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Complex Sleep Apnea: Help Analysing OSCAR and advises - C3POap - 01-14-2024
Hello,
Newcomer to this world of sleep apnea and xPAPs (after what probably (in retrospective) has been years / decades with it).
I started recently with a CPAP treatment (barely 2 months).
I did a sleep study in labo, got diagnosed with Severe Complex sleep apnea, with an AHI of 52 (36 OSA, 16 CSA).
I was given a CPAP: ResMed Airsense 11 (to start with, since the majority of events are OSA, even a CPAP will not treat the CSA).
Besides of insurance reasons (based in Europe here), the doctors said they see majority of patients with complex apnea (when majority is OSA) that after some months, when OSA is treated, CSAs tend to disappear as well. Is this a true fact?
I did then a second study in labo (actually a titration) for the doctors to configure the pressure.
It was initially set to 8 (constant).
For the first week I used rampUp from 4. I adapted quite well to the CPAP treatment and the mask, surprisingly.
Afterwards I switched RampUp off, as I could handle the 8 pressure quite ok. EPR is also off.
Initially I was still having around 12 AHI, almost all central events (OSA was almost 0).
After 1 month, I called the doctors since I was still having ~10-14 AHI, still almost all Central events (back them I did not use yet Oscar, just what the CPAP told me).
They just lowered the pressure to 6 to see if it helped (although my CSA is not treatment-emergent).
Needless to say, AHI remained the same (even OSA events did not increase, it seems).
Some weeks later I went on holidays. I also changed one medication I was taking (for other reasons; stopped with Gabapentin, started with Duloxitine).
Dunno which of the 2 was the impacting one (I suspect the medication), but I started seeing a lower AHI of 4-8.
After coming back from holidays, initial peaks of 12 AHI for few days, then settled again in 4-8 AHI.
I started using Oscar then, and I see A LOT of CSA happening mostly at the beginning of the night (from correlations I've made, seems to be in the transition of sleep states, but before deep sleep; sometimes I would see a lot of CSA even when still awake).
I see then some good sleep with no events, then lots of CSA again, sometimes mixed with a lot of Obstructive hypnoapneas.
I am attaching some screenshots of OSCAR. Let me know if you would like to see something different.
How to read Oscar analysis? What to deduce from it?
Why are there so many CSA events at what seems to be specific moments only? (And even more at the beginning of the night, before deep sleep)
Is there anything I can do (with the current CPAP) to try to further reduce the apneas (CSA, hypoapneas, ...)?
Or do I need to talk with the doctors to try to get a BiPAP / ASV machine?
Any advises from the experts around?
Thanks a lot in advance!!
[attachment=58383]
[attachment=58385]
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RE: Complex Sleep Apnea: Help Analysing OSCAR and advises - C3POap - 01-14-2024
In case it helps, the results of the 1st sleep study:
[attachment=58387] [attachment=58388] [attachment=58389]
RE: Complex Sleep Apnea: Help Analysing OSCAR and advises - DancesWithCats - 01-14-2024
"Elite" is only a CPAP. So my initial thought that you should set it to APAP mode is not possible...
Try turning EPR on at 3, full-time. If 8 was tolerable and 6 isn't better, set at 7 to start with so EPR has the full range to work with (Machine won't go below 4, so 7-3 is 4...)
EPR moves the machine "more towards" the BiPAP/ASV realm, to the extent that a CPAP with EPR available will.
If results are not intolerable, try giving it a week so you get statistics based on more than a single night.
RE: Complex Sleep Apnea: Help Analysing OSCAR and advises - Old Steve - 01-14-2024
I agree with DancesWithCats, although I would set your CPAP to at least 8cm with the EPR at 3. I have an APAP, but I use it in CPAP mode with a pressure of 10cm with 3 EPR, by using the EPR it is quite comfortable. You may also be having some positional apneas (clusters of apneas) if you sleep on your back normally they will be worse. Try sleeping on your side, use a lower pillow or purchase a soft cervical collar to keep you neck from bending and closing off your airway.
RE: Complex Sleep Apnea: Help Analysing OSCAR and advises - Deborah K. - 01-14-2024
Your central apneas were quite high in your sleep study. It may be that you need a different type of pap machine called an ASV. Hopefully, the experts will respond soon and give you better advice than the rest of us can.