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24 AHI Pie Charts: Trying to understand where I Am
#11
Spy Car, those pie charts are deceiving in that your AHI number is so low that even wide variations in the pie chart is still just a little change. From a treatment point of view-you are done, in that the apneas are controlled. HOWEVER...

Being comfortable with that treatment is a whole other issue and this seems to be what is going on in your case. Your sleep cycle is being disturbed and you/we need to figure out what that is. It can be:
1. that you just need to relax and get used to CPAP
2. humidity is not set to what you like best
3. you are having some difficulty exhaling into pressure
4. the hose is pulling on the mask and you need better hose management
5. the mask is leaking enough to bother you
6. the mask is too tight and bothering you
7. the starting pressure is a little too low (sometimes by only one cm) and that is bothering you
8. you are feeling congested
9. well you get the idea, lots of things that are personal to you and your experience with CPAP.

We can look for things in the more detailed plot, but nothing in the pie charts will lead us to which to look at. show us one and lets start the hunt. Get in tune with how you feel when using CPAP, none of this is "normal" and we need to focus on what is happening and what that means in relation to CPAP. Congestion may just be the pressure that used to mean congestion.

There are many adjustments on these machines and the next level machine has many more to try. Adjust them slowly, keep a journal as to what you did, how you felt, how long you slept, how often you got up.... so you can track down your personal right settings. Then talk with us as you go and we can share what we have found that might help.
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#12
(09-12-2016, 06:52 PM)PoolQ Wrote: Spy Car, those pie charts are deceiving in that your AHI number is so low that even wide variations in the pie chart is still just a little change. From a treatment point of view-you are done, in that the apneas are controlled. HOWEVER...

Being comfortable with that treatment is a whole other issue and this seems to be what is going on in your case. Your sleep cycle is being disturbed and you/we need to figure out what that is. It can be:
1. that you just need to relax and get used to CPAP
2. humidity is not set to what you like best
3. you are having some difficulty exhaling into pressure
4. the hose is pulling on the mask and you need better hose management
5. the mask is leaking enough to bother you
6. the mask is too tight and bothering you
7. the starting pressure is a little too low (sometimes by only one cm) and that is bothering you
8. you are feeling congested
9. well you get the idea, lots of things that are personal to you and your experience with CPAP.

We can look for things in the more detailed plot, but nothing in the pie charts will lead us to which to look at. show us one and lets start the hunt. Get in tune with how you feel when using CPAP, none of this is "normal" and we need to focus on what is happening and what that means in relation to CPAP. Congestion may just be the pressure that used to mean congestion.

There are many adjustments on these machines and the next level machine has many more to try. Adjust them slowly, keep a journal as to what you did, how you felt, how long you slept, how often you got up.... so you can track down your personal right settings. Then talk with us as you go and we can share what we have found that might help.

I actually feel pretty comfortable with the treatment. The ResMed machine is quiet, and I don't mind mask and set-up.

I'm still looking for the most minimal mask possible, and hopefully tomorrow I'll be able to order a P-10 pillow style to try. I don't mind the Wisp nasal.

I'll try to answer a few concerns from your list above:

1) I feel pretty relaxed about using A-CPAP. Zero anxiety.
2) Humidity is at 5. Seems comfortable.
3) The feature for exhaling is set to 3 so little exhale pressure (the way I like it).
4) No problems with hose.
5) Mask seals have been pretty good.
6) Mask not too tight
7) Don't know about the best starting pressure; 4 is comfortable for me.
8) Not congested
9) Still waking up tired.

Bill
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#13
(09-12-2016, 02:23 PM)Spy Car Wrote: How does one determine how to narrow the window, and in which direction first?

Look at your pressure graphs and statistics. See how high the pressure goes and set the max just above that. See how much pressure it takes to eliminate most of your obstructive events and set the min just below that.


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#14
(09-12-2016, 07:32 PM)Spy Car Wrote: I actually feel pretty comfortable with the treatment. The ResMed machine is quiet, and I don't mind mask and set-up.

I'm still looking for the most minimal mask possible, and hopefully tomorrow I'll be able to order a P-10 pillow style to try. I don't mind the Wisp nasal.

I'll try to answer a few concerns from your list above:

1) I feel pretty relaxed about using A-CPAP. Zero anxiety.
2) Humidity is at 5. Seems comfortable.
3) The feature for exhaling is set to 3 so little exhale pressure (the way I like it).
4) No problems with hose.
5) Mask seals have been pretty good.
6) Mask not too tight
7) Don't know about the best starting pressure; 4 is comfortable for me.
8) Not congested
9) Still waking up tired.

Bill

No problem. You answered your own question.
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#15
I am about six months in, still wake up tired, and use OS X. I suspect the last two are not related. Grin

I am still actively working to figure out what it is. I think I have ruled out choking myself to death. But it could be this or something else:
- medications like anti-depressants
- temperature
- leg/limb movements
- bed partner
- respiration based sleep disturbances that don't correlate to AHI (UARS, RERA)
-hormones
- stress/anxiety

I could go on. My point being that treating sleep apnea eliminates one cause of unrestful sleep, it does not necessarily eliminate them all. Keep at it, keep badgering your doctors.
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#16
Yesterday I moved my preset range from 4-20 up to 5-20. Minor change.

I'm attaching a screen grab from SleepyHead from last night. Looks like 4 hours in I had a bathroom break.

I really appreciate any input on how this data is understood by those with experience.

[Image: 09_14_16Daily.jpg]

Bill


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#17
I see some pretty labored breathing when your machine is at minimum pressure 5/4, and it seems to even out as pressure increases. Not easy to see at that scale, but large tidal volume moving against low pressure does stand out. A huge snore and flow limit event when you resume treatment after the break, again at minimum pressure. With your EPR set at 3.0, you would probably be better starting at 7/4. I'd be very surprised if you found that uncomfortable, and it would really stabilize your treatment during the night. It may or may not decrease AHI, but all that pressure bounce doesn't look like fun to me.
______________________________________________
Organize your SleepyHead Data
Post your SleepyHead Data from Imgur
Robysue's Beginner's Guide to Sleepyhead
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#18

I agree with justMongo start pressure should be just below the average pressure plotted over several weeks.

It may creep up on you after you first raise it, but don't worry because It will stabilize.

My average runs around 13.2 and I have my start set @ 12.6

2004-Bon Jovi
it'll take more than a doctor to prescribe a remedy

Observations and recommendations communicated here are the perceptions of the writer and should not be misconstrued as medical advice.
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#19
(09-14-2016, 05:10 PM)Sleeprider Wrote: I see some pretty labored breathing when your machine is at minimum pressure 5/4, and it seems to even out as pressure increases. Not easy to see at that scale, but large tidal volume moving against low pressure does stand out. A huge snore and flow limit event when you resume treatment after the break, again at minimum pressure. With your EPR set at 3.0, you would probably be better starting at 7/4. I'd be very surprised if you found that uncomfortable, and it would really stabilize your treatment during the night. It may or may not decrease AHI, but all that pressure bounce doesn't look like fun to me.

So I'm clear, 7/4 means 7 is the minimum pressure setting and there is ramp up? I can reset for tonight if that's your suggestion.

Really appreciate the help!

Bill

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#20
(09-14-2016, 05:11 PM)0rangebear Wrote: I agree with justMongo start pressure should be just below the average pressure plotted over several weeks.

It may creep up on you after you first raise it, but don't worry because It will stabilize.

My average runs around 13.2 and I have my start set @ 12.6

In my summary, the average pressure over the last month appears to be 7.2.

Bill
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