New User - CSR in Oscar

andy2024 · Post by **andy2024** » Sat Feb 24, 2024 7:05 pm

Hey all,

Sorry if I have incorrectly done anything with submitting.

I attached my image below. I currently started CPAP therapy 2 weeks ago. Been struggling to stay consistent.

Mostly 2-3 hours max before I wake up and take off the mask (i've tried F30i, N30i, P30i)

Last night I was exhausted and I was able to wear it for the whole night for the most part. Still woke up here and there but I noticed CSR in my Oscar data this morning and am freaking out a little.

I have played around with a bunch of settings to see what will work best for me. I don't have a sleep doctor yet, took a home sleep study for measure me with 5.3 AHI with 17 RDI.

Would appreciate any guidance here on any advice on what I should be doing. Will try to find a local sleep doctor once works slows down soon.

Thank you!

vandownbytheriver · Post by **vandownbytheriver** » Sat Feb 24, 2024 9:35 pm

andy2024 wrote: ↑
Sat Feb 24, 2024 7:05 pm
(snip)
Last night I was exhausted and I was able to wear it for the whole night for the most part. Still woke up here and there but I noticed CSR in my Oscar data this morning and am freaking out a little.
(snip)

Yep, that would freak me out too. I also see lots of CA's, not so many hypopneas, only one RERA.

You may be stripping your CO2 out... EPR 2-3 with these higher pressures tends to oxygenate you more than straight CPAP. Without CO2 in your system your drive to breathe disappears... then you get into a cycle where you starve for O2, then binge, then starve... positive feedback oscillations.

I'd say as an experiment bring down the max pressure and go to EPR 1 or 0. You're probably still in recovery mode from no PAP... and you're not under a doctor's care right now... as you can see flying blind can get to be alarming at times. Hopefully others will chime in here (why are you set to 'for her' mode?) but I say do a night of straight CPAP at 9cm with EPR off... better to have OA's than CA and CSR's IMO. Seeing plenty of flow limitations... are you a back sleeper? Start doing side-sleeping if you can... the FL's are what drives the pressures up, many of us have positional OSA, supine is the worst position.

And by all means get a doctor involved. And stick around here, lots of help available.

andy2024 · Post by **andy2024** » Sat Feb 24, 2024 9:57 pm

vandownbytheriver wrote: ↑
Sat Feb 24, 2024 9:35 pm

Yep, that would freak me out too. I also see lots of CA's, not so many hypopneas, only one RERA.

You may be stripping your CO2 out... EPR 2-3 with these higher pressures tends to oxygenate you more than straight CPAP. Without CO2 in your system your drive to breathe disappears... then you get into a cycle where you starve for O2, then binge, then starve... positive feedback oscillations.

I'd say as an experiment bring down the max pressure and go to EPR 1 or 0. You're probably still in recovery mode from no PAP... and you're not under a doctor's care right now... as you can see flying blind can get to be alarming at times. Hopefully others will chime in here (why are you set to 'for her' mode?) but I say do a night of straight CPAP at 9cm with EPR off... better to have OA's than CA and CSR's IMO. Seeing plenty of flow limitations... are you a back sleeper? Start doing side-sleeping if you can... the FL's are what drives the pressures up, many of us have positional OSA, supine is the worst position.

And by all means get a doctor involved. And stick around here, lots of help available.

That makes a lot of sense, so turn of the Auto portion of the machine?

I was just experimenting to see if I can get any setting to make it feel more comfortable. It sometimes feels a little suffocating and I get the feeling like I'm not getting enough air.

I sleep on my side initially but I tend to roll around a lot in my sleep.

Thank You! For the advice I will find a doctor ASAP, been pushing off due to time.

vandownbytheriver · Post by **vandownbytheriver** » Sat Feb 24, 2024 11:06 pm

andy2024 wrote: ↑
Sat Feb 24, 2024 9:57 pm
That makes a lot of sense, so turn of the Auto portion of the machine?
(snip)

Yes... sorta. The pressure will climb to fight Flow Limitations... it's not going sky high, but less variables now the better. IMO you're over-treating... what with those CA's and CSR. Baby steps... just turn off EPR and try a night. If you can't exhale lower your start Min IPAP. If you wake up because pressure climbed due to FL's bring that pressure down some... you're still getting used to pressure. Not familiar with the masks you listed, I like big masks that flow lots of air, pillows are not for me... big nasal or FF mask what I like... any resistance makes me feel starved, panicky.

Are you female? You have a female-tuned algorithm set... not sure you realize that. Your upper limit is 14cm, you didn't hit that, and evidently slept through the peaks... that may be different with EPR off.

Turning off EPR will bring your O2/CO2 back in balance... If you think you can stand the 12cm try it... lower it to what you can stand on exhale... you are having FL's, but the CA/CSR is alarming to me. Good luck, keep us informed.

andy2024 · Post by **andy2024** » Sat Feb 24, 2024 11:16 pm

Are you female? You have a female-tuned algorithm set... not sure you realize that. Your upper limit is 14cm, you didn't hit that, and evidently slept through the peaks... that may be different with EPR off.

I am not, just seen that it might be helpful to some males? Though seeing conflicting stuff online if it actually does anything. Just tried it last night with this.

Will try what you suggested. Almost all my nights so far I get maybe -0.2-2% OA at while CA 's hover between 3-8%.

Will definitely try what you mentioned and keep going. Will follow up when I get more results! I really appreciate the help

zonker · Post by **zonker** » Sun Feb 25, 2024 12:40 pm

andy2024 wrote: ↑
Sat Feb 24, 2024 11:16 pm

Are you female? You have a female-tuned algorithm set... not sure you realize that. Your upper limit is 14cm, you didn't hit that, and evidently slept through the peaks... that may be different with EPR off.
I am not, just seen that it might be helpful to some males? Though seeing conflicting stuff online if it actually does anything. Just tried it last night with this.

don't think because it's "female-tuned" that a man can't use it. we cpap using folks have a lot of tools in the drawer and may as well use one when we find it. in this case, using the "for her" algorithm won't hurt anything and may just help!

Pugsy · Post by **Pugsy** » Sun Feb 25, 2024 12:50 pm

I have my doubts as to whether that flagged CSR is really CSR. Not enough centrals in the flagged CSR portion.
Can you zoom in on the CSR section??? Like maybe a 5 minute section from the very beginning where a couple of centrals were flagged.

You need a LOT more CSR flagged segments and a LOT more centrals within the flagged segments and you need a very specific breathing pattern for it to be real CSR. Not everything flagged as CSR is real CSR and thus nothing to worry about.

andy2024 · Post by **andy2024** » Sun Feb 25, 2024 4:08 pm

Pugsy wrote: ↑
Sun Feb 25, 2024 12:50 pm
I have my doubts as to whether that flagged CSR is really CSR. Not enough centrals in the flagged CSR portion.
Can you zoom in on the CSR section??? Like maybe a 5 minute section from the very beginning where a couple of centrals were flagged.

You need a LOT more CSR flagged segments and a LOT more centrals within the flagged segments and you need a very specific breathing pattern for it to be real CSR. Not everything flagged as CSR is real CSR and thus nothing to worry about.

Here is it zoomed in a bit.

Also new one from last night but I think my masks magnet came undone towards the middle of my sleep.

A little confused, I started it at the beginning before I got to bed and just put on some TV but even while awake I have CA's?

andy2024 · Post by **andy2024** » Sun Feb 25, 2024 4:16 pm

don't think because it's "female-tuned" that a man can't use it. we cpap using folks have a lot of tools in the drawer and may as well use one when we find it. in this case, using the "for her" algorithm won't hurt anything and may just help!

Really just trying anything. Back in college, I was sleeping around 8-11 hours a day and still feeling groggy for the most part. I had a sleep study done and only slept an hour or two but the Doctors mentioned there was no need for another one and I had an AHI < 5 and with my age and weight, they just couldn't believe it is sleep apnea so they just gave me some anti-depressants.

Never really got better, snore really loud for 1-3 hours a night.

6 years later did another sleep study test but this time at home with Lofta to hopefully sleep through the whole night using my own bed. Actually hoping it was Sleep Apnea just to figure out what is freaking wrong with me.

Here were my results - Obstructive Sleep Apnea (G47.33) - Mild to Moderate based on pAHI=5.3, pRDI=17.4 and O2 nadir of
89%

I've been feeling better some of the days, I think. Some other days I still feel tired waking up,

Honestly just want to wake up and not feel like I'm fighting myself to get out every day. Recently moved to a new city, really need to find a doctor here but keep putting it off cause of work deadlines but I think I'll start setting some boundaries on the hours I put in

Pugsy · Post by **Pugsy** » Sun Feb 25, 2024 5:01 pm

andy2024 wrote: ↑
Sun Feb 25, 2024 4:08 pm
A little confused, I started it at the beginning before I got to bed and just put on some TV but even while awake I have CA's?

The machine only measures air flow....it has zero way to know if you are awake or asleep.
It only measures breathing and our awake breathing is irregular when compared to asleep breathing and the machine can and will flag those awake breathing irregularities in air flow as some sort of apnea event. The machine just calls them like it sees them but sometimes what it is seeing isn't real asleep breathing.

Doesn't matter because awake flagged anything doesn't count. You MUST be asleep for it to matter. You have to ignore anything flagged when you weren't asleep.

Your zoomed in segment of CSR....that's not real CSR and I have my doubts as to whether you were even asleep.
Quit worrying about CSR....you don't have a problem with centrals or CSR.
Instead concentrate on just getting good sound sleep.

Now this person....he had bad CSR and also was in heart failure as well. He had a problem. I think you can see that his CSR pattern is very different from yours.

andy2024 · Post by **andy2024** » Sun Feb 25, 2024 10:16 pm

Pugsy wrote: ↑
Sun Feb 25, 2024 5:01 pm
Your zoomed in segment of CSR....that's not real CSR and I have my doubts as to whether you were even asleep.
Quit worrying about CSR....you don't have a problem with centrals or CSR.
Instead concentrate on just getting good sound sleep.

Thank you for the reinsurance! I definitely will, just gotta stay consistent.

Appreciate all of y'all who gave advice in here. Looking forward to getting better with the cpap treatment

New User - CSR in Oscar

New User - CSR in Oscar

Re: New User - CSR in Oscar

Re: New User - CSR in Oscar

Re: New User - CSR in Oscar

Re: New User - CSR in Oscar

Re: New User - CSR in Oscar

Re: New User - CSR in Oscar

Re: New User - CSR in Oscar

Re: New User - CSR in Oscar

Re: New User - CSR in Oscar

Re: New User - CSR in Oscar