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

[mugen4u]

You had 2 hours 59 minutes therapy. Your 45 minute Ramp at 5 is stealing therapy time, while your CPAP pressure setting is 6. You likely don't need Ramp to lock you in 1 cmH20 below your static pressure, certainly not 45 minutes worth.

Ramp has a tendency to enhance Central Apnea as well, possibly due to the slight pressure variation.

The time of your zoomed in area looks to be just after a cluster of 4 CA begins, followed by 3 CA, and then another 2.

Timing according to the chart near your zoomed section, CA at 2:24, 2:27.5, 2:29, 2:30.5, which means your zoom of 2:26-2:29.5 has 2 CA. Over the whole 3:44 hours session, there were 13 CA flagged.

Hm ok. But what causes the AHI of 10 while there was no event?

[SarcasticDave94]

You had Central Apnea flags overall at 13 events. There were events, at minimum a 10 second breath pause for 13 times.

[Expat31]

Thanks for the information.

Sarcastic David is spot-on with his analysis.

Only one minor detail I would like to add. In your first graph with the 3 minute view, it looks like you have lots of "mini centrals" that are probably too short in duration to have been flagged by the machine, -see the annotations I have added to your graph. It appears to me they are <10 seconds. (Sorry arrows have partially obscured  the time scale, but in your original without these it's easier to see.

If my observation is correct, you have a persistent underlying problem with centrals.

In my non-medical opinion, and is purely an opinion, changes in pressure will not resolve central apnea. You may want to look at the link for more information.

If I remember correctly in an earlier post, your sleep doctor did vaguely indicate to you that you may need another type of machine if the current machine was ineffective, taking into account the number of centrals in your sleep study? 

You could also refer back to Sarcastic Dave's observations of 21/12/24.

"Actually with 11 of your 18 Apnea as you say were Central on your 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".

Which I think is right.

[mugen4u]

Thanks for the information.

Sarcastic David is spot-on with his analysis.

Only one minor detail I would like to add. In your first graph with the 3 minute view, it looks like you have lots of "mini centrals" that are probably too short in duration to have been flagged by the machine, -see the annotations I have added to your graph. It appears to me they are <10 seconds. (Sorry arrows have partially obscured  the time scale, but in your original without these it's easier to see.

If my observation is correct, you have a persistent underlying problem with centrals.

In my non-medical opinion, and is purely an opinion, changes in pressure will not resolve central apnea. You may want to look at the link for more information.

If I remember correctly in an earlier post, your sleep doctor did vaguely indicate to you that you may need another type of machine if the current machine was ineffective, taking into account the number of centrals in your sleep study? 

You could also refer back to Sarcastic Dave's observations of 21/12/24.

"Actually with 11 of your 18 Apnea as you say were Central on your 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".

Which I think is right.

i really understand that but i am going through a CPAP trial and they wont give me another one. However with the current CPAP my overall AHI is twice as long as my last sleep study and 1.5 times lower than the sleep study i had 1 year ago (AHI of 8.2) so doesnt this mean that CPAP at least lowers the AHI for some weird reason? 

Only one minor detail I would like to add. In your first graph with the 3 minute view, it looks like you have lots of "mini centrals" that are probably too short in duration to have been flagged by the machine

So long as i don't wake up briefly i don't mind, i don't want it to mess with my sleep.

[Expat31]

It would be useful to compare the two sleep study to see were the difference were. But I understand you don't have these details? If so, obtaining copies with full details, would be helpful.

One likely positive of using a CPAP is hopefully it is at least successfully treating most obstructive apneas.

[mugen4u]

It would be useful to compare the two sleep study to see were the difference were. But I understand you don't have these details? If so, obtaining copies with full details, would be helpful.

One likely positive of using a CPAP is hopefully it is at least successfully treating most obstructive apneas.

During the first sleep study i didn't have any OSA, only CSA. I think the main reason i got so many OSA during the second sleep study was because i gained like... 10kg and got some neck fat as well, we all know that causes OSA. 

So it is sure that CPAP doesn't do anything to my central events even tho my Central apnea events are less than both sleep studies? is it sure that the central events are not caused by UARS or something else?  cause if it is caused by UARS then that would explain why my AHI is a lot lower while on CPAP.

[SarcasticDave94]

If as I understand, you had only Central Apnea in the first sleep study, the best treatment is with a ResMed Lumis in ASV.

[mugen4u]

If as I understand, you had only Central Apnea in the first sleep study, the best treatment is with a ResMed Lumis in ASV.

I am going to call my doctor today because this is really pissing me off as CPAP does almost nothing for the CSA events. I do find it weird that my total CSA events are about twice as low since i used CPAP, but the events i do get won't go away.

However since an Apnea event is only counted after 10 seconds, i understand why my AHI is lower to begin with but what i still dont know is if i have arousels after an event. 
it is very difficult to see on the flow chart, even after zooming in.

[mugen4u]

i called my doctor and told her about the central events. She said that i need to sleep with the device way longer to even see if it helps or not, mostly because the overall AHI is much lower. It does worry her that a lot of central events are less than 10 seconds and that a lot of events are not solved with CPAP.

She lowered my pressure to 5 to see if those centrals are CPAP induced and disabled EPR.
I have about 3 weeks to sleep at least 4 hours every day, if i still dont feel better or if the numbers arent better then i am going to get bipap.

She did not recommend ASV because sleeping with that device is so much more difficult and my symptoms and the fact that it is hard for me to even sleep with CPAP will cause sleepless nights on ASV for sure. She didn't say i wont get ASV, she said that sleeping with it is so much more difficult, so she is aiming for the Bipap device.

was a nice conversation too, she gave lots of detailed information.

[Expat31]

I am glad she has been fair with you. It all sounds good, and all should be well over the coming next few months.