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+--- Thread: Oscar Data. No events flagged but weird flow rate pattern during REM (/Thread-Oscar-Data-No-events-flagged-but-weird-flow-rate-pattern-during-REM)
RE: Oscar Data. No events flagged but weird flow rate pattern during REM - Sleeprider - 07-14-2024
Ynot, I have not checked into your thread for a while and you're now using the Vauto. You need to have trigger sensitivity on high or very-high to avoid the centrals, and I don't think you need PS greater than 5.0. Am I missing anything?
RE: Oscar Data. No events flagged but weird flow rate pattern during REM - Ynot - 07-14-2024
(07-14-2024, 08:29 PM)Fixit50 Wrote: It seems like you possibly have periodic breathing where the amplitude slowly raises and decreases to a near stop or hypopnea and then increases again. In your graphs, I saw a few instances of this. Is this regular for you, and does it continue for a large part of the night? If so, I wonder if you are presenting Cheyne-Stokes Respiration (CSR), a type of central breathing disorder usually associated with heart failure. The VAuto won’t detect CSR but the AirSence 10 will log it under periodic breathing. I’m not familiar enough with CSR to say you have it, or don’t have it, but if that increasing amplitude followed by decreasing amplitude is something you see a lot of, then I’d be very suspicious. Do you have any kind of heart history?
No. The pattern does not happen at lower pressures. No heart history. Pretty sure it is TESCA. Waning and waxing pattern before central apnea develop.
RE: Oscar Data. No events flagged but weird flow rate pattern during REM - Ynot - 07-14-2024
(07-14-2024, 08:37 PM)Sleeprider Wrote: Ynot, I have not checked into your thread for a while and you're now using the Vauto. You need to have trigger sensitivity on high or very-high to avoid the centrals, and I don't think you need PS greater than 5.0. Am I missing anything?
Hi Sleeprider,
I changed it to high sensitivity, and it certainly helped. When ps is lower than 5, I get flow limitations. I attached some examples. What pressure settings do you think I should try?
thanks
RE: Oscar Data. No events flagged but weird flow rate pattern during REM - Ynot - 07-14-2024
very high sensitivity helped a lot
RE: Oscar Data. No events flagged but weird flow rate pattern during REM - SarcasticDave94 - 07-14-2024
If I were to use mid December 2023 as the start, if that's an accurate CPAP start date, this is 7 months, I would think treatment emergent Central Apnea would have diminished now.
Wouldn't the VAuto mode help with flow limits more than S mode?
RE: Oscar Data. No events flagged but weird flow rate pattern during REM - Ynot - 07-14-2024
TESCA did not occur with cpap. ps solves my reras and fls but causes TESCA. It's been like 4 months with bilevel. I did not notice a difference with VAuto. I only get both FLs and RERAs in rem, so I do not see why Vauto would help as there should be an optimal pressure and ps for those rem cycles.
RE: Oscar Data. No events flagged but weird flow rate pattern during REM - SarcasticDave94 - 07-15-2024
If you want the pressure to vary for the night, then VAuto is it. This does not go up specifically for sleep stages, just therapy needs based at the time.
I would think this CA is more common breath pauses now. It would very likely be that the higher PS is causing them.
RE: Oscar Data. No events flagged but weird flow rate pattern during REM - Ynot - 07-15-2024
I tried a variety of Vauto ranges and it looks about the same as s mode. I do not necessarily need the pressure to change because my breathing needs are pretty consistent throughout the night. As I mentioned this is because both my obstructive and TEC issues are in rem. Outside of rem, except with excessive ps (7+), TEC events are never an issue, so I can just focus on the right pressure at rem, which does not vary that much. The issue is that there does not seem to be a right pressure. Only better and worse ones.
Also, I find Vauto counterproductive. For two main reasons: I do not think that varying pressures are beneficial - especially for TECSA issues. Second is that according to my data, for a given ps, an increase in epap slightly increase flow limitations. For example, I have slightly less flow limitations in 8ipap, 3epap, 5ps than in 11ipap, 6epap, 5ps. It is like the ps is more significant. It is my understanding that Vauto increases epap when it detects flow limitation or snores. In my case, that increase does not really help with flow limitations.
In a nutshell, even though I do not believe there are settings with bilevel that completely fix my issues, I do think that there is optimal fixed settings so I do not see the point of Vauto.
That said, I tried Vauto before so if you think I should try a specific range, maybe I can show you the corresponding or similar data.
RE: Oscar Data. No events flagged but weird flow rate pattern during REM - Ynot - 07-15-2024
And yes, the high ps definitely leads to the TECSA, but without high ps, I have worse flow limitations, so I'm unsure on what is optimal.
RE: Oscar Data. No events flagged but weird flow rate pattern during REM - Ynot - 07-15-2024
I've been reading a bit about asv. Obviously, it might not help me, and either way, it's gonna be a while before I can think about affording it. But I think it might maybe help me because:
1: Whereas a varying epap with Vauto does not seem to benefit me, a varying ps with asv could, as both the severity of my flow limitations and TEC events are directly related to ps.
2: I've seen the asv is a gold standard for complex sleep apnea, which is a similar condition to what I have: (Concurrent FL and TEC events).
3: It is my understanding that asv induces a dynamic ps increase when minute ventilation decreases below a certain threshold. Changing trigger sensitivity helped me, and ASV seems to function in a similar manner, but with the additional ability of inducing a breath.
Does ASV also have the trigger sensitivity option on top of the dynamic ps?
Please let me know if my understanding is wrong, asnd share any thoughts you have.
Thank you