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Good afternoon. I am new to the board. Long time cpap user but new to Oscar and. trying to understand data. My history. diagnosed with a fib about 9 years ago.
went through sleep test. Came back sever events over 70. Have been using cpap machine since that time. For the most part have been able control events, depending on altitude any where from 3 to 9. Suddenly about a month ago events jumped to as high as 30, most times over 25. Tried pressure settings, auto fixed , changed epr. Tried different pillow , no help.
read about cervical collar, worked great for a couple of nights, 3.5,4,7, than started climbng to the teens. Not smart enough to read and understand Oscar...
It is difficult to say what is happening with all the leaks. Is that typical? If it is a recent phenomenon, what changed?
Some things to consider…
When is the last time you changed you mask cushions?
When did you last change your headgear?
When did you last change you hose and water chamber?
Assuming the mask is sized correctly as you have used it a long time, what else has changed?
How long have you had the AirSense 11? Was it is a recent acquisition? Is that when things changed?
A soft cervical collar can help with positional apnoea and mouth leaks, but it must be correctly sized. I have attached a chart that helps figure out what should work. I am not sure they are mouth leaks as yet, but something to hold in reserve if needed later.
For pressure, things look a bit off. Try the following:
Mode APAP
Min pressure 9
Max pressure 15
EPR 3 full-time
No ramp
You are spending most of your time right around 9 anyway, so we are just bumping up the top end a bit to see where it lands.
Your flow limitations are quite high as well. That, coupled with the leaks, are driving the pressure higher. It is possible you will need a bilevel to get more pressure support and trigger controls. One step at a time though.
I have a different take on the problem. You are still having positional apnea. You have a collar but it is not adjusted correctly or it is the wrong size. The main measurement is the distance of the chin from your sternum. That is the correct height of the collar you need. Or maybe it is your chin slipped down past the collar. At any rate look into your positional apnea.
A note as to the cpap and detecting centrals vs obstructive. Sometimes the cpap does a poor job or detecting centrals. It is much more reliable in the sleep lab to identify central apnea with all of the wires and chest belt to determine if you are trying to take a breath (obstruction) or holding your breath (central). All the machine does is give a number of small bursts of air and if the air is not returned it is considered a central. So many may not be detected correctly. So please take a look at Positional as being a problem and rule it out as a cause before you do anything else.
I don't think the leaks are a problem. None of them are high enough to interfere with therapy. On the left panel, they are listed as 0.00 and 0.01 because they are too low to affect therapy. Positional apnea was present all three nights and was particularly bad on the 7th.
Thanks gang, good catch. I had too many windows open and was confused on the charts. Got two threads mixed.
Back to the positional, which may or may not be affecting the cluster of CA’s. Start with a flatter pillow, then a properly sized soft cervical collar.
The following link shows what an SCC can do to help.
Thank you so much to those who replied. I have very flat pillow now. I am using the collar, and I think i have it adjusted better. My obstructive events are down but ca's are still a little high. I can feel the difference in the morning now. feel alive again.
Sunday oa 1,17 ca 4,10
Monday oa 1.98 ca14.7
Tues Oa 3.7r ca 7,38
Again thanks to those who have helped. Any additional advice would be appreciated,
Did you have a lot of CAs in your sleep study? If you don't know, could you post a redacted copy of your sleep study? If you don't have it, your doctor is required by law to provide it to you.
