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Comments on Data Please
I'd appreciate insights on the attached data from last night. As mentioned in another thread, there's no consistent pattern yet, but this one is perhaps as typical as they get. There are three or four clusters, the last two being the most dense. Generally speaking, it's clusters that prevent me from breaking AHI of 5. I'm pretty sure some of them occur while I'm awake, but am not sure of that for this scan. Note the bumps of increased respiration. They appear most nights. They usually appear near a cluster, but not necessarily coincident. (I have questions about clusters; saving for another thread.)

I've been on APAP a bit over 2 months now. Getting a bit discouraged that I can't seem to consistently break AHI of 5.

Some supplemental info: The Rx was low pressure=7.5, high=16. (I'd been on low of 7.0 prior to last doc visit; he suggested bump to 8.0, but I said let's go slowly, so he agreed on 7.5) I changed them to 8.0 & 14.5 about 2 weeks ago. SH doesn't seem to recognize that the humidifier is on (bug?). I was on Ambien chronically until about 8 mos. ago, but it did not prevent me from awakening after ~4 hours sleep, and I was not dreaming. No benzodiazepines now, and I dream vividly every night. Also sleep straight through about half the nights. I've also noticed the reduced need for bathroom during night, and perhaps best of all, my refractory systolic hypertension seems reduced (yay!). Feeling somewhat better in AM, but not that carpe diem zip I've been waiting for.

Will be happy to post zoomed data if someone points out a good spot to zoom on. Many thanks for any help,

EDIT - Meant to mention, been with the Dreamwear mask about 4 weeks. It does shift a bit at night, but no consistent major leaks. Prior masks were nasal and ffm, but no dramatic AHI reduction with any mask. Also, I sleep mostly on side, occasionally slipping to supine, and if there's a snore, that's when it's likely to occur. Not ready yet to "go to the tennis ball." Smile


We are such stuff
As dreams are made on, and our little life
Is rounded with a sleep.
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Hi rkl122

I would zoom in on some of the Hypopneas and Centrals. You need to see if the Hypopneas are obstructive in nature or if they are more like periodic breathing. If your Hypopneas are not Obstructive than it might indicate that you have Mixed or Complex Apnea. The sections scored as Periodic Breathing could also indicate more of a residual Central apnea. It seems that your Obstructive Apnea is pretty much under control. You may be a candidate for an ASV machine which can deal with those Hypopneas and Centrals. Post some screen shots of those Hypopneas and Central for more opinions on this.

Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

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In the later part of the night, the H and CA clusters seem to be associated with what is flagged as PB as well. Really hard to call this one. I might try increasing the minimum pressure by .5 increments and observing if it improves the hypopnea or makes it worse. If it gets worse, then I would consider Rich's hypothesis a possibility. If it improves things, then I would continue increases until CA exceeds obstructive events.
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Thanks Rich. How's this:

Uh. Oh. Can't yet post clickable link. And don't want to remove first attachment to make room for second. Any other way for me to post image?*

FWIW, I knew about ASV therapy (from this board) and mentioned it to doc. He dismissed it. Said I didn't need it. If you folks think I do need it, would appreciate best reasons to present to doc.

Thanx, -Ron

*Incidentally, this image posting policy seems a tad strange to me. I understand spam worries, but we noobs are the ones most in need of diagnostic assistance. Oh well....Will try to get my post count up....

This penguin walks into a bar.....
We are such stuff
As dreams are made on, and our little life
Is rounded with a sleep.
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Hi Ron. I haven't seen periodic breathing on an events graph before, so I'll leave that for other people to comment on. It also looks like you're having quite a lot of clear airway events. I don't know much about those, either.

But, for obstructive events, maybe you could post a zoomed-in graph for times around 5:55-6:05 am to look at. Also 2:00-2:10 if you want.

If you click, then drag your pointing device, and highlight that time period on the events graph, it will zoom the other graphs for you.

I was just looking at the response of pressure (or lack of response) on your graph. In the period from 3 am - 4 am, you have four hypopneas and one clear airway event and no pressure response at all. Oh-jeez

I am still learning how the Philips Respironic pressure algorithm works. I know that it doesn't increase pressure if you have a clear airway event.

What I don't know, though, is how the algorithm responds if you have a mix of obstructive and clear airway events in close proximity.

I have the fixed CPAP machine that's similar to yours. I've been running it in auto-trial mode for the last week, and I have also wondered why the pressure isn't going higher. The other thing that I've noticed is that when I get into a cluster of events, if a couple of minutes goes by with no obstructions, the algorithm starts to lower the pressure, and then there's another event.

I don't have the periodic breathing or the clear airway events in my case, but still wondering about the algorithm response in some cases.

Interesting graph.

I put my SleepyHead screenshots on imgur for sharing here.

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Ron...here is the dirty little secret. Just reply and say hi!

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Let's see if a DropBox link works:

Nope. And my zoomshot is too large as an attachment.

Thx Sleeprider and Green Wings. Will mull over your comments. I was going to say the PB is an anomaly because most nights I don't have any, but I just checked, and guess what, I do! I've pretty much ignored them, I guess because I don't understand them. It looks like my PBs are not necessarily coincident with clusters. But if a cluster is dense, it's more likely than not to have PB close by.

As to hypopneas, I thought they were obstructive by definition - just not 100% so. I notice that my machine rarely issues a pulse pressure after a HA, and that fits with what I thought I read about the PResperonics algorithm for them - that it's based strictly on the preceding flow data. (The machine always issues a pulse after an OA event.)

Gotta find that Australian journal article again and read up on these algorithms. -Ron

We are such stuff
As dreams are made on, and our little life
Is rounded with a sleep.
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Feels like cheating, but Hi Tom. Heh.

We are such stuff
As dreams are made on, and our little life
Is rounded with a sleep.
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Bumpity bump.
We are such stuff
As dreams are made on, and our little life
Is rounded with a sleep.
Post Reply Post Reply

Ok here are a couple zooms around the suggested windows. Any new info here?

9 min zoom from penultimate cluster

zoom from around 2AM

Thx, -Ron
We are such stuff
As dreams are made on, and our little life
Is rounded with a sleep.
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