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[Diagnosis] My AHI went to to 27.3 last night, averaging over 20 for past 8 nights - Need Help !!
#11
RE: My AHI went to to 27.3 last night, averaging over 20 for past 8 nights - Need Help !!
[attachment=5429 Wrote:Ron AKA pid='255159' dateline='1524108491'][attachment=5430]
(04-18-2018, 08:55 PM)tmrlhk Wrote: Hi Ron,

Thank you for your advice !  Here are the screenshots for further review and evaluations.  Pls note that the date showing Apr 19 is wrong.  Actually it was Apr 17 as I could not amend the machine after I travelled aboard several times. 

Unfortunately you seem to be running out of pressure to control the obstructive apneas. As a first step I would set the max pressure at 20 cm and see what happens for results. Minimum pressure needs to come way up too. I would suggest 11 cm as a start. To gain a bit more comfort in getting to sleep with those higher pressures, I would suggest using the Auto Ramp with a Ramp Start pressure of 6 cm.

You can get more on the SleepyHead chart if you get rid of the big pie chart. Click on File, Preferences, Appearance, and uncheck the show pie chart box. I did not explain it well, but if you click and drag on the gray lines between the graphs you can scrunch them down a bit to get more graphs on one screen.
Hi Ron,

Thank you so much for your advice !  Here are a couple charts. If you need details on more charts, pls let me know.
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#12
RE: My AHI went to to 27.3 last night, averaging over 20 for past 8 nights - Need Help !!
Those two charts are not very helpful. You need to get the Detail bar on the left back. Just get rid of the pie chart only, not the whole bar. As for graphs the essential ones for now are the Event Flags (be sure to pin it to the top), and the Pressure.
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#13
RE: My AHI went to to 27.3 last night, averaging over 20 for past 8 nights - Need Help !!
tmrlhk, please see the guidelines for formatting your SleepyHead charts. http://www.apneaboard.com/wiki/index.php...ganization

At this stage we need to see the whole chart (as per the guidelines) then zoomed in so that about 10 minutes is showing. We need to see the detail on the airflow graph.
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#14
Grin 
RE: My AHI went to to 27.3 last night, averaging over 20 for past 8 nights - Need Help !!
    Hi Ron,

Good morning !  Thank you so much for you help.. like

I set the machine at max 20/min 9 last night, and the AHI came way down to under 5.  I forgot to insert back the SD disk last night into the machine, and inserted it back this morning.  For some reason, I could not get any meaningful data from Sleepyhead for last night.  I hereby attach a screen shot of the ResScan software report for last night.

Tomorrow, I'll upload my results of tonight, which hopefully will be good again. Thanks

Thanks again and have a great day !
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#15
RE: My AHI went to to 27.3 last night, averaging over 20 for past 8 nights - Need Help !!
(04-19-2018, 11:12 AM)tmrlhk Wrote: I set the machine at max 20/min 9 last night, and the AHI came way down to under 5.  I forgot to insert back the SD disk last night into the machine, and inserted it back this morning.  For some reason, I could not get any meaningful data from Sleepyhead for last night.  I hereby attach a screen shot of the ResScan software report for last night.

I've kind of done that too. I once forgot to unlock the SD card, and that has the same result. No detailed data is collected. 

I would try 10 cm minimum for tonight. 11 cm that I suggested before might be a touch to much. However your detailed SleepyHead chart is the one we need to see for the best results. See the screenshot below for my last night. That is the kind of format I like to see to make adjustments.
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#16
RE: My AHI went to to 27.3 last night, averaging over 20 for past 8 nights - Need Help !!
[attachment=5450 Wrote:Ron AKA pid='255238' dateline='1524162529'][attachment=5450]
(04-19-2018, 11:12 AM)tmrlhk Wrote: I set the machine at max 20/min 9 last night, and the AHI came way down to under 5.  I forgot to insert back the SD disk last night into the machine, and inserted it back this morning.  For some reason, I could not get any meaningful data from Sleepyhead for last night.  I hereby attach a screen shot of the ResScan software report for last night.

I've kind of done that too. I once forgot to unlock the SD card, and that has the same result. No detailed data is collected. 

I would try 10 cm minimum for tonight. 11 cm that I suggested before might be a touch to much. However your detailed SleepyHead chart is the one we need to see for the best results. See the screenshot below for my last night. That is the kind of format I like to see to make adjustments.

Good morning !  I did all the settings as suggested, and it went ok last night.  I had to switch the Auto Ramp to "Off" around 3.30 am after I woke up and went back to sleep, as there seems to be not enough air.  The graph is attached per your advice.  Pls let me know if you need some other details.  Thank you so much !
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#17
RE: My AHI went to to 27.3 last night, averaging over 20 for past 8 nights - Need Help !!
(04-20-2018, 11:23 AM)tmrlhk Wrote: Good morning !  I did all the settings as suggested, and it went ok last night.  I had to switch the Auto Ramp to "Off" around 3.30 am after I woke up and went back to sleep, as there seems to be not enough air.  The graph is attached per your advice.  Pls let me know if you need some other details.  Thank you so much !

Most of your obstructive events are happening when the machine is trying to ramp up pressure, and it is not doing it fast enough to stop all the events. You probably would gain some reduction in OA events by increasing minimum to 11 cm.

On your not enough air during the ramp, that is usually quite easy to fix. I would suggest setting the Ramp Start pressure higher. Usually having it at 6 or 7 is about right, but I currently have mine at 7.6 and that is good for me. I would suggest trying the machine during the day with different Ramp Start pressures. With the right Ramp Start and EPR on I find that there is a pressure where it feels there is no effort to inhale or exhale. If you get up in the night and the machine is stopped, it will start again at that pressure which should be comfortable.
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#18
RE: My AHI went to to 27.3 last night, averaging over 20 for past 8 nights - Need Help !!
Would you suggest to have " Auto Ramp " or switch Ramp to "Off" ?  Thanks and have a good day !
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#19
RE: My AHI went to to 27.3 last night, averaging over 20 for past 8 nights - Need Help !!
(04-20-2018, 12:57 PM)tmrlhk Wrote: Would you suggest to have " Auto Ramp " or switch Ramp to "Off" ?  Thanks and have a good day !

In ResMed terms I would set "Ramp Time" to Auto, and then set "Start Pressure" to 6 or 7 cm. Test while you are awake to see how that feels to you for pressure. Lower it if too much, or increase it if you feel you are not getting enough air.
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#20
Grin 
RE: My AHI went to to 27.3 last night, averaging over 20 for past 8 nights - Need Help !!
[attachment=5465 Wrote:Ron AKA pid='255392' dateline='1524248608']
(04-20-2018, 12:57 PM)tmrlhk Wrote: Would you suggest to have " Auto Ramp " or switch Ramp to "Off" ?  Thanks and have a good day !

In ResMed terms I would set "Ramp Time" to Auto, and then set "Start Pressure" to 6 or 7 cm. Test while you are awake to see how that feels to you for pressure. Lower it if too much, or increase it if you feel you are not getting enough air.

Hi Ron,  Good morning !  My AHI went down to 2 last night, the best ever for me. like 
 The big leakage was probably because I adjusted the strap in the middle of last night.  I did tighten it up later, and hopefully the big leakage will not happen tonight.  Otherwise, I'll switch to a new cushion, which I just received in the mail yesterday.  Do you see any other adjustments ?

Thank you again and have a great weekend !
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