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ittiandro

ittiandro
Joined Oct 2020
ittiandro
Joined Oct 2020

HI Thanks for your comments and explanations. I am sending a couple more daily reports after the pressure change to 12-16. Those I have previously sent are perhaps not as representative, because they are way off my average in terms of AHI. I sent them in case you see something standing out. It is the first time that my AHI’s keep under ONE for two consecutive days. May be it is a sign of improvement. Regarding the “pressure plots disabled”, I have now restored the setting to default as per your instructions. I have also upgraded to Oscar 1.2. I am unable to turn off the EPR, though. This option does not seem to be included in the Preferences, but I prefer not to play with this setting. I’ll just wait to see if there is any improvement after increasing the pressure. I have also checked the CSR issue. The Stats show an incidence of 0% over the last 30 days and 0.11% over the last 6 months. I don’t think I should worry. From what I begin to understand, there may be some interesting clues in the Flow rate, the Flow limit and the Minute Ventilation graphics, but all this is kind of nebulous for me at this stage, because the analysis of these parameters involves a good understanding of technical and physiological issues. It is really a fascinating issue, even more so that it is about my health and I hold dearly to it.

Here are the reports. The 2nd one won't go through o. Thanksn the same post. I'll send it separately

Thanks I am on PC, Windows 10 32-bits. Here are some more points.

1.The term AHI is, from what I understand, an umbrella term including a variety of apnea events, like O.A, Hypoapnea, Central Apnea and others. To be able to identify them individually is essential, but if Resmed, to this purpose, removes the AHI’s from the report in case of large leaks, will these individual apnea modes be still traceable? If not, won’t the reports be unreliable, if they don’t show the correct number of AHI events?. It is a bit like deleting a folder from the computer: all the files it contains will also be gone.

  1. Your comments have been invaluable, also because they have led me to look into the differences between the various apnea events, like Central Apnea, Obstructive Apnea, Hypoapnea, etc.
    I don’t have, though, a clear appreciation of their impact on the patient’s sleep quality and, ultimately, on his/her health. .

I’d would think that OA has perhaps the greatest impact, but perhaps other apneas are just as important..

My AHI’s have drastically gone down, in the average, to well under 2 /day over one year. . Sometimes there is none and sometimes, very rarely, they spike to 6-8 in one night. Looking at my reports, I found that the OA’s represent about half of my AHI’s. and this raises a few questions.

Of course, if the AHI’s for the night are down to one or less, the OA component becomes insignificant. When, however, the AHI’s are six or eight and half of them are OA’s, I wonder if there isn’t a more serious impact on health.

The report of 12/22 , which I will attach as soon as I know how to do it, shows for example 8.47 AHI’s, of which 7.02 ( practically 90%) are OA’s. Considering the TTIA for the night ( about 20:min), each OA had a duration of 2.85 min. A lot! . Of course, I didn’t stop breathing foe almost 3 min, or I’d be dead, but 20 min. of OA’s events shouldn’t perhaps be underestimated. This may be why my doctor has decided to increase the pressure.

3.I’d also like to have your take about the possible connection between sleep apnea and cardiac arrythmias. Can sleep apnea cause arrythmias?. Two years ago, before being treated for Sleep Apnea, I had an episode of Afib, when I was about to begin my usual 6 km running session . I am 79 and it was the 1st time. The cardiologist put me on betablocker ( Metaprolol) as a precaution, but I had a 2nd episode a few days ago, with the pulse briefly shooting up to 160 bpm, with absolutely no discomfort, though.
I spoke to the doctor again. In the meantime my heart had gone back to normal, except that I have a lingering arrhythmia, with the pulse fluctuating between 90-110 bpm ( it usually is 60 bpm at rest ) , It doesn’t go away. I don’t even feel it and I can detect it only with the cardio watch, but it is still there. If it it doesn’t go away, I’ll speak to my doctor again, but I wonder if arrythmias are an expected… byproduct of Sleep Apnea.

Thanks for your input, as usual

Ittiandro

Hi thanks for your reply and your offer to review some of my Oscar reports. I don’t know how to attach them, though. I have no IMAGE files for them, only PDF documents. If you want, I can e-mail them to you. Or you can give me instructions. In the meantime, I’d like to comment briefly on your reply, with a few questions, so that I can better understand how to read the reports . It is fascinating, but a bit challenging as I am neither a doctor, nor a technician with biomedical background ( I can read much more easily… ancient Greek than matters pertaining to medical technology ..) First off, I have compared both the Oscar and the ResMed reports . Indeed, that inverse correlation holds for both. You were right, there are no AHI’s in the report for the hourly time windows of the large leaks. Why so ? How reliable then are these reports if they miss some AHI’s? . Let me say, though, that I find it difficult to understand why both Oscar and ResMed should exclude from the count the AHI’s occurring when the leaks are large. Why should these AHI’s be of a lesser value in the overall clinical appraisal of the report, to the point of ignoring them? In fact, I find it a bit intriguing that my doctor would want to increase the pressure setting in spite of the very low AHI readings. I simply told him that occasionally I still wake up in a light sweat and a slight head ache. So he must have sniffed something else, in spite of the very low number of AHI’s. … May be I misunderstood the explanation he gave me, which you yourself question, but my doctors’ explanation went at least some way to explain the correlation, rather than simply saying that both Resmed or Oscar have deliberately designed the reports to ignore AHI’s when the leaks are large. If so, the question is, again, why? Perhaps there is a scientific explanation.... Secondly, why do you say that in the 2nd report with large leaks that you zoomed on there must be some AHI’s that are not shown?
Thirdly, I assume that perhaps the duration of the AHI’s is more important than their number, but where is the duration of each AHI occurrence ( or the total duration) shown? Lastly, in my reports which you will hopefully receive, the mask pressure graphic shows as “plots disabled “ Why ?

You may want to have a look at these issues. I’d really appreciate.

Thanks

Franco V.