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Data Collection - Please educate me.
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Kemosabe Offline

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Machine: ResMed S9 AutoSet
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Post: #51
RE: Data Collection - Please educate me.
(02-04-2013 10:38 AM)snuffles Wrote:  What do you suggest to get it down to 5??? I'm at a loss..

Or... am I just worrying for nothing???

Based on my understanding here:
Apnea-hypopnea index, or AHI, is an index used to assess the severity of sleep apnea based on the total number of complete cessations (apnea) and partial obstructions (hypopnea) of breathing occurring per hour of sleep. These pauses in breathing must last for 10 seconds and are associated with a decrease in oxygenation of the blood. In general, the AHI can be used to classify the severity of disease (mild 5-15, moderate 15-30, and severe greater than 30).

Since the goal of CPAP treatment is to minimize the effects of apneas, it follows that the less frequently you stop breathing the better. An average AHI of 5 or more is still considered to show that you are experiencing sleep apnea - mild, to be sure, but still apnea. AHIs lower than 5 are considered mild enough to not be considered sleep apnea.

It is not an unreasonable goal - many, if not most, of us see AHIs even below 1 after working out various adjustments and kinks. I went from 70 AHI to less than 1 with CPAP, as have many others. It is largely for this reason that many of us like to have the feedback the data from the software gives us, as it seems you are beginning to see yourself. Frankly, I find it easier to remain motivated about using my CPAP machine in part because of the positive feedback I'm getting from the data. It helps make the hassle worthwhile. Information is empowering.

Don't let misguided folks who tell you you shouldn't have this software or data dissuade you from what you know is true: it's your health. No one should care about it more than you.

Good luck.
02-04-2013 08:45 PM
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jgjones1972 Offline

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Posts: 516
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Machine: ResMed S9 AutoSet
Mask Type: Full face mask
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CPAP Pressure: 18 - 20
CPAP Software: ResScan SleepyHead

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Location: Ohio - USA

Post: #52
RE: Data Collection - Please educate me.
Kemosabe hit it right on the nose. Of course everyone is different and some might have confounding issues that prevent attaining an AHI of 5 or lower; but, the lower the better - and the best way to get it as low as possible (within reason) is to collect and process the data in order to fine tune the therapy. My AHI was way, WAY up there. Pulse would swing back and forth between 40bpm -178bpm when I slept. My Internist said that my O2 desaturations were so bad that, had I been in a hospital, I would have been "coded" (not 100% sure how bad that is, but I know nothing good ever comes of it on TV shows). I had narcolepsy - I would fall asleep mid-sentence and fall face first onto the floor or ground (still not happy that nobody ever tried to catch me). Doc said I had absolutely NO NREM3 or REM sleep and it was hard to say how long it had been since I had had any. Hormones all screwed up, blood pressure through the roof, acid reflux and I could go on and on...

Went on PAP at the end of August last year and struggled for a month or two, was at the end of my rope and almost ready to give up - if I was going to go, I probably would have tried to take that damned respiratory therapist and DME manager with me (just kidding...maybe Thinking-about ); then I found Apnea Board and took control of my own therapy (with my doctor's blessings). I got my AutoSet from an online supplier toward the end of November 2012. My AHI average over the last two months is .9 (that decimal point before the 9 wasn't an accident). O2 Saturation lately is 97% - 98% all night, every night. Up to about 7 hours of uninturrupted sleep per night. ZEO shows me spending about 40 minutes early on in NREM3 then three or four 45 - 60 minute sessions of REM every night. I feel like I'm 16 again.

Last night I had my first 0 AHI night - didn't really feel any different than a .8 night and the ZEO data still looks about the same, but it's nice to see. The AutoSet still kicked the pressure up a few times, I'm not sure why.

I-love-Apnea-Board

PATIENT EMPOWERMENT!!!
02-04-2013 10:28 PM
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Sleepster Offline
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Machine: ResMed AirCurve10 VAuto
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Post: #53
RE: Data Collection - Please educate me.
(02-04-2013 10:38 AM)snuffles Wrote:  I have corrected my leak issue and studying the data for the past week or more I see my AHI has improved but it's still up at 6 to 8.

It would be nice your machine could determine the CA, OA, and hypopnea indices. If the CA is too high we might recommend lowering the pressure, if not then raising it might be the thing to do. At this point I'd advise you to wait a week or two and see if the AHI goes down on its own. If not then maybe raise the pressure a tiny bit and again wait a couple of weeks to see what happens.

Quote:Based on my understanding here:
Apnea-hypopnea index, or AHI, is an index used to assess the severity of sleep apnea based on the total number of complete cessations (apnea) and partial obstructions (hypopnea) of breathing occurring per hour of sleep. These pauses in breathing must last for 10 seconds and are associated with a decrease in oxygenation of the blood. In general, the AHI can be used to classify the severity of disease (mild 5-15, moderate 15-30, and severe greater than 30).

The only thing I would say is that these events may be associated with a decrease in oxygenation. That's why it's important to zoom in on the waveform (the graph of flowrate versus time) to see how long they last. You can even use an oximeter to see how low the oxygenation goes.

The other issue is that these events can interrupt the sleep cycle and lower the quality of your sleep.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
(This post was last modified: 02-04-2013 11:07 PM by Sleepster.)
02-04-2013 11:02 PM
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jgjones1972 Offline

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Posts: 516
Joined: Nov 2012

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: ResMed Quattro FX
Humidifier: ResMed H5i
CPAP Pressure: 18 - 20
CPAP Software: ResScan SleepyHead

Other Comments: CMS50I PulseOx

Sex: Male
Location: Ohio - USA

Post: #54
RE: Data Collection - Please educate me.
Sorry Snuffles,

I thought you were asking why you should get below 5, not asking for suggestions on how to get below 5.

According to earlier posts you have been on CPAP for quite a while. Your profile says your machine pressure is set to 17 - has it been at 17 for a while or was it recently raised to 17? Forgive me if you've mentioned that before. Also, you say the data card gave you data for a good stretch back. Is that old data showing AHI averages? Has the AHI been trending up or down and how does it look in relation to pressure changes, if any?

As Sleepster said, if you look at the Waveform graph in daily data on your recently downloaded nights on ResScan there should be little flags at the top of each event with a number 10 or higher on them. Those numbers are the duration of the events in seconds. Are these numbers generally 10, 11, 12 etc. or are they generally higher?
02-04-2013 11:41 PM
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archangle Offline
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Machine: ResMed S9 AutoSet
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CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

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Post: #55
RE: Data Collection - Please educate me.
(02-04-2013 10:38 AM)snuffles Wrote:  I did notice one anomaly with it though. I guess it's really the machine. ResScan reports 17.6 lbs pressure but when an external tester is applied to the machine the tester reports 17 lbs. The machine thinks it's doing better than it really is and reports so.

If I were confident it was really blowing 17.6 all the time, I wouldn't worry about it. I'd just adjust the pressure to whatever worked for me.

Also, I'd try to be sure it's the CPAP machine that's wrong, not the pressure gauge.

It's also important to test what the pressure is at the mask end of the hosel, while in use, etc.

Now if it were blowing 14 and reading 17, I'd be more concerned.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
02-05-2013 06:40 PM
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snuffles Offline

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Post: #56
RE: Data Collection - Please educate me.
(02-04-2013 01:53 PM)PaulaO2 Wrote:  Remind me again, how long have you been using CPAP? If it is not that long, this is something to discuss with your doc. But if you are an old hand at this, try to raise your pressure very slowly to see what happens. Each change should take a week at minimum so you can watch the data and see a trend.

The reason for the doc is that new users need to be monitored and assisted until their body and brain get used to the pressure. But for those of us who have been at it longer and have acclimatized, we understand better how our bodies and brain are doing with treatment. Whereas before I didn't really notice I was so tired, once I started getting good sleep, I saw I was miserable before and just didn't know it because I had nothing to compare it to. I do now!

Also consider doing a sleep journal, even if all you do is writing down the change you made and the date. But a sleep journal during changes can really help. Write down how you feel when you woke up, how your day went (stress wise), how you feel when you went to bed, anything new and different for that day, etc.

I've been on CPAP for... gosh... over 5 years now but this is the first time I've ever read the data. I just slept and I sleep deeply.

I noticed though that as my leaks dropped my AHI went up.

I have a full face mask and it's all quite comfortable. I'm a night owl. I stay up 'til maybe 2 in the morning and get up about 10am next day. Same time every day. I don't move at night much. I wake up on my back in the same position I went to sleep in. My S8 was just checked a couple of weeks ago and is bang on 17 pounds and Doc doesn't want me to change it. The sleep study showed that was the best pressure.

I did realise though that my leaks where due to my itchy nose. I stick my finger in and scratch.. then the machine reports a leak. (I have creepy skin, in so far as it gets tickled by the moving air)
02-07-2013 12:23 AM
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snuffles Offline

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Mask Make & Model: Resmed Quatro
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CPAP Software: ResScan

Other Comments: Retired - No Kids - No responsibilities

Sex: Male
Location: Summer-Cruising the lake and Winter- Hiding in Kingston

Post: #57
RE: Data Collection - Please educate me.
(02-04-2013 08:45 PM)Kemosabe Wrote:  
(02-04-2013 10:38 AM)snuffles Wrote:  What do you suggest to get it down to 5??? I'm at a loss..

Or... am I just worrying for nothing???

Based on my understanding here:
Apnea-hypopnea index, or AHI, is an index used to assess the severity of sleep apnea based on the total number of complete cessations (apnea) and partial obstructions (hypopnea) of breathing occurring per hour of sleep. These pauses in breathing must last for 10 seconds and are associated with a decrease in oxygenation of the blood. In general, the AHI can be used to classify the severity of disease (mild 5-15, moderate 15-30, and severe greater than 30).

Since the goal of CPAP treatment is to minimize the effects of apneas, it follows that the less frequently you stop breathing the better. An average AHI of 5 or more is still considered to show that you are experiencing sleep apnea - mild, to be sure, but still apnea. AHIs lower than 5 are considered mild enough to not be considered sleep apnea.

It is not an unreasonable goal - many, if not most, of us see AHIs even below 1 after working out various adjustments and kinks. I went from 70 AHI to less than 1 with CPAP, as have many others. It is largely for this reason that many of us like to have the feedback the data from the software gives us, as it seems you are beginning to see yourself. Frankly, I find it easier to remain motivated about using my CPAP machine in part because of the positive feedback I'm getting from the data. It helps make the hassle worthwhile. Information is empowering.

Don't let misguided folks who tell you you shouldn't have this software or data dissuade you from what you know is true: it's your health. No one should care about it more than you.

Good luck.

Originally I didn't know any better but now after monitoring I couldn't agree more with you. It's a great benefit to see what's going on. I take frequent readings now and adjust things to see what works.
02-07-2013 12:27 AM
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snuffles Offline

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Machine: ResMed S9 Elite
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Other Comments: Retired - No Kids - No responsibilities

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Location: Summer-Cruising the lake and Winter- Hiding in Kingston

Post: #58
RE: Data Collection - Please educate me.
(02-04-2013 11:02 PM)Sleepster Wrote:  
(02-04-2013 10:38 AM)snuffles Wrote:  I have corrected my leak issue and studying the data for the past week or more I see my AHI has improved but it's still up at 6 to 8.

It would be nice your machine could determine the CA, OA, and hypopnea indices. If the CA is too high we might recommend lowering the pressure, if not then raising it might be the thing to do. At this point I'd advise you to wait a week or two and see if the AHI goes down on its own. If not then maybe raise the pressure a tiny bit and again wait a couple of weeks to see what happens.

Quote:Based on my understanding here:
Apnea-hypopnea index, or AHI, is an index used to assess the severity of sleep apnea based on the total number of complete cessations (apnea) and partial obstructions (hypopnea) of breathing occurring per hour of sleep. These pauses in breathing must last for 10 seconds and are associated with a decrease in oxygenation of the blood. In general, the AHI can be used to classify the severity of disease (mild 5-15, moderate 15-30, and severe greater than 30).

The only thing I would say is that these events may be associated with a decrease in oxygenation. That's why it's important to zoom in on the waveform (the graph of flowrate versus time) to see how long they last. You can even use an oximeter to see how low the oxygenation goes.

The other issue is that these events can interrupt the sleep cycle and lower the quality of your sleep.

This is one of the things my Doc has me wear on a regular basis (every couple of months) and my oxygen is always 98 to 99%. I guess I need to monitor and understand this more.
02-07-2013 12:32 AM
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snuffles Offline

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Posts: 56
Joined: Jan 2013

Machine: ResMed S9 Elite
Mask Type: Full face mask
Mask Make & Model: Resmed Quatro
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CPAP Pressure: 17
CPAP Software: ResScan

Other Comments: Retired - No Kids - No responsibilities

Sex: Male
Location: Summer-Cruising the lake and Winter- Hiding in Kingston

Post: #59
RE: Data Collection - Please educate me.
(02-04-2013 11:41 PM)jgjones1972 Wrote:  Sorry Snuffles,

I thought you were asking why you should get below 5, not asking for suggestions on how to get below 5.

According to earlier posts you have been on CPAP for quite a while. Your profile says your machine pressure is set to 17 - has it been at 17 for a while or was it recently raised to 17? Forgive me if you've mentioned that before. Also, you say the data card gave you data for a good stretch back. Is that old data showing AHI averages? Has the AHI been trending up or down and how does it look in relation to pressure changes, if any?

As Sleepster said, if you look at the Waveform graph in daily data on your recently downloaded nights on ResScan there should be little flags at the top of each event with a number 10 or higher on them. Those numbers are the duration of the events in seconds. Are these numbers generally 10, 11, 12 etc. or are they generally higher?

No problem.. yes I wondered how to get AHI down.

This machine gave me data back to last July and AHI is always just below 10. Then started dropping. (near 5) My leaks were high but when I got rid of the leaking the AHI went up. Surprised me. Even so it's 6 to 8. Mild as per the definition but I'm trying to get it lower.

The S8 is only capable of 20 pounds pressure and this one is starting to squeak as it is. My other (older) machine is a trouper... always worked better than this one. Data on it shows the same.
(This post was last modified: 02-07-2013 12:40 AM by snuffles.)
02-07-2013 12:39 AM
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snuffles Offline

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Posts: 56
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Machine: ResMed S9 Elite
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Mask Make & Model: Resmed Quatro
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CPAP Software: ResScan

Other Comments: Retired - No Kids - No responsibilities

Sex: Male
Location: Summer-Cruising the lake and Winter- Hiding in Kingston

Post: #60
RE: Data Collection - Please educate me.
(02-04-2013 11:41 PM)jgjones1972 Wrote:  Sorry Snuffles,

I thought you were asking why you should get below 5, not asking for suggestions on how to get below 5.

According to earlier posts you have been on CPAP for quite a while. Your profile says your machine pressure is set to 17 - has it been at 17 for a while or was it recently raised to 17? Forgive me if you've mentioned that before. Also, you say the data card gave you data for a good stretch back. Is that old data showing AHI averages? Has the AHI been trending up or down and how does it look in relation to pressure changes, if any?

As Sleepster said, if you look at the Waveform graph in daily data on your recently downloaded nights on ResScan there should be little flags at the top of each event with a number 10 or higher on them. Those numbers are the duration of the events in seconds. Are these numbers generally 10, 11, 12 etc. or are they generally higher?

I'm not sure of what events you refer to. On the graph which shows the AHI there are no reported events at all. I see "events/hr" at the left but no numbers on any column. The AHI is now in the 6 to 8 range and AI is usually 0.20 to 0.40.

I'd show a portion of the graph if I could figure out how to put a picture on here.
02-07-2013 12:48 AM
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