Suddenly my Centrals got a lot more disruptive

[SarcasticDave94]

I've not seen ASV in 4 years, used 10 series AutoSet about 2 nights again about 4 years ago. I'm not certain there were differences in the flow limits chart or otherwise reported.

I'm not finding the Lumis 150 ST details right now. It might be equal to the US version ST-A, but again I'm not finding info right now. ST itself would not equal VAuto. ST is spontaneous timed, and it's used for lung disease like COPD due to timing requirements. It's dumb in the sense that it's single EPAP and single IPAP. At least according to versions in the US. VAuto can do S mode but not ST.

[tcinoz]

I'd like to have one last go at clearing up the question of interpreting Flow Limitation data from different machines - anyone, please?

In the summary screenshot below, the left half of the graph was when I was using a CPAP machine, the right half was when I was using an ASV. You'll notice that the ASV bar graph isn't broken down into three segments like the CPAP one is. When you hover the mouse over it, it claims to be the 99.5% figure. For the CPAP ones, you get a Median (barely discernable on the graph), a 95% and a 99.5% breakdown.

Can anyone please tell me whether I can deduce anything relevant from the graphs on the screenshot, or is there simply not enough info provided by the ASV bar graphs to make any valid assumptions? Why does the ASV not give a median figure on Oscar? And does the 99.5% figure really tell us much anyway - isn't it the median that really matters? Maybe comparing Tidal Volume figures is a better indicator of how much air (and hence Oxygen) is getting through into my lungs?

I'm keen to understand this aspect of the treatment better and get my Flow Limits down. If anyone has any insights that might help and is willing to share them I'd be most grateful.

Thanks as always.

   

[tcinoz]

I wonder if someone could please help identify whether the 'Cheyne-Stokes' periods on my latest Oscar report is indeed Cheyne-Stokes or whether it's positional, as I understand it can sometimes be misidentified for. I've attached a zoom shot as well.

I have a heart condition characterised by arythmia and very low heart rate at times. My O2 readings (from a Wellue O2ring) hold up well - average of 96 most nights - but my heart rate fluctuates wildly between low 30s and high 90s. Despite this, I feel OK most days and my cardiologist doesn't want to fit a pacemaker at this stage, but I'm worried that these latest Cheyne-Stokes occurrences mark a new phase.

My recent Oscar charts have fluctuated wildly in recent weeks, anything from <2 to >10 AHI. I have an ASV machine as well but stopped using it because those bursts of air often prevented me from falling asleep. Likewise with the Airsense 11, any increase in pressure results in much the same thing, and because I've had successful nights with this relatively low pressure max setting, I'd prefer not to raise it if possible.


         

[Jay51]

There is a possibility that these could be real (they are symmetrical like real CSR; and you have arrythmia's and bradycardia (and possible tachycardia also).  The best thing to do would be to show your Cardiologist these exact charts (and even a couple more examples as well) and let Cardiologist diagnose or not and decide on any corrective action.  Great job being proactive with your sleep apnea and heart health by noticing this.

[tcinoz]

Thank you Jay - yep, good advice, and probably what I was intending on doing if the trend persists beyond a few nights. As indicated, I've been having nights with low AHI as well, but the last two or three nights have given me cause for concern. I may have to give the ASV machine another workout and see if I can get used to the way it operates.

[edenmaker]

You made an interesting comment. You said that the cluster of Central apneas was probably Obstructives. What led you to this conclusion?
I've been having a few clustered Centrals lately which is a big change for me. How can you tell they are not really Centrals?

[tcinoz]

I'm no expert but it seems that zooming in on a few breaths and studying the shape of the flow can indicate whether they're central or obstructive. I've seen posts where the experts opine that such clusters, including those diagnosed by Oscar as CSR, can in fact be obstructive. I've had centrals from the start of my diagnosis, so I'm pretty sure that's what most of mine have been, but thought it was worth running a couple of charts past the forum elders as the CSR was a recent development for me.

Since posting, I've gone back to using the ASV machine I bought a few months ago, and have now got used to its peculiarites with good results. The CSR and centrals have disappeared from my nightly charts and my AHI is down below 1 on most nights.

If you are regularly getting a lot of centrals on your chart, I'd recommend seeing your sleep doctor with a view to discussing the possibility of an ASV machine. I can vouch that they do what they're designed to do - zapping centrals - in my case, anyway.

[edenmaker]

Thanks so much for the insight! I will look into ASV

[tcinoz]

You're welcome. Good luck with your journey.