Shallow Breather Oscar Screenshots

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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ShallowBreather
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Shallow Breather Oscar Screenshots

Post by ShallowBreather » Sat Apr 23, 2022 7:40 am

Went to bed about 10 pm. It's been a rough couple of days.

Using the Dreamwear pillow mask to start. But small steady leak started about 10:30. I believe that I made the switch to the Swift FX at 2:02 am.

Bathroom break at 11:36 pm.

I was awake I felt like, and just lying there, for most of the 1:00 am hour. Then, I made the mask switch. I remember being mad about not being able to sleep. But look at that Flow Rate as we approach 2 am! Nice.

So, now in the Swift FX. Never noticed a leak.

2:30 am, I think I'm asleep.

4:00 am, I couldn't get a breath and woke up dreaming about trying to breathe. I was cycling between deep breaths and shallow breating, and I bottomed out on a shallow and it was like I had super sinus congestion.

The 5:00 am hour was weird because I kept ramping up and down from shallow to deep to shallow again. The shallow was really shallow and it kept me from going to sleep. I think I fell back asleep around 5:45 am. Not sure.

*I'm also including a closeup of a time when I was in a very relaxed but not asleep period. You can see that I am shallow breathing a couple of times, then deeper breathing a couple of times, and then back to shallow, and then a hypopnea. How do I get this to not happen? :?

It's now 9:30 am, and I'm pretty tired today.
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Julie
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Re: Shallow Breather Oscar Screenshots

Post by Julie » Sat Apr 23, 2022 8:27 am

Hard to compare these without having to look all over in previous threads.

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ShallowBreather
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Re: Shallow Breather Oscar Screenshots

Post by ShallowBreather » Sat Apr 23, 2022 8:32 am

Julie wrote:
Sat Apr 23, 2022 8:27 am
Hard to compare these without having to look all over in previous threads.
These are my first OSCAR posts. The previous posts had to do with my sleep studies and trying to get advice on machine use.

I've been diagnosed with central apneas and a bunch of hypopneas. Mid-30 AHI.

My apologies.
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LSAT
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Re: Shallow Breather Oscar Screenshots

Post by LSAT » Sat Apr 23, 2022 9:04 am

*I'm also including a closeup of a time when I was in a very relaxed but not asleep period. You can see that I am shallow breathing a couple of times, then deeper breathing a couple of times, and then back to shallow, and then a hypopnea. How do I get this to not happen? :?



The changes in breathing may be the back up rate setting on your ST machine. See your doctor....that is a sensitive setting.

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Re: Shallow Breather Oscar Screenshots

Post by Julie » Sat Apr 23, 2022 11:10 am

The point of staying with one thread is so that all your info re OSA, machines, Oscar, etc. is in one place so people can follow what's what... but it's not a biggie, just a nuisance. :D
Last edited by Julie on Sat Apr 23, 2022 1:49 pm, edited 1 time in total.

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ShallowBreather
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Re: Shallow Breather Oscar Screenshots

Post by ShallowBreather » Sat Apr 23, 2022 11:36 am

LSAT wrote:
Sat Apr 23, 2022 9:04 am
The changes in breathing may be the back up rate setting on your ST machine. See your doctor....that is a sensitive setting.
LSAT, which setting do you mean?

Thanks!!
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Re: Shallow Breather Oscar Screenshots

Post by palerider » Sun Apr 24, 2022 3:07 pm

ShallowBreather wrote:
Sat Apr 23, 2022 8:32 am
Julie wrote:
Sat Apr 23, 2022 8:27 am
Hard to compare these without having to look all over in previous threads.
These are my first OSCAR posts. The previous posts had to do with my sleep studies and trying to get advice on machine use.

I've been diagnosed with central apneas and a bunch of hypopneas. Mid-30 AHI.

My apologies.
*PLEASE* stop posting in multiple threads,

You want help, keep everything in one thread. It's a very simple request made of everyone that comes here for help (https://www.cpaptalk.com/viewtopic/t172 ... STING.html) and people that ignore it just make it more difficult on those that they're asking for help from.

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ShallowBreather
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Re: Shallow Breather Oscar Screenshots

Post by ShallowBreather » Sun Apr 24, 2022 5:46 pm

Seems to be an inconsistency here. I’ve been looking at other threads, and this message of “only post in one thread” appears to be only for me.

Ok, fine. I’ll never post in any thread but this one, but you need to go talk to a lot of other people.
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Re: Shallow Breather Oscar Screenshots

Post by palerider » Sun Apr 24, 2022 9:50 pm

ShallowBreather wrote:
Sun Apr 24, 2022 5:46 pm
Seems to be an inconsistency here. I’ve been looking at other threads, and this message of “only post in one thread” appears to be only for me.

Ok, fine. I’ll never post in any thread but this one, but you need to go talk to a lot of other people.
Did you even READ the first post on the bloody forum?

Apparently not.

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Re: Shallow Breather Oscar Screenshots

Post by ShallowBreather » Mon Apr 25, 2022 6:55 am

palerider wrote:
Sun Apr 24, 2022 9:50 pm
ShallowBreather wrote:
Sun Apr 24, 2022 5:46 pm
Seems to be an inconsistency here. I’ve been looking at other threads, and this message of “only post in one thread” appears to be only for me.

Ok, fine. I’ll never post in any thread but this one, but you need to go talk to a lot of other people.
Did you even READ the first post on the bloody forum?

Apparently not.
Can't let it go, can you?
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Re: Shallow Breather Oscar Screenshots

Post by Pugsy » Mon Apr 25, 2022 7:17 am

ShallowBreather wrote:
Sun Apr 24, 2022 5:46 pm
Seems to be an inconsistency here. I’ve been looking at other threads, and this message of “only post in one thread” appears to be only for me.

Ok, fine. I’ll never post in any thread but this one, but you need to go talk to a lot of other people.
No....Not only you. If you read the Sticky at the top of the Announcements section "Newbies please read before posting"
I ask for the "keep things to one thread" up there...for everyone. It was there long before you ever came here.

The idea to stick to one thread is just so that people who are wanting to try to help you can have quick easy access to all your past history in case it might be needed for some reason or other.
It's YOU making it easy for someone who might be trying to help YOU by providing as much information as possible.
Granted most of your past posts were about your difficulties getting proper equipment...and not actual therapy but it would have been good manners to at least provide a link to those past posts just in case someone felt the need to be better informed. It would be YOU attempting to help the others help YOU better.

Coming off with an attitude and getting snotty about the request is a good way to get ignored.
Most of the forum members won't remember any of your past history and they won't take the time to go back and read what you posted in the past. It's not their job or they simply don't have time to go hunting past reports.

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Re: Shallow Breather Oscar Screenshots

Post by ShallowBreather » Mon Apr 25, 2022 7:42 am

Pugsy wrote:
Mon Apr 25, 2022 7:17 am
ShallowBreather wrote:
Sun Apr 24, 2022 5:46 pm
Seems to be an inconsistency here. I’ve been looking at other threads, and this message of “only post in one thread” appears to be only for me.

Ok, fine. I’ll never post in any thread but this one, but you need to go talk to a lot of other people.
No....Not only you. If you read the Sticky at the top of the Announcements section "Newbies please read before posting"
I ask for the "keep things to one thread" up there...for everyone. It was there long before you ever came here.

The idea to stick to one thread is just so that people who are wanting to try to help you can have quick easy access to all your past history in case it might be needed for some reason or other.
It's YOU making it easy for someone who might be trying to help YOU by providing as much information as possible.
Granted most of your past posts were about your difficulties getting proper equipment...and not actual therapy but it would have been good manners to at least provide a link to those past posts just in case someone felt the need to be better informed. It would be YOU attempting to help the others help YOU better.

Coming off with an attitude and getting snotty about the request is a good way to get ignored.
Most of the forum members won't remember any of your past history and they won't take the time to go back and read what you posted in the past. It's not their job or they simply don't have time to go hunting past reports.
Pugsy

This all new to me. CPAP, this forum, fighting for the right machine, all of it. I'm not intentionally being snotty, but, yes, I am feeling ignored. I feel like somehow I accidentally kicked a sacred cow and am now being ostracized. I came here in good will, and my experience hasn't been that great. You've been very nice. You use words and explain things. Other people get after me, add a bunch of exclamation marks, and in general don't seem to want to do anything but correct my forum etiquette. I appreciate that you have to run a tight ship, but it's been far from enjoyable being corrected all the time.

I don't mind taking the responsibility for not knowing and adhering to all the rules. I read them 9 months ago. (Yes, I did read them. I've read most of the WIKI and most of the pinned comments.) I'm not super-active here. I don't know hardly anybody.

I ALREADY said that I would just post everything in this thread, but PaleRider seems intent on coming back for another pound of flesh over and over again.
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Re: Shallow Breather Oscar Screenshots

Post by Rubicon » Mon Apr 25, 2022 8:12 am

So do you have a question in re: above screenshots?

After letting go of the tree I was hanging onto when the earth stopped turning because you made multiple posts, I found your comments on the first study:
ShallowBreather wrote:
Tue Aug 24, 2021 8:54 pm
First, I failed it. The study was 7 1/2 hours long, of which I slept 3 hours 3 minutes. Part of that was just the new surroundings and wires. I had 33 awakenings after sleep onset. Sleep latency was 55 minutes and REM latency was 218 minutes. 94 stage shifts in sleep patterns.

I didn't have a mask on until 12:30 am. During the no-mask period, I had 42 respiratory events consisting for 15 apneas (3 obstructive, 1 mixed, and 11 central) and 27 hypopneas. I can't figure out the difference between a central apnea and a hypopnea. ??? AHI was 35.5 and CAI (central apnea index) was 9.3. REM AHI was 0.0. non-REM AHI was 35.5 and arousal index was 34.6. Average oxygen 92.0% and minimum oxygen saturation of 80.0% YIKES! I was below 90% about 10 total minutes. Supine the entire time.
...

The diagnosis from this first study is two part:
G47.33 (severe) Obstructive sleep apnea
G47.37 Treatment emergent central sleep apnea
(I disagree with the "treatment emergent" part as this was one of my complaints to the doctor that led to the study. See avatar name. But I understand that it can also apply to CPAP persistent central sleep apnea.)
So I'm kinda looking at that and thinking "is this guy's chief problem train wreck sleep architecture?" and we've been spending the last 6 months trying to fit a square peg in a round hole?

Do you have the actual 1st report?
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Re: Shallow Breather Oscar Screenshots

Post by Pugsy » Mon Apr 25, 2022 8:25 am

This ship is far from tight but I try to keep things down to a small roar. :lol:

There are a lot of people here who it is REALLY important that people stick to one topic at least for a while especially when new to therapy because they usually have a gazillion questions. Me, personally, I am a little more flexible about it but others aren't. They get to have their opinions too you know.

I don't remember all your history and I know it is lengthy and consists mainly about your struggles to get proper equipment for your problem and I haven't gone back to reread them but there's probably not much in there that would really help us.

So back to this post and new topic.....I don't see a question in there anywhere. Was there a question that I missed???
I see a detailed report and comments that might explain breaks in therapy.
I don't see any questions that need answering and even if I did...you are on that damn ST machine and we simply don't have much experience with evaluating the data the ST machine records. I don't know if I could answer any questions if they were there.

The detailed report is, on a whole, unremarkable in terms of what it is reporting.
The fixed back up rate along with fixed bilevel pressure thing is pretty much going to force you to breathe the way the machine is set up. It's going to make things look good on paper anyway.

Obviously the biggest problem is your getting adjusted to the way it does things and to be honest there's not much we can offer. If you were a family member of mine....you would never have this machine. I think I already explained why back in one of your other posts.

So the reasons you may feel ignored are
1...some people really wanted to have more history available so they just won't bother.
2...I don't see any questions...not that I could for sure answer any questions but without a question people really have nothing to offer
3...There are very few members here who know anything at all about the ST model and the very few who might...maybe don't come here all that often to even see your thread.

Your machine is going to offer reports that are pretty much unremarkable but your main issue is going to be adjusting to the way the machine wants to do things. It simply can't do any adjusting....you have to do the adjusting and what it is wanting you to do isn't easy at all. Surely not comfortable.

I have never seen a ST user come here happy with the machine and the way it does things.

Finally you are using PS of 6...I am concerned that you maybe aren't getting enough of a push to deal with your centrals.
I understand why the lower PS...you couldn't handle the original 10 PS. I asked a sleep tech how much PS does a person really need to adequately deal with centrals and his response to me was that at at minimum...PS at 8.
I don't know that your centrals are being optimally dealt with at these settings.

So ...you aren't sleeping well...we have no way to know if the 6 PS is doing a good job....and I suspect if I asked you how you were feeling the answer wouldn't be positive.


Edit:....I see Rubicon has posted....he is one of the very few people here who knows about all this stuff.
I suggest you answer any questions he may have and provide (if you can) anything he might request.
He's blunt...but he knows his stuff inside and out.

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Re: Shallow Breather Oscar Screenshots

Post by ShallowBreather » Mon Apr 25, 2022 8:40 am

Rubicon wrote:
Mon Apr 25, 2022 8:12 am


Do you have the actual 1st report?
SLEEP ARCHITECTURE:
The study started at 21:26:04 and ended at 05:06:10. Total sleep time (TST) was 183 minutes resulting in a sleep efficiency of 40.2% (total recording time (TRT) = 455 m). There were 33 awakenings with a total time awake after sleep onset of 216.5 minutes. The sleep latency was 55.5 minutes and the REM latency was 218 minutes. The patient spent 86.6% of sleep time in the supine position. The sleep stage percentages were 25.1% stage N1, 40.2% stage N2, 23.2% stage N3 and 11.5% REM sleep. There were 126 arousals, resulting in an arousal index of 41.3. There were 94 stage shifts.

BASELINE RESPIRATORY DATA:
Snoring was noted. There were 42 respiratory events consisting of 15 apneas [3 obstructive (20.0%), 1 mixed (6.7%), and 11 central (73.3%)] and 27 hypopneas. The patient spent 100.0% of baseline sleep time in the supine position. The apnea-hypopnea index (AHI) was 35.5 and the central-apnea index CAI) was 9.3. The supine AHI was 35.5. The off-supine AHI was 0.0. The REM AHI was 0.0. The non-REM AHI was 35.5 and the arousal index was 34.6. The mean oxygen saturation was 92.0%, with a minimum oxygen saturation of 80.0%. The patient spent 9.5% (6.8 min) of sleep time with an oxygen saturation below 90% and 3.3% (2.3 min) of sleep time with an oxygen saturation at or below 88%. The wake supine end-tidal CO2 (ETCO2) value was 37 mmHg. The patient spent 0.0% of sleep time with an ETCO2 above 50 mmHg and 0.0% above 55 mmHg. Cheyne-Stokes/Periodic Breathing was not present. Supplemental oxygen was not administered.

From Pugsy...this is where I get in trouble removing the indent tab stuff and had to stop since things won't line up
REM-Time REM AHI NREM-Time NREM AHI Total-Time Total AHI
Supine 0.0 m -- 71.0 m 35.5 71.0 m 35.5
Transcription Off-Supine 0.0 m -- 0.0 m -- 0.0 m --
Transcription Total 0.0 m -- 71.0 m 35.5 71.0 m 35.5

POSITIVE AIRWAY PRESSURE THERAPY:
During the second part of the study, CPAP titration was initiated at 00:51:34 Transcription and ended at 05:04:47. The patient did not have difficulty falling back asleep. Snoring was eliminated at a CPAP setting of 6 cmH2O. There were 52 respiratory events consisting of 43 apneas [0 obstructive(0.0%), 0 mixed (0.0%), and 43 central (100.0%)] and 9 hypopneas. The mean oxygen saturation during the study was 95.0%, with a minimum oxygen saturation of 84.0%. The patient spent 2.1% (2.4 min) of sleep time with an oxygen saturation below 90% and 1.2% (1.3 min) of sleep time with an oxygen saturation at or below 88%. Cheyne-Stokes/Periodic Breathing was not present. Supplemental oxygen was not administered. A medium Fisher and Paykel Eson 2 nasal mask without chin strap was used. The mask leak at the most effective pressure was within normal limits.

PAP SUMMARY:
By Pressure:
PAP O2 TST %Sup SupAHI REM RAHI CAI HI AHI ArIdx Nadr AvgSaO2
05 0 5.5m 100% 120.0 0.0m -- 120.0 0.0 120.0 65.5 84% 94%
06 0 9.5m 100% 37.9 0.0m -- 18.9 18.9 37.9 37.9 87% 92%
07 0 3.5m 100% 51.4 1.0m 0.0 51.4 0.0 51.4 68.6 89% 94%
08 0 21.0m 100% 17.1 0.0m -- 14.3 2.9 17.1 22.9 88% 94%
09 0 18.0m 100% 63.3 0.0m -- 50.0 13.3 63.3 60.0 85% 95%
10 0 28.5m 100% 4.2 18.5m 6.5 4.2 0.0 4.2 6.3 93% 95%
11 0 26.0m 6% 0.0 1.5m 0.0 9.2 2.3 11.5 30.0 88% 95%

MOVEMENT DATA:
No abnormal behavior was noted. There were 17 periodic limb movements during sleep, resulting in a PLM-index of 5.2. Of these, 1 movements were associated with arousals, resulting in a PLM-arousal index of 0.3

ECG DATA:
The average heart rate during sleep was 68 beats per minute, with a range of 64 to 82. During wake, the heart rate ranged from 64 to 101 beats per minute.
No arrhythmias were noted.

ICSD DIAGNOSIS:
Obstructive Sleep Apnea Syndrome [G47.33]
Emergent Central Sleep Apnea [G47.37]

IMPRESSION:
1. Severe obstructive sleep apnea. Note that the baseline apnea-hypopnea index may have been underestimated due to the baseline portion of this study. Respiratory events were associated with oxygen desaturations to a nadir of 80%.
2. At none of the tested PAP settins was the patient's apnea-hypopnea index absolutely normalized due to the presence of residual supine and REM related respiratory events. In addition central events were present raising concern for possible complex sleep apnea, or possibly were due to the lack of acclimation to PAP therapy prior to this study.
3. Abnormal sleep architecture likely due to respiratory events, PAP titration,, medications, and first night effect.


RECOMMENDATIONS:
1. As the AHI was not absolutely normalized, and as there was the presence of central respiratory events, recommend the following: return to the sleep lab for a full night titration study starting at 10 cmH2O and during which there
should be a low threshold for transitioning to bilevel therapy if persistence of central respiratory events is observed during the titration study.
Last edited by ShallowBreather on Mon Apr 25, 2022 2:06 pm, edited 1 time in total.
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