think it would be natural to tighten the straps to minimize/eliminate leaks. But is is the exact opposite. Cranking down the straps distorts the shape of the seal, resulting in leaks. Suggest trying the straps as loose as possible without creating leaks.