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Zombie
Unread post  Post subject: Oscar showing central apneas questions  |  Posted: Sun Mar 14, 2021 9:32 am

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New to forums, thanks in advance for your help.
Need some help interpreting my Oscar reports

Long time CPAP user switched to APAP 1 year ago, noticed no data card 1 month ago, put one in and got Oscar.
Noticed the central apneas and have a few questions.
Are they real?
Are they something to be concerned about?
If so what are ways to treat/address them?
Anything else in the report standout?

thanks


Attachments:
oscar mar 11 2021 detail.png
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DeltaBravo3.8
Unread post  Post subject: Re: Oscar showing central apneas questions  |  Posted: Sun Mar 14, 2021 1:33 pm
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Welcome to the forum.

Without the diagnosic sleep study data, but with the info regarding that you've been on PAP for some length of time, I'd say these centrals are probably real enough. Raise your pressure to 5 at least to combat the Hypopnoea, and drop EPR to 1 to see if CA decrease. If you have your sleep study data, mention the event count and type that showed. If CA were high there and along with wherever or not they drop any with a lower EPR, these would help tell us the type of CA they are. How disruptive are the Central events? Are you sleeping well? Any symptoms along with the CA flags?

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https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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Pugsy
Unread post  Post subject: Re: Oscar showing central apneas questions  |  Posted: Sun Mar 14, 2021 1:37 pm
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http://freecpapadvice.com/sleepyhead-free-software

Watch the videos at the above link and they will help you try to figure out if the centrals are real or not.
You have to evaluate the flow rate to figure out if awake or asleep flagged events.

If you weren't asleep they don't matter other than to point to being awake.

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Zombie
Unread post  Post subject: Re: Oscar showing central apneas questions  |  Posted: Sun Mar 14, 2021 6:41 pm

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Thanks for the replies. I don't have my sleep study, I am not waking up much, like once a night, but not sleeping very long, around 5 hours, and I am quite tired during the day. I am watching the videos and will try the adjustments and let you know how it goes.


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Zombie
Unread post  Post subject: Re: Oscar showing central apneas questions  |  Posted: Wed Mar 17, 2021 4:13 pm

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Hi
After watching some videos I have a better idea of how to interpret the events.

I reviewed 3/13, 3/14, 3/15, 3/16 see below for the details.

Surprised no obstructive apneas and by the number of arousals, about 20 a night.
I seem to have a central apnea problem, but several arousals were followed by fake CA events.

The bump in min pressure to 6 and lowering EPR to 1 helped a lot last night, I will keep monitoring.

I do see CSR pattern which kind of freaks me out a bit, see attached overview screenshot.


3/13 Pressure 4.6-12 EPR 3 AHI 5.27 CSR 1 CA 29 OA 0 H 5 Arousals ?
My review-------------------------------- CSR 1 CA 23 OA 0 H 1 Arousals 29

3/14 Pressure 5.0-12 EPR 1 AHI 5.15 CSR 1 CA 31 OA 0 H 5 Arousals ?
My review-------------------------------- CSR 2 CA 18 OA 0 H 1 Arousals 18

3-15 Pressure 5.0-12 EPR 1 AHI 9.73 CSR 1 CA 49 OA 0 H 4 Arousals ?
My review------------------------------- CSR 2 CA 26 OA 0 H 2 Arousals 22

3-16 Pressure 6.0-12 EPR 1 AHI 3.83 CSR 0 CA 19 OA 0 H 4 Arousals ?
My review------------------------------- CSR 0 CA 03 OA 0 H 2 Arousals 20


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oscar overview.png
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oscar mar 16.png
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Pugsy
Unread post  Post subject: Re: Oscar showing central apneas questions  |  Posted: Wed Mar 17, 2021 5:09 pm
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Did your machine flag CSR or did you just think it looks like CSR?

Need to see what is either flagged or you think is CSR.
About a 5 minute segment and be sure to include the flow rate just prior to the flagging.

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Zombie
Unread post  Post subject: Re: Oscar showing central apneas questions  |  Posted: Wed Mar 17, 2021 10:47 pm

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This was the CSR the machine flagged on the March 15th


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oscar mar15 CSR.png
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Pugsy
Unread post  Post subject: Re: Oscar showing central apneas questions  |  Posted: Thu Mar 18, 2021 6:10 am
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Were you for sure asleep when those got flagged?

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Zombie
Unread post  Post subject: Re: Oscar showing central apneas questions  |  Posted: Thu Mar 18, 2021 8:21 am

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Good question, I am not sure, here are some where I am sure I was asleep

thanks for your help!


Attachments:
oscar mar 2 flagged csr.png
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oscar feb25 flagged csr.png
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oscar feb20 flagged csr.png
oscar feb20 flagged csr.png [ 462.81 KiB | Viewed 1783 times ]
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Pugsy
Unread post  Post subject: Re: Oscar showing central apneas questions  |  Posted: Thu Mar 18, 2021 8:49 am
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All of the 3 examples you show reflect arousal breathing prior to the flagged CSR breathing and the bulk of the flagged CSR breathing looks more like regular periodic breathing to my eye.

CSR has a very distinctive pattern and yours are mostly a waxing and waning but not that distinctive pattern.
And it must follow for sure asleep breathing.

But if you are concerned about all this then you need to be talking to your doctor.

Image

Image

Image

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Zombie
Unread post  Post subject: Re: Oscar showing central apneas questions  |  Posted: Thu Mar 18, 2021 12:29 pm

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Ok thanks for taking a look. I finally got a referral to a sleep doctor today and will bring it up when I see him next month.


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DeltaBravo3.8
Unread post  Post subject: Re: Oscar showing central apneas questions  |  Posted: Thu Mar 18, 2021 1:26 pm
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Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
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Humidifier: HumidAir and Heated hose
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FWIW the OSCAR team is aware that ResMed machines sometimes flag CSR when it's highly likely periodic breathing like Pugsy suggests. It's not a flaw within OSCAR, but rather a product to interpretation of the PAP data given. If you prefer to, you can check with your doc. Even so, I think if you had CSR you'd be getting attention from a cardiac doc.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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Pugsy
Unread post  Post subject: Re: Oscar showing central apneas questions  |  Posted: Thu Mar 18, 2021 4:49 pm
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Both brands of machines that flag CSR will often flag normal periodic breathing as CSR.
Afterall CSR is a form of periodic breathing but not all Periodic Breathing is Cheyne Stokes Respiration.
I think that the idea is better to be safe than sorry when it comes to CSR breathing and better to.
Respironics used to just call it all periodic breathing but ResMed decided to go full into calling all PB as CSR.
Scares a lot of people needlessly but better to be safe than sorry I guess.
PB doesn't mean much of anything but of course CSR can mean potential problems so we don't want to ignore it.


Here's one of mine that got flagged....obviously no where near CSR but it got flagged anyway. I see this fairly often.
Also a lot of the time awake or arousal breathing will fool the machine into thinking its PB/CSR and it's not. If we aren't asleep....it doesn't matter what it is or isn't.

Image

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