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Chainbreaker
Unread post  Post subject: OSCAR Report Interpretation  |  Posted: Mon May 31, 2021 10:29 am

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I have been using a CPAP since Apr. 28 and started using OSCAR a couple weeks later. If you want to see any other specific charts please let me know. I am looking for any general advice that you might have concerning my results and device settings. I'm guessing that I'll be talking with my doctor soon, not sure if I should contact her or wait and see if she calls, as she did after my last sleep study. 
Thanks


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Chainbreaker
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Mon May 31, 2021 3:04 pm

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I forgot to mention that after the first week or so I got a chin strap, after which my numbers got better but I think I still breathe from my mouth sometimes when I sleep.


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Pugsy
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Mon May 31, 2021 7:50 pm
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Your leaks are more than I would be happy with.
Are they waking you up?

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Chainbreaker
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Tue Jun 01, 2021 4:53 am

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Thanks for the reply, I do not wake up from the leaks. My mask feels like a good fit, I think the leaks are from when I open my mouth during sleep but I don't know for sure. My report from last night is a little better, please see attached.


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Respirator99
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Wed Jun 02, 2021 12:59 am
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The shape of the leak graphs, with the flat-topped "plateau" areas does suggest the leaks are coming through your mouth. There are various strategies you could use to prevent this, or you could change to a full-face mask (my personal preference).

Apart from the leaks, the number of central (clear airway) apneas is excessive. These occur when your brain fails to send the "breathe now" signal to your lungs. There are a number of possible reasons:

- It could be your body's reaction to being able to breathe properly in your sleep. The level of CO2 in your blood is greatly reduced and does not reach the threshold at which the signal is generated. This is called "treatment emergent central apnea". In many cases it is self-correcting after a few weeks or months.

- It could also be something endemic, possibly caused by a neurological problem.

- Finally, centrals can sometimes be associated with events during your sleep, such as moving about and holding your breath. Can also be associated with leaks. In your case, I think there are too many, and too widely dispersed to fall into this category.

It's important to know if the central apneas are treatment-emergent or whether they are pre-existing. It might be a good idea to post a copy of your sleep study report for us to have a look at. Let's see the whole document including the chats and tables, not just the one page summary. Very often (too often) the charts and tables will clearly show central apnea but the doc writes it up as obstructive, thereby derailing your treatment before it even starts. If you do decide to post the report, I suggest you erase any personal information (name, address, Medicare number etc).

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Chainbreaker
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Wed Jun 02, 2021 7:35 am

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Thanks for your interpretation of my sleep report! As requested I have attached my sleep study results. I will post the last page in a separate post since it seems that five attachments is the limit.


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Chainbreaker
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Wed Jun 02, 2021 7:47 am

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Attached are the last page of my second sleep study and my report from last night in which my large leaks number is a bit better.


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sleep study 2 pg 3.jpg
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Pugsy
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Wed Jun 02, 2021 10:10 am
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Where do you live?
What sort of insurance do you have?
Do you have a follow up visit scheduled yet with your sleep doctor?

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Chainbreaker
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Wed Jun 02, 2021 10:37 am

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I live in the U.S. and my insurance has been good in regards to the CPAP. I sent my doctor an email this morning and expect to hear back later today or tomorrow. My AHI has been under 5.0 for five of the last ten days. Is my current device a good choice for helping against central apneas or would I be better served with a different type of CPAP machine?


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Pugsy
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Wed Jun 02, 2021 4:13 pm
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The jury is still out on how well your device handles the central apneas....probably not ideal but in the US most insurance companies will require the person to start off with the cpap/apap machine before they will consider paying for a machine that might do a better job.
The reason they do that...because sometimes cpap/apap works and people don't need to move up to the higher end (more expensive) specialty machines.

It's not like you are having 30 or 40 centrals per hour so probably not an urgent need to fast forward to the high end machine.

Your doc will probably want to give it time....how much time I don't know but I think 3 months is probably a fair trial.
In the insurance world people usually need at least 5 centrals per hour average before insurance will even consider doing anything about the centrals.
Sounds like you are borderline now and there is always the chance that it will improve with a bit of time.

For sure though....keep the follow up appt with the doc and make sure you discuss the central apnea situation with him

How are you feeling? How's your sleep quality?

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Chainbreaker
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Thu Jun 03, 2021 7:34 am

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Thanks for the info. I'm feeling a little better than I did before the cpap, and I am also sleeping better than before. I'm sure the cpap is helping but I also stopped taking short naps during the day which I think slightly affected my sleep at night. I used to take a twenty minute or sometimes longer nap late in the morning or early afternoon, sometimes on purpose and other times I would fall asleep in a chair. Now I am making an effort to not sleep at all in the daytime and I think that I get to sleep faster as a result. I will be speaking with my doctor on Wednesday so I'm looking forward to hearing their advice.


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ajack
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Mon Jun 07, 2021 8:16 pm

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I would move to a mask that covers your mouth and nose. It should resolve the mouth breathing messing up your treatment. Pressure induced CA can take a while to settle. If they don't settle within 12 weeks, I would ask about a more suitable machine.
Your obstructive apnea resolved at pressure 6cm. I would ask your doctor if that setting would be worth trying. It may help with CA. I know the sleep study showed CA resolved at 9, but I don't have an explanation for that. Perhaps your doctor will. I would expect less pressure induced CA with less pressure.


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Respirator99
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Mon Jun 07, 2021 11:24 pm
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Ajack, the original test results clearly show there is a pre-existing problem with CA - it's not pressure-induced. I'm impressed that the Autoset has done such a good job controlling them, but there is obviously still room for improvement.

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Chainbreaker
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Tue Jun 08, 2021 8:02 am

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Thanks for the replies, I will be speaking with my doctor tomorrow and will see what he has to say about a different mask and machine.


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Chainbreaker
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Thu Jun 10, 2021 4:36 pm

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The sleep doctor recommended a mouth/nose mask and depending on how well that works we will possibly try some lower pressures though I still don't know exactly why that would help.


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Respirator99
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Mon Jun 14, 2021 12:11 am
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Your doc is taking a conservative approach to try and minimise the central apnea using a conventional machine with low pressures and minimum fluctuations. It might work. More likely, though, it will give you very inconsistent results with great results followed by horrible nights.

I would start the discussion about graduating to an adaptive servo ventilator - ASV. Guaranteed to fix your central apnea problem, but quite expensive. (It won't fix your leaks!)

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TheLankyLefty
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Wed Jun 16, 2021 11:44 am
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Chainbreaker wrote:
I do not wake up from the leaks. My mask feels like a good fit, I think the leaks are from when I open my mouth during sleep but I don't know for sure.
You are 100% waking up from the mouth leaks. You wouldn't necessarily remember it, but I promise that you are. Start taping your mouth. Cover roll stretch works great by BSN. Your mouth leaks are about as bad as they get. That's good news because it's easily fixed.

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Chainbreaker
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Wed Jun 16, 2021 1:17 pm

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Respirator99 wrote:
Your doc is taking a conservative approach to try and minimise the central apnea using a conventional machine with low pressures and minimum fluctuations. It might work. More likely, though, it will give you very inconsistent results with great results followed by horrible nights.

I would start the discussion about graduating to an adaptive servo ventilator - ASV. Guaranteed to fix your central apnea problem, but quite expensive. (It won't fix your leaks!)



I believe that you are probably correct about the doc's conservative approach and graduating to an ASV. I'm not sure if my insurance will want to pay for an expensive new device when my current device is getting me below 5 AHI. We will have to wait and see how low I can get that number with a couple more pressure changes. Also, I just got a new full face mask, an Airfit F20. I used it last night for the first time and got a 4.4 AHI and a smiley face for mask fit, unfortunately I forgot to put my card back in the device last night so I do not have any Oscar data. It seems odd that my CPAP machine gave me a smiley for my mask fit but myAir gave me a 7/20 for mask seal and 87/100 overall. Thanks


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Chainbreaker
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Wed Jun 16, 2021 1:56 pm

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TheLankyLefty wrote:
Chainbreaker wrote:
I do not wake up from the leaks. My mask feels like a good fit, I think the leaks are from when I open my mouth during sleep but I don't know for sure.
You are 100% waking up from the mouth leaks. You wouldn't necessarily remember it, but I promise that you are. Start taping your mouth. Cover roll stretch works great by BSN. Your mouth leaks are about as bad as they get. That's good news because it's easily fixed.


I don't remember waking up from large leaks but I'm sure it's possible that I do. In my previous post I mentioned changing to a new mask so I will see how it works out but if it doesn't I may try the mouth tape if I go back to the nasal pillows. Friday through Monday my pressure was lowered from 9 to 8, this improved both my AHI and large leak numbers. AHI readings were 4.32, 2.99, 2.92, and 4.09, large leaks were my lowest yet at 6.49, 6.49, 10.16, and 10.69. My Monday Oscar data is attached, no Oscar data for Tuesday. What is an acceptable number for large leaks?
Thanks


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TED 97
Unread post  Post subject: Re: OSCAR Report Interpretation  |  Posted: Fri Jun 18, 2021 4:33 pm

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i can get oscar the lap top wonts app the stuid thing


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