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bchofmann
Unread post  Post subject: New CPAP user - Confused about results on OSCAR  |  Posted: Thu May 21, 2020 3:00 pm

Joined: Wed May 13, 2020 3:35 am
Posts: 3
PAP Mask: Philips Respironics Dreamwear Nasal
PAP Machine: ResMed AirSense 10
Pressure Setting: APAP 4-20

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I received a type 4 at home sleep study in early April. The equipment was a Philips Respironics Alice NightOne. Results showed 113 obstructive apnea events, 0 central apneas, 3 hypopneas, and an AHI of 13.8.

Fast forward, I have now completed 3 nights of PAP therapy using a ResMed AirSense 10 Auto (4-20 range), and a Philips Respironics Dreamwear Nasal mask. OSCAR data shows 0 obstructive apnea events for any of the nights, and 99, 93, and 60 central apneas for each of the three nights, in addition to a few hypopneas, RERAs, and Cheyne-Stokes triggers.

So I'm confused why my initial sleep study was heavy on obstructive apneas with no central apneas, but now that I'm on PAP therapy, it's the opposite. I also paid out of pocket for my equipment since I'm on a high deductible health plan, and part of me wants to ensure I'm really on the best type of therapy while I still have a chance to return things.

Any insight would be appreciated.

-Ben


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Pugsy
Unread post  Post subject: Re: New CPAP user - Confused about results on OSCAR  |  Posted: Thu May 21, 2020 5:55 pm
User avatar

Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1682
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirCurve 10 VAuto
Humidifier: ResMed AirSense/AirCurve 10
Pressure Setting: Depends on the machine as I actually have more than one

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Are you using EPR? If so, at what setting?
Try turning EPR off and see what happens.

Post a typical detailed report from your OSCAR software so we can see what you are seeing.

Telling the total number of anything without knowing the time period makes the number meaningless.


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Respirator99
Unread post  Post subject: Re: New CPAP user - Confused about results on OSCAR  |  Posted: Thu May 21, 2020 8:34 pm
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Joined: Mon Apr 27, 2020 1:06 am
Posts: 38
Location: Australia
PAP Mask: Resmed Airtouch F20
PAP Machine: Resmed S9 VPAP Adapt
Humidifier: Resmed H5i
Pressure Setting: Min EPAP: 8.0 Max EPAP: 11.0 PS Min: 3.0 PS Max: 8.0

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G'day bchofmann. Welcome to the form.

As Pugsy said, let's see some Oscar daily screenshots so we can get a detailed view of what's happening.

However in the meantime I will hazard a guess that you're experiencing treatment-emergent central apnea. This is not uncommon with new users and usually resolves itself over a period of weeks or months.

To understand it, we need to look at how the body knows when it needs to take a breath: This is the primary school version, as that's all I understand! Your brain stem has an organ to sense the proportion of carbon dioxide in your bloodstream. When the CO2 reaches a certain level the brain sends a message to the diaphragm saying "breathe now". When going onto the hose for the first time, the CO2 level is reduced below the threshold and the brain says "all's well, no need to breathe" and you get a central apnea.

The way to treat it is by reducing the pressure support between inhale and exhale - on your Airsense, set EPR to zero. It's often a good idea to set the minimum and maximum pressures close together (or go to CPAP mode). However we need to see the Oscar output before making any pressure recommendations.

If you can't get the centrals to clear up (or reduce to an acceptable degree) then it might be necessary to consider an ASV machine. However these are expensive and you will need to jump through hoops to get one.

_________________
Regards from Australia

* Download Oscar
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bchofmann
Unread post  Post subject: Re: New CPAP user - Confused about results on OSCAR  |  Posted: Fri May 22, 2020 3:19 am

Joined: Wed May 13, 2020 3:35 am
Posts: 3
PAP Mask: Philips Respironics Dreamwear Nasal
PAP Machine: ResMed AirSense 10
Pressure Setting: APAP 4-20

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Thank you both for responding. Yes, EPR is on at level 1. I will turn it off tonight and see what happens. Also here are OSCAR screenshots from 2 different nights. If there are things I didn't capture that are important, I'm happy to go back and capture them. Is there a standard set of parameters that is best to share?

-Ben


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bchofmann
Unread post  Post subject: Re: New CPAP user - Confused about results on OSCAR  |  Posted: Wed May 27, 2020 3:51 pm

Joined: Wed May 13, 2020 3:35 am
Posts: 3
PAP Mask: Philips Respironics Dreamwear Nasal
PAP Machine: ResMed AirSense 10
Pressure Setting: APAP 4-20

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Well, my Clear Airway Index does seem to be on a downward trend. It's the purple on the top line. Last night it was 4.23. I'll keep my eyes on it.


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Pugsy
Unread post  Post subject: Re: New CPAP user - Confused about results on OSCAR  |  Posted: Wed May 27, 2020 6:14 pm
User avatar

Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1682
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirCurve 10 VAuto
Humidifier: ResMed AirSense/AirCurve 10
Pressure Setting: Depends on the machine as I actually have more than one

Offline
You can get all that we normally need to see on one image.
If we need something else we can just ask.

Hide the calendar on the left side. This allows potentially useful statistics to move up into view.

On the right side...just need these graphs
Events
Flow Rate
Pressure
Leak
Flow Limitation


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