help with sleep study deciding on a new machine

[georgesadam]

I’m feeling very confused and would appreciate some guidance.


Last month, I had a sleep study that showed a lot of central and obstructive apneas (https://imgur.com/a/lab-sleep-study-mbqRViP). However, my doctor didn’t mention the centrals and simply told me to get a CPAP. I’ve been using it for a month, and according to OSCAR, I barely see any centrals—maybe 1 per day, sometimes none, which confuses me a lot. Despite having a low AHI (always below 4), I’m still feeling tired, and my flow limitations and RERAs remain consistently high.

Do you think a lab sleep study is more reliable than OSCAR data, given that it uses EEG?

I’m wondering if I should trust the lab study more for detecting centrals and consider getting an ASV, skipping BiPAP, since I’ve already invested in an APAP and don’t want to waste more money.

LAB study :https://imgur.com/a/lab-sleep-study-mbqRViP
OSCAR data : https://imgur.com/a/mn6jVmM

[staceyburke]

I'm sorry I have no experience with the cpap you have. But your Flow Limits are high and that can cause you to wake up or not get into deep sleep. The ResMed models that I am know about use EPR (exhale Pressure Relief) or PS (pressure support) is what we use for Flow Limits. Check your manual for both terms and set your machine to the highest number for EPR or PS which ever your machine uses.

[georgesadam]

Thanks for your feedback, but I’ve already lost hope in my APAP machine and am currently looking for a new one. Could you at least advise, based on my sleep study, whether I need an ASV or a BiPAP VAuto?
2.15.0.0

[SarcasticDave94]

If that linked test results were your diagnostic, you have almost equal Central to Obstructive at 45, 42 consecutive. You may be best served with ASV then if you have to buy your own machines.

Going by your CPAP charts, CA were low each session from what I could see. I think Hypopnea and flow limits were high each time, indicates needing more pressure and pressure support from a bilevel or EPR exhale relief. However this may setup an increase in CA, which this machine cannot treat if this does happen.

[georgesadam]

Thank you for your input but I wonder why OSCAR not showing my Centrals as the sleep study showed.
Since I’m planning to go and buy an ASV, do I need to do any tests beforehand? I’ve read that some heart tests are required. I’m 32 and healthy, but I’m unsure about the potential consequences of using an ASV.

[quiescence at last]

check out https://pubmed.ncbi.nlm.nih.gov/16552275...intubation.

and
https://ccforum.biomedcentral.com/articl...-2001-3003
which in part reads: "This study used echocardiography to demonstrate that even a brief application of BiPAP results in favorable hemodynamic changes, including increased cardiac output."

QAL

[SarcasticDave94]

Echocardiogram is typically either suggested or required. It will focus of the left ventricle ejection fraction or LVEF %. I had an ASV and do have a heart timing condition called Pulmonary Ventricular Contraction (PVCs).

Before being issued an ASV, my LVEF was 55%, with 45% and lower as the cutoff. After using ASV for 2 years my LVEF went to 63%.

I am not currently using ASV as apparently my CA are lower and COPD and ASV didn't play well with each other.

If you had a heart condition that ASV might make in any way worse, you'd probably know you're not in good health. At least ask doctor to be sure.

[georgesadam]

thanks ill definitely ask my doctor just to be sure
2.15.0.0

[williamwu1107]

It is recommended that you take your positive pressure ventilator to the sleep laboratory for another night. It will become clear where the problem is.