can someone read my oscar chart and tell me if it's good or bad?

[mugen4u]

The first night was a disaster, after 30 minutes I took off the mask
The second night was even worse because I kept coughing, which turned out to be due to an emerging cold
The 3rd night after taking a sleeping pill I slept, but there were drops of water in the hose and I turned it off after 1.5 hours

then not used for a week due to illness and a huge cold.

Last night I took another sleeping pill that was prescribed by the doctor, YES, I know this is not the intention, but this way my body can get used to the fact that there is a mask pressed on my face that keeps air in my throat. and was very curious whether CPAP would even lower my AHI as my previous experience was the opposite.



Although I feared that my AHI would become a lot higher (mainly because I also had this a year ago with the Airsense 10 after using a sleeping pill, but then I could only sleep 4 hours at the most) and we all know that your tongue and everything still If I become weaker due to sleeping medication and cause more obstruction, my AHI last night was 5.23, of which 4.9 was central.

PSG had an average AHI of 18, of which 11 was central and 22 during REM sleep.

I was able to sleep 5.2 hours with it last night, I can see that I had a leakage of 4l/min and I wondered how that is possible given the mask seal score is simply 20/20.

I attached oscar data but had to split the image as the size was to big, i have no idea what it all means but i hope you guys can tell me more.

[Expat31]

Hello, and welcome

To be able to help you, we really need a set of these 5 graphs as below:-

Events, Flow Rate, Pressure, Leak Rate and Flow Limitations. 

To do this, please use the F12 key to take screenshot of the Daily screen. This will include the valuable information on the Daily Screen's left side, but important to firstly disactiving the calendar to enable sufficient space.

Please see also the link Attaching images, files and posting charts.

What I can see from your statistics is that you have a very low fixed pressure of 6cms, and with high central apneas. You indicated that you had central apneas in your sleep study, so can you give us a summary of these results? 

It is quite likely sleeping tablets could be currently worsening the situation.

But without your OSCAR graphs, it is just guesswork at this stage.

So we are awaiting your graphs now.

Thanks

[mugen4u]

I don't understand, i thought i posted the charts? i did a F12 of my daily oscar and added it to the attachment. is that good?

my PSG sleep study had an average AHI of 17 and during REM it had 22, of wich mostly was central sleep apnea (about 12 per hour, and 5 till 10 OSA)
Arousel index was 12.1 per hour

[Expat31]

Hello 

Several things,

It would help if the left hand pane of the daily screen together with just the 5 essential graphs, could be all on one page to assist in easy analysis.

To improve visibility, go to Preferences/Appearance/Graph settings.

Try the settings in the attached screen shot to see if these helps.

I did suggest we needed just 5 graphs, this is normally the initial requirement to understand your overall situation. Always with the events graph on the top.

But eventually we may well need the other remaining graphs.

Hopefully some settings could be changed to reduce your centrals, but if not, a Bi-PAP may need to be considered.

We have some great members with Bi-PAPs here who can help out. 

I have only just realised that you have already have 8 or 9 other different previous threads already concerning your therapy, with perhaps answers already given on some aspects.

I did reply to the last one of these, differently entitled "First night on my third CPAP" regarding screen formatting.

I have not gone through all of these to see what has already been discussed which could well be gemaine to understand your overall situation.

[mugen4u]

Thank you, i did what you told me in the attachment and i think i did it right this time.
yeah sorry for all the threads, i really wanna do it right this time as the first 2 CPAP devices/therapy failed on me miserably. and because i didnt really took it serious.

What I see myself is that my AHI seems to be getting higher and higher, with a peak of 12 around 2 o'clock in the night (I think because that was when my REM sleep was in progress)?

I think an AHI of 12 is quite high!

why isn't my AHI lower with CPAP? are the pressure settings incorrect or does this mean that my CPAP just can't fix the central events? And which graph should I use to see when there were moments of arousal?

[Deborah K.]

There are still problems with your chart.  We need to see the following, and only the following on your first page, in the order listed:

Event Flags
Flow Rate
Pressure
Leak Rate
Flow Limits

We need to be able to read to the very bottom of the Flow Limits.  Generally, we only need to see the first page.

Also, your AHI was not 12 for the night shown.  It was 5.34.  Your AHI is the overall average for a given night.

To see what settings you need you need to set your machine to Autoset mode, and set a pressure range.  I suggest that you set your range at 7 to 13.  That way when you next post a chart we will be able to see how much pressure your body needs.

Good luck at improving your therapy and comfort!  

[mugen4u]

There are still problems with your chart.  We need to see the following, and only the following on your first page, in the order listed:

Event Flags
Flow Rate
Pressure
Leak Rate
Flow Limits

We need to be able to read to the very bottom of the Flow Limits.  Generally, we only need to see the first page.

Also, your AHI was not 12 for the night shown.  It was 5.34.  Your AHI is the overall average for a given night.

To see what settings you need you need to set your machine to Autoset mode, and set a pressure range.  I suggest that you set your range at 7 to 13.  That way when you next post a chart we will be able to see how much pressure your body needs.

Good luck at improving your therapy and comfort!  

Sorry but this is getting to difficult for me (and i mean OSCAR). 

Pressure was set on 5 min and 6 max, so i should set this to 6 min and start with 7 max and see how that goes or something?
Correct me if i'm wrong, but shouldn't the pressure be low when it comes to preventing central sleep apnea?

i thought high pressure was needed for mostly OSA?

[SarcasticDave94]

Actually with 11 of your 18 Apnea as you say were Central on you test, this indicates you'll either need VAuto style bilevel, using Trigger High or Very High, or the VAuto failing to give good therapy, the ASV to treat CA.

[Expat31]

Thank you so much. I understand it is all very confusing in the early period of therapy.

We can see the settings and statistics in the left hand section side by side with the right hand side graphs, so we can now compare them easily.

Just one last thing before discussing therapy, can you just have the 5 graphs only at this stage. It sounds pedantic, but helps focussing on just the essentials. It will become clearer as we progress.

Firstly, some considerations concerning central apnea. 

-  With the central apneas appearing in your sleep study, did the  examining doctor make any particular observation, as I understand these centrals were quite dominant? Did the doctor prescribe the fixed press of 6 that you have now.

  - For information, central apnea can be present in the early periods of therapy, and disappear once you get used to the machine. They are called "machine induced" central apneas. I am not sure if this applies you, as I don't know how long in total you have been using a machine. Perhaps the answer is in one of your earlier threads. A board monitor may consolidate into just one thread.

Concerning your therapy settings, have you ever use APAP, ie setting a minimum and maximum pressure, using an EPR setting? 

It may be useful to examine a single central event by doing a 3 minute zoom, by clicking in an event in the top graph.

Sorry, a lot to absorb in the early stages.


I will not be available for the next few days as I have family staying over Christmas. Will pick up afterwards.

[mugen4u]

Actually with 11 of your 18 Apnea as you say were Central on you test, this indicates you'll either need VAuto style bilevel, using Trigger High or Very High, or the VAuto failing to give good therapy, the ASV to treat CA.

Thank you so much. I understand it is all very confusing in the early period of therapy.

We can see the settings and statistics in the left hand section side by side with the right hand side graphs, so we can now compare them easily.

Just one last thing before discussing therapy, can you just have the 5 graphs only at this stage. It sounds pedantic, but helps focussing on just the essentials. It will become clearer as we progress.

I don't understand what you mean with this (sorry English isn't my main language). I followed the steps you gave me on the viewing part of the cahrt.

Firstly, some considerations concerning central apnea. 

-  With the central apneas appearing in your sleep study, did the  examining doctor make any particular observation, as I understand these centrals were quite dominant? Did the doctor prescribe the fixed press of 6 that you have now.

not really, only that most centrals happened after 'something' (she mentioned some kind of event, not sure what she said). And that most of them happened during REM sleep. 
Also that i didn't always wake up after a CSA event.

  - For information, central apnea can be present in the early periods of therapy, and disappear once you get used to the machine. They are called "machine induced" central apneas. I am not sure if this applies you, as I don't know how long in total you have been using a machine. Perhaps the answer is in one of your earlier threads. A board monitor may consolidate into just one thread.

this is my fourth night on CPAP and first night where i was actually able to sleep for a few hours, all other nights failed miserably. 

Concerning your therapy settings, have you ever use APAP, ie setting a minimum and maximum pressure, using an EPR setting? 

I used those settings in the past with other CPAP devices but since i couldn't sleep (not even a minute) i have no idea if those settings were correct. 

It may be useful to examine a single central event by doing a 3 minute zoom, by clicking in an event in the top graph.
i tried that but i didn't understand it at all. all i see on the CSA events chart is [Clear Airway CSA] followed by a number (17, 11, 22, and so on)


Sorry, a lot to absorb in the early stages.
That's ok, any help at all would be apreciated.  

I found the 5 charts you told me earlier and managed to make 5 graphs as you requested.
According to the chart and after clicking on a CSA event, i see that my breathing just stops for xx seconds and then i start breathing again. i should have known that CPAP doesn't do anything about those events. However since my AHI is 3 times lower than my PSG sleep study i think that maybe CPAP does cause less CSA events?

And also that most of those events happen during REM sleep.

what i still can't see is if i woke up during those CSA events, or that my brain decided to send a signal to breathe again after xx seconds.


I will not be available for the next few days as I have family staying over Christmas. Will pick up afterwards.

Happy Holidays!