Sleep Woes-Need help with Oscar results

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When is the last time you saw your regular primary care doctor?

When was the last time you saw a sleep doctor?

Last saw him last September 2019. Next appointment is Feb 19th this year. Seen a tech and doctor last visit and it seems to me all they want to do is change pressure but will know better next month.

I am concerned about the centrals until a doctor says they aren't anything to worry about.
Mainly because of your AFib history. It may be nothing more than idopathic (no known cause) but I am not comfortable pooh poohing them off totally until your doctor is okay with pooh poohing them off.

It appears that you may need a lot more pressure to deal with the obstructive stuff as well which might mean a different machine.
Would they want to make that machine something that could also deal with centrals when they happen????? Good question that I don't know the answer to. If it were me...that is what I would want.

You need to make the doctors pay attention to your complaints and not be so dismissive. Those centrals won't be fixed with more pressure from your machine and I don't think the CSR stuff is triggered by the obstructive stuff...meaning if we could kill the obstructive stuff better that the centrals would go away. You have centrals even without obstructive stuff happening.

You could try more pressure again and see what happens but if end up like you did with the last try at 17...I don't know what else to offer.
We have about exhausted my basket of ideas.
With your history of AFib...makes me really cautious about coming up with some out on the limb ideas.

Do you happen to have a DreamWear mask of some sort in your box of masks?

I understand. In answer to your question yes I have a dreamware mask (nasal Cushion) but I was getting much worse results with it compared to now with the Airtouch. It wasn't till I switched to full face mask that my numbers went down a considerable amount. I was getting ahi of 25-45 with dreamware.

Do you happen to remember at what pressure you were using when you used the DreamWear???
Was the AHI mainly central or mainly obstructive?

Well I just went to some old data and I got up to 15 pressure before switching to FFM. My biggest problem was air leaks with the Dreamware. As far as Centrals went it looked like pretty steady at 1. whatever to 3.00 events. Obstructive was really high which I thought was because of the air leaks.I do not want to take up all your time but you have been helpful to me.

You aren't taking up all my time so don't worry about that.
I am just frustrated that I am out of ideas to help you out. There is so much that I don't know and have no way of knowing about what is going on with you. I don't want to suggest something that might harm you in anyway.
The intermittent central clusters....I have seen worse but that doesn't mean I want to ignore yours.
I was so hoping that stopping the EPR would be a nice simple solution.
I do know (chatted with a sleep tech once about it) that sometimes people just get central clusters like yours randomly and no one has ever really figured out why so they shrug their shoulders and move on.
I can't advise that though because that's really something a doctor should do only after he was done a thorough investigation of his own.

I was asking about the pulse oximeter because I was thinking maybe wear it and see if your oxygen levels drop when the centrals get really ugly...but you don't have one and even if you did you never really know when they will pop up so that means you would have to wear it every night until they came back.
It might be reassuring to know what your oxygen levels are doing if they are holding up well and if they aren't holding up well then it would be more ammunition to get the doctors off their lazy asses and do something.

That's about all I can think of at this point to offer.....verify oxygen levels with an overnight recording pulse oximeter. $50 to 100 will get you a decent one that will work with OSCAR/SleepyHead.

If anything else pops into my brain I will share it.

I appreciate the candid and lengthy response. The tech at the place where I get my masks etc. said a long time ago that there was something else going on with me. She had said maybe trying BIPAP. When I brought that up with sleep doctor he said no way as that would increase the centrals. What I will try , since I do not see sleep doctor for a few weeks, I will increase pressure in increments to see if that helps. I will try 16.2 tonight then onward from there. The problem I may face at the hospital is sometimes it is just a tech and no doctor and I think they will not be happy with me changing settings on my own. We will see what happens though. Maybe new sleep study but not looking forward to that.