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.

I recently brought to my doctor's attention that there seems to be an inverse correlation between masks leaks and AHI events. More specifically, I took five days with the highest AHI's and five days with the lowest AHI's and I found out that in all five sample-days the lowest leaks ( under 20 l/m) invariably yielded higher or higher -than -my-average AHI's ( 3-7 AHI's) while, conversely, the occasional highest leaks ( 30-70 l/m ) yielded AHI's within my usual low average ( less than 1.5).

The doctor found my observation very pertinent ( he qualified it as "intelligent.."). In fact he evinced from the Resmed report that, no matter my low average AHI rate, often my air ways are still obstructed more than they should and gave me a prescription to increase the CPAP air pressure from 9-15 to 12-16. He said this would take care of the occasional slight head=aches and sweating at wake-up, caused by the AHI's.

He then went on to explain that the airway obstruction creates a pressure build-inside the mask and the machine reacts by automatically evacuating the excess pressure as a mask leak.

This explains the occasional high-leaks, but not the inverse correlation. In fact I would have thought that the airway obstruction should always yield a high-leak rate. He tried to explain this over the phone, but it was getting a bit technical and we were short of time. Can anybody comment on this?

Thanks

Ittiandro

Thanks

It is an Air Sense 10 autoset, full face mask You speak of pressure above 24 l/min. I was speaking of air leaks. Is it the same thing? In fact my "pressure cannot go higher than 15 psi, because the machine is set between 9-15 psi. Also, I get the full data report from the SD with Oscar and the AHI are always recorded even when the leaks are above 24 l/m. Whether they are accurate or not, I don't know, but they seem to be consistent with the overall pattern of the last eight month. Thanks

Ittiandro

Hi I have been on treatment for Sleep Apnea for about 8 months. My AHI are now dramatically down to around 1.6 or less , but sometimes, lately, my air pressure leaks go up to 35 l/min., sometimes, very occasionally, even 50 l/m Should I worry, if the AHI readings are good? THe only reason I ask is that I fear that high air leaks in the long run may cause the compressor to overwork and shorten the life of the machine Lately the velcros on the straps come off. They don’t hold as they used to, because the material of the strap is too smooth and does no longer offer the same grip as before. No doubt a bit cheap. I stitched on new, better velcros and now the mask hold pretty well. In spite of this, there still is, more often than not, a hissing air sound coming off the Resmed mask silicone seal. I’d hate to think that it is worn out after only eight months ( unless there is an obsolescence factor deliberately built in the product by the manufacturer..)

I’d appreciate your comments

Thanks

Ittiandro

Hi, I am 79 and I have been diagnosed with severe Sleep Apnea last May ( 40 AHI/min.) Now I am down to about 2 AHI/min , after wearing a CPAP mask for three months..The doctor says I'm OK now and I'm relieved.. I’d have liked to discuss a few more details with the doctor, but he was busy and we had no time...Sometimes doctors are rather dismissive as they think we are too dummy to understand and to ask the right questions..…

Here are my questions, 1.What is the max acceptable leak rate? My avg has been 4.37 l/min over one week. 2.What is the Large Leak threshold? Out of 8 readings, 5 were between 0.00-0.17%, one at 0.88%, one at 6.79% and one at 33.88%.. 3,Respiration rate : in my case, it averages at about 21-22 l/min (95%) with occasional peaks of 30-32 l/min. I have read it should be 12-20 l/min . What does it mean?

Can you comment on this, please?

Thanks Franco

Thanks so much

Hi, once the sleep reports have been imported and opened with Oscar, is it possible to save them as a file attachment to be e-mailed , instead of printing them ? Probably my recipient ( the doctor) does not have the Oscar app to open them. Also It would save time, ink and print paper.

Thanks

Ittiandro

Just a few thoughts

From my Resmed SD reports I have been able to learn a few interesting things ..Of course the number of AHI/hr events gives a good, overall indication of the sleep quality.

The doctor told me that my AHI score went dramatically down from 30-40 AHI/hr to an average of 2. ( Strangely, though, I never had any symptoms before going on treatment, but I have them now, because I feel more sleepy and sluggish than before..) . All this sounds great..

The point I am making, though, is that I see from the SD reports that the AHI rating is like an umbrella which includes other sleep apnea parameters like OSA, hypoapnea, clear airway and RERA, each one going with its own number of events into the total number of AHI's./hr : for ex. OSA, which is a total airway blockage, is, I believe, more serious than hypoapnea, which is only a restriction of the airway and does allow the flow of air. The RERA. events, too, can be as serious and as damaging ( especially for the brain) as OSA.

All this to say that the sane AHI rating could have a different clinical significance depending on the mix OSA, Hypoapnea, RERA and Clear Airway.
In my report, there were also instances of a Cheyne-Stokes respiration pattern. I know what it is. I mentioned all this to my doctor, but he politely scoffed everything off, like I was a..smart ass. All he said was " Don't worry, you are doing well,., As I said before, I am not too sure I'm doing better than before ..May be he just went by the number of AHI's, without looking at the details of the reports..

Ittiandro .

Thank you so much , Sierra. Oscar works very well. I have been able to view all my sleep reports. Of course they confirm what the doctor told me, but it is always nice to see the details. Ittiandro

Hi I am unable to download the Resmed PC App. to read the detailed reports from the SD card of my CPAP. When I try to create an accouint they keep telling me that the e-mail address is wrong, but it is correct. I tried 4 times! I suspect these reports are not available in all the countries. I am in Canada. or may be they are only for medical personnel. I can only access the daily summary reports with the My Air App, but they are too skimpy. Is there any other app I can download somewhere else to read the SD card?

Thanks

Ittiandro.