Grandfather's CPAP Results

[Geer1]

I have been visiting family and was curious to view Grandfather's OSCAR results. When tested he had severe sleep apnea and severe oxygen desaturation. Over the past year they had started to notice physical and cognitive decline and then realized it was because he wouldn't use his CPAP machine when taking 1-2 hr nap in the afternoon. Since he has started doing that has seen some improvement (noticeable since last visit ~ 6 months ago).

When I reviewed his data I see average AHI is ~15, basic settings of 6-20 cm on a Resmed S9 and average is ~14 and hits max most nights. EPR set full time @ 3. Long periods of large leak which is due to mouth leakage, he has tried a FFM and chin straps but found both uncomfortable. He has periods of what appears to be similar to if not Cheyne Stokes looking respiration(not flagged by machine but not sure if S9 does that), he is in his early 80s and has coronary artery disease, atrial fibrilation and hypertension. Data for some reason is limited to ~1 week for flow data and ~1 month for other data and just over a year for daily stats with no graphs, ~1 year ago didn't seem to have as many centrals but more obstructive.

The doctors and therapists that he has dealt with sound useless, not surprising due to his location.

I am thinking the following and would be interested if others have any thoughts.

1) Try some different full face masks to get rid of leaks. Airfit F30, Airtouch F20, Dreamwear FFM and Mirage Liberty look potentially interesting. He currently uses P10 nasal pillows and likes the minimal looks but doesn't like the stretchy band. He likes the look of my P30i which is one reason I was thinking Dreamwear FFM. Maybe try mouth tape although he doesn't sound interested in that.

2) Try to find a better doctor/clinic and arrange a titration study. I imagine bilevel or maybe even ASV would be beneficial and if they could arrange a study to test that or at a minimum determine better settings for APAP machine that would be good.

Any other thoughts?

Ron CPAP Statistics.PNG (23.54 KiB) Viewed 384 times

Ron Sleep Report 2019-12-11.PNG (110.77 KiB) Viewed 384 times

Ron Possible Cheyne Stokes Respiration.PNG (20.87 KiB) Viewed 384 times

[Jas_williams]

Your grandfather needs a different machine, that will treat the centrals. An ASV is required.


He needs to go back to his dr as this machine is not adequately treating is complex sleep apnoea that has now developed. The S9 does not keep the detailed graphs for more than 7days

[D.H.]

I think that he does not at least a BiPAP if not an ASV. Meanwhile, try lowering the max to 12, see if that cuts down on the CAs without a serious increase in obstructive events.

[Geer1]

Yeah I know he could play with settings to see if that helps.

Raise minimum since it is too low.
Try reduced EPR.
Try reducing maximum to see if it is actually helping or just causing more discomfort/leaks.

Problem is this side of the family is computer illiterate and I live a ways away so would have to try to teach them to send sd card data just so I could give ideas on things to try and then try to explain how to change settings. Might still do this if they can’t get in with a decent doctor though which is my first thought. He needs a new machine anyways so trying to line up a titration study seems like a good option, problem is finding a place to do it out here.

[palerider]

Any other thoughts?

It'd help if you'd organize your screenshots like: http://cpaptalk.com/wiki/index.php/Oscar:organize

Step one would be to turn off EPR and see if that lowers the amount of centrals appreciably.

[Geer1]

Those photos were taken that way for a summary report to show doctor, will see what happens if he can get a titration study or not.

I talked him into turning ramp off, changing min pressure to 8 cm and turning epr off. Tried it while awake for a bit and seemed ok so will leave this way and see what happens over the next few days. I have to leave but will figure out a way to get his data.

I figured those were the steps but was a bit hesitant with the more complicated case his known heart issues etc. Thanks for confirming.

[chunkyfrog]

If he had 2 sd cards, then one could be in the mail or with you--while one is always in the machine.
Almost the same as being in 2 places at once--almost.

[Geer1]

If he had 2 sd cards, then one could be in the mail or with you--while one is always in the machine.
Almost the same as being in 2 places at once--almost.

I am going to FaceTime them and walk them through step by step to upload data to onedrive.