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

[Expat31]

Hi,

Back again, last one from me for the night.

I understand better after your last post with explanations.

1. Your last graph looks OK.

2. As you are only on day 4 of CPAP. Could be that these centrals will disappear, once your settings are properly adjusted. It is always possible they are actually false central events, 

3. I agree with Deborah start using APAP mode with minimum 7, maximum 13. Why? - We will be able to see where the machine rises and falls in response to apnea or other events,  it is a good place to start, so we can try to better understand what is happening.
 
4. If they are genuine central events, then the point that Sarcastic Dave made are very relevant.

So, If we can, let's make it simple and work first with pressures 7/13 to see what happens.

Some other explanations to your questions.

 - Detecting arousals. This can be done by looking at the Flow Rate graph. A spike in the flow, followed by a recovery could indicate an arousal. We would be looking for a reason, event, flow linitation, leak, pressure increase etc. The last few minutes of sleep before awaking could give an indication also.

- Pedantic. This means (me) being too concerned with detail and presentation.

 - 3 minute zoom. I think don't worry about this at the moment,bwe can see about this later. 

  - (17, 11, 22, and so on)... These are the duration in seconds of how long each central apnea lasts. You can find the same information in the event tab, in between details and notes.


As for me, I'll leave it there until after next week,

[mugen4u]

Hi,

Back again, last one from me for the night.

I understand better after your last post with explanations.

1. Your last graph looks OK.

2. As you are only on day 4 of CPAP. Could be that these centrals will disappear, once your settings are properly adjusted. It is always possible they are actually false central events, 

3. I agree with Deborah start using APAP mode with minimum 7, maximum 13. Why? - We will be able to see where the machine rises and falls in response to apnea or other events,  it is a good place to start, so we can try to better understand what is happening.
 
4. If they are genuine central events, then the point that Sarcastic Dave made are very relevant.

So, If we can, let's make it simple and work first with pressures 7/13 to see what happens.

Some other explanations to your questions.

 - Detecting arousals. This can be done by looking at the Flow Rate graph. A spike in the flow, followed by a recovery could indicate an arousal. We would be looking for a reason, event, flow linitation, leak, pressure increase etc. The last few minutes of sleep before awaking could give an indication also.

- Pedantic. This means (me) being too concerned with detail and presentation.

 - 3 minute zoom. I think don't worry about this at the moment,bwe can see about this later. 

  - (17, 11, 22, and so on)... These are the duration in seconds of how long each central apnea lasts. You can find the same information in the event tab, in between details and notes.


As for me, I'll leave it there until after next week,

thanks for the detailed information. 

As for the arousels on the flow chart, how big of a change in the flow are we talking about? i added a screenshot of a few min flow chart and you see spikes in the lines, but some lines are only slightly higher than the normal lines while other lines are kinda high. so which lines mean i had an arousel? 

and should i continue the current settings to see if things change or do i have to change the settings right away?

[Expat31]

This is my last, last post for tonight...just a quickie reply. Regarding actual look of arousals, there are examples out there, but too late tonight to find them tonight.

I would start as soon as you can with Deborah's settings. You know how to adjust settings? If not see this video Clinician's hidden menu. Once you access the clinician's menu, go to options and select "Essentials Plus", but the video is self explanatory.  Good night, hope yours gets better and able to make progress.

[Expat31]

3 quick links re arousals and waveforms:-

Lanky lefty-1

Lanky lefty-2 

Resmed

[mugen4u]

Hello again,

i did not change the settings yet as i wanted to give it a few nights to see if anything changes, and while the AHI was again slightly lower than the other night (i was at AHI 4.5 instead of 4.8) and central was slightly less at AHI 3.3 but got a bit more hypo events which is explainable cause my nose was a bit stuffed last night.

I slept for 2.5 hours with the device, this is not long but i know it takes time.


What i don't understand is this part (see attachment). For about 15? minutes, my AHI went up to 10 while there were no apnea events recorded at all. so i don't really understand why that happened. i also did not wake up when i look at the flow chart.

For tonight i am going to do what Deborah recommended and increase the max pressure to 7 cause during the REM sleep moments it keeps increasing to 10 and higher (Centrals), because of this i want to turn EPR on and set it to 1. Is this a good setting? 

i don't like the starting pressure of 6 or higher cause it makes breathing more difficult and i feel the air stream sound way more and makes it difficult to fall asleep. With min pressure 5 i can fall asleep faster. Also the device is still set to CPAP mode and not autoset, should i change that as well?


Merry Christmas!!!! I hope you all spend it with your loved ones with some good food, and if not then i hope you still enjoy these days.

[SarcasticDave94]

Members will need the full night OSCAR chart to get an overall view as well. Flow is being suppressed for some reason, in my opinion, but these clipped out chart sections aren't showing much. They don't include enough to indicate what's going on.

[mugen4u]

Members will need the full night OSCAR chart to get an overall view as well. Flow is being suppressed for some reason, in my opinion, but these clipped out chart sections aren't showing much. They don't include enough to indicate what's going on.

yeah i know but only had max 3 hours of sleep so i didnt find it neccesary. the only weird thing about last night was the AHI of 10 suddenly.
i changed the settings as recommended, EPR set to 1 and max pressure set to 7 to begin with.

i am just glad that i am at least able to sleep with the device, even tho its only for about 3 hours (for now). The first 2 cpap trials failed miserably with barely 1 hour of sleep at random nights.

[Expat31]

@ Mugen4u

Yes, let's have the data for the 3 hours you mentioned you were on the machine

 Please just post these 5 essential graphs:-

1.Events
2.Flow rate
3.Pressure
4.Leak rate
5.Flow limitations

We should be then able to reply to your question about the “15 minutes where the “AHI went up to 10 while there were no apnea events”. (?) 
Were you by any chance looking at the separate AHI graph that shows the AHI for the last hour? 

Next it would be useful to post a detailed zoomed view of one of your central apnea events. 

To do this, the easiest way is as follows;-

Open the events tab. 

On the left hand side you will see the summary of each category of event, centrals, obstructive, hypopneas and any large leaks.

Click on the category central apneas. A drop list of individual central apneas will appear with a timestamp of duration in seconds for each event. Click on the central event with the longest duration. 
The graphs on the right will now change to showing a 3 minute view.

You will also see a slider bottom left hand side a slider with 3mins showing. You can use the slider to  adjust to say 5 to see a little more detail.

So  to summarise,

 - A normal set of essential graphs (no zooms).
 - A zoomed event of the longest duration central event.

Thanks.

[mugen4u]

@ Mugen4u

Yes, let's have the data for the 3 hours you mentioned you were on the machine

 Please just post these 5 essential graphs:-

1.Events
2.Flow rate
3.Pressure
4.Leak rate
5.Flow limitations

We should be then able to reply to your question about the “15 minutes where the “AHI went up to 10 while there were no apnea events”. (?) 
Were you by any chance looking at the separate AHI graph that shows the AHI for the last hour? 

Next it would be useful to post a detailed zoomed view of one of your central apnea events. 

To do this, the easiest way is as follows;-

Open the events tab. 

On the left hand side you will see the summary of each category of event, centrals, obstructive, hypopneas and any large leaks.

Click on the category central apneas. A drop list of individual central apneas will appear with a timestamp of duration in seconds for each event. Click on the central event with the longest duration. 
The graphs on the right will now change to showing a 3 minute view.

You will also see a slider bottom left hand side a slider with 3mins showing. You can use the slider to  adjust to say 5 to see a little more detail.

So  to summarise,

 - A normal set of essential graphs (no zooms).
 - A zoomed event of the longest duration central event.

Thanks.

Thank you very much. I tried to do everything you said and i THINK i have the info you need. I also added an extra record with the AHI included (The part where the AHI suddenly went to 10 without any clear apnea events.

this is the zoomed in version of the longest CSA event
https://ibb.co/68BvGcv

i hope i did everything right

[SarcasticDave94]

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.