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Can't see correlations
#1
Looking at these graphs reminds me of reading tea leaves.

Trying really hard to understand what's going on here, but can't see how the various measurements relate to each other.

For all these nights, used the same mask - P10. Clean pillows every night, washed headgear every 6 days. Same chinstrap every night.

Settings were changed - which is another variable for which I can't discern the effects.

Are there other variables that are in play here that I'm not seeing? Or just that I don't understand how these measurements relate to each other?

   

   
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#2
I find the data more useful when looking at the high rate data for a single night.
From that, I can see how flow limitation and snore are precursors to OSA.
I can also see if my pressure is maxing out.

On a day to day basis I compare mentally how each night differs.
[Image: pBt22Od.jpg]
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#3
justMongo, that's another strange thing -- my OSA tends to be quite low, but hypopnea is often frequent.

So, still napping once or twice a day. Those AHI rates are almost all above 5. I'm not new to CPAP, although the machine is new, so don't understand why my AHI is still so high. It's the hypopneas that push it up, I'm sure.
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#4
(04-29-2015, 11:17 AM)AirSign Wrote: justMongo, that's another strange thing -- my OSA tends to be quite low, but hypopnea is often frequent.

So, still napping once or twice a day. Those AHI rates are almost all above 5. I'm not new to CPAP, although the machine is new, so don't understand why my AHI is still so high. It's the hypopneas that push it up, I'm sure.


AirSign,
If you would do a screenshot of the daily graph page, the one that shows events at top for a single day, including pressure graph, snore graph, flow limitation, and the chart to the left of the graphs. This is what is needed to answer your questions.
Smile
OpalRose
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#5
OpalRose, I hope this is what you're asking for, but, when I made changes based on the one 4 days ago, I'm getting almost the same profile. I had to remove that one because this would have pushed me over the attachment limit.

Why, over 2 weeks, with attempts to control as many of the variables as possible, is there so much variation in the AHI, with a reading below 5 only twice?

I did notice that raising the starting pressure to 9 means that I seem to have a lot more leaking at the nasal pillows than before, or at least that I'm hearing it more. Even with using water-soluble sealing, every time.


   

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#6
AirSign,
Did you have that many CA events before you raised your pressure? You can click the calendar to compare different days.

When I would change my pressure, I got a notebook and wrote down the changes I made. It is easier then to compare the graphs and data day to day.

I do see the high leak rate. One was around 3:00 am when you got up, wouldn't worry about it, but it looks like you had leaks going on all night. If you have a lot of high leaks, the data may not be accurate. You need to do what you can to control those leaks.

It doesn't look like your pressure (on this day) is maxing out. You may possibly be one of those people
that will get CA's with higher pressure, so need to watch that.

Hang in there, hopefully someone else will look at your graphs and give a different perspective than I
can. I know it's frustrating, but you've only been at it a short while.

Just noticed you said your not new to CPAP, just a new machine. What were your readings like on the machine you had prior?
OpalRose
Apnea Board Moderator
www.ApneaBoard.com

How to Organize and Post ScreenShots

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#7
(04-29-2015, 02:14 PM)OpalRose Wrote: AirSign,
Did you have that many CA events before you raised your pressure? You can click the calendar to compare different days.

When I would change my pressure, I got a notebook and wrote down the changes I made. It is easier then to compare the graphs and data day to day.

I do see the high leak rate. One was around 3:00 am when you got up, wouldn't worry about it, but it looks like you had leaks going on all night. If you have a lot of high leaks, the data may not be accurate. You need to do what you can to control those leaks.

It doesn't look like your pressure (on this day) is maxing out. You may possibly be one of those people
that will get CA's with higher pressure, so need to watch that.

Hang in there, hopefully someone else will look at your graphs and give a different perspective than I
can. I know it's frustrating, but you've only been at it a short while.

Just noticed you said your not new to CPAP, just a new machine. What were your readings like on the machine you had prior?

[Image: pBt22Od.jpg]
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#8
Previous machine was a RemStar Model M and did not have the data. There is a credit-card in it, but when the MD read that in Encore [?] really all that was available was compliance data.

So this is the first time since this year's sleep study that I've had any information.

On the Jan 2015 titration study, interrupts went up at Pressure 11 then back down at Pressure 13. There's no record of 12. Clip of that is attached.

As for keeping a notebook, Sleepyhead already keeps a record of the changes to the settings which I can see on the Statistics page. I've included a clip as the 2nd image in my first post on this thread.

To answer your question, OpalRose, the CA [Clear Airway??] events were mostly 8 or 9 before the last changes to raise the start-up pressure and lower the EPR from 3 to 2. For the past 3 nights, they have been 16, 21, 23 in that order.

Have been using the same P10 mask, with the same routine, all the time. And, the same chinstrap. Why would I suddenly start having leaks? Unless it's got something to do with the settings.

Dont-know




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#9
I'll have to review what you might have said in other posts, but from your overview I saw a distinct difference when you raised your start pressure, and regard it as positive - OA scores went way down (nice). You left plenty of room for pressure to increase if it needs to.

You now have several more days at the setting. Have the CA scores continued or subsided?

You may want to also review your TTIA (total time in apnea) in your overview as well. You may have increased the number of events, but each one could be shorter, resulting in less total time.

From the one day, the CAs looked like they come in clusters, the large leaks also seem to be confined to certain periods.

Large leak. My guess is that you probably purposely overpowered your chin strap and did mouth breathing during the large leak periods.

Higher CAs. You may not have been asleep during the periods of multiple CAs, although you probably were (asleep) if the individual CAs are in excess of 16 seconds. If you are getting mostly longer CAs, then the more likely cause is some sort of hyperventilation possibly related to transitioning to REM sleep.

Some support for the "CAs related to REM transition" theory is seen in your titration study - the periods at 10, 11, and 13, your oxygen minimums went down to 82 thru 84. All of those periods contained some REM sleep.

To sum up, it looks like you are doing good. Relax, and enjoy the sleep.

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#10
AirSign, here is an alternate way to post graphics that will not be limited by the forum size or attachment limits: https://sleep.tnet.com/reference/tips/imgur

I'm in agreement with QAL, however I think you should experiment with reducing your EPR (exhale pressure relief) from 2 to zero or 1. The reason central apneas and hypopneas can occur is a low CO2 residual in your body that may reduce respiratory effort. EPR has the effect of improving ventilation, and in some people that can cause centrals. Reducing EPR is a worthwhile experiment to see if it affect your comfort, and if it improves CA and H events.

Overall, I think you're doing well to start, and controlling leaks should be your priority.
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