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+--- Thread: Lanners - Therapy Help (/Thread-Lanners-Therapy-Help)
RE: help interpreting oscar data - Lanners - 02-27-2024
Looking for someone who can read oscar charts in original post.
Any suggestions to improve treatment effectiveness? I am averaging 8 to 12 ahi per hour.
Thanks in advance.
RE: help interpreting oscar data - CPAPfriend - 02-29-2024
You have a lot of central events, despite being a month into therapy. I suggest trying fixed pressure first, then go from there. Also worth trying is no EPR. Do one change at a time, and then let's go from there. Put fixed pressure somewhere 10-11cm. There's a chance you might respond to ASV, but I suggest trying these smaller trial changes first.
RE: help interpreting oscar data - Lanners - 02-29-2024
Thank you for the reply. Yesterday I went to the Dr and he changed my settings to 10-14, so I need to give that a fair try before making any other adjustments.
First night readings after this adjustment were weird because for the first time I had Cheyne Stokes Respiration (CSR) recorded. Oscar says it was 5.68%. Not sure what that means, but it looks like it was a period of 20 minutes or so.
Last night was much improved (my lowest ever - only 2.2 ahi per hour!) so I am mystified by the night before.
Cheyne Stokes Respiration for first time - is this an error? - Lanners - 02-29-2024
My doctor adjusted my pressure from 9-15 to 10-14. That night I had the attached report showing about 27 minutes of Cheyne Stokes Respiration. is this an error? I am attaching a zoomed in picture below.
RE: Lanners - Therapy Help - Crimson Nape - 02-29-2024
Lanners - Because all your threads dealt with your therapy, I have merged them into one. This helps the reader see your history to help form a better recommendation. Please use this thread to post about your therapy here. To help make the name be more inclusive, I changed it to, Lanners - Therapy Help.
- Red
RE: Lanners - Therapy Help - Lanners - 03-01-2024
Last night I again had Cheyne Stokes Respiration for about 30 minutes. I have attached a picture of the who night
s data and a zoomed in shot of those 30 minutes. This week is the only time that has occurred in any collected data. FYI, my low heart rate was 47 bpm. usual low is 54 bpm with and average of 62 bpm.
Can anyone help me understand what is going on? Is this something the machine is identifying in error?
RE: Lanners - Therapy Help - Jay51 - 03-01-2024
[attachment=60431]
This was one of the best pictures I could find of cheyne - stokes. Notice the "crescendo (upward) and decresendo (downward) pattern to the breathing (it looks like a round ball from a distance). And the flat line in between during sleep would be a central apnea of no breathing.
It seems like the vast majority of the time, cheyne - stokes are wrongly flagged. But every once in awhile they could be correct. Do you have any health issues that may be causing cheyne - stokes breathing? Cheyne stokes is common with congestive heart failure.
I defer here to the experts here also. If they think this is true cheyne stokes or not. A PCP or Cardiologist would be able to tell IMO.
RE: Lanners - Therapy Help - Sleeprider - 03-01-2024
Lanners, I would like to get some screenshots that are zoomed in much further at a 3 to 4 minute resolution. What I want to do is determine the extent to which these events can be attributed to obstructive flow limitation, or if the are actually central. If you have a copy of your diagnostic flow limitation, it would help to see results with personal information redacted/blacked out. Mostly we need to see the distribution of obstructive and central events.
RE: Lanners - Therapy Help - Lanners - 03-01-2024
Thanks so much for looking at this for me. Attached are the shots you asked for.
RE: Lanners - Therapy Help - Sleeprider - 03-01-2024
The Oscar chart appear to have some feedback loop breathing and is mainly central in nature. Your sleep study had very low apnea occurrence, with zero OAI and only 0.5 CAI, so that was central. You mainly had hypopnea events at 12.6 per hour. The hypopnea can be central or obstructive, and it seems reasonable to believe your events were predominately central during the diagnostic test as they certainly are with CPAP. Your apnea index is higher with therapy, so you have therapy onset central apnea. What I am seeing in your results is not only zero improvement from the baseline condition, but you actually have a much higher apnea index, mainly central, and the diagnostic hypopnea have simply progressed to central apnea.
Our last remaining options are to continue to try to optimize your CPAP therapy, which is clearly not currently efficacious, or just referring you back to your doctor for evaluation for ASV. To optimize CPAP for central apnea, the best approach is to use the lowest fixed pressure that avoids obstructive apnea, with a low or no EPR. Since you had only 0.5 obstructive AHI, we should be able to put you on fixed pressure at 7.0 or 8.0 and use EPR 1 and see what happens. If the outcome does not significantly improve, the next step is to bring this lack of efficacy and the "real" diagnostic results, which clearly show central, not obstructive sleep disordered breathing, to your doctor's attention and ask for treatment using an Aircurve 10 ASV. That will result in near-zero AHI. Are you working with a sleep specialist, or your treating physician?