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[Diagnosis] Please help me read this daily chart
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PaBlum Offline

Members

Posts: 15
Joined: Aug 2013

Machine: Resmed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Quatro Air
Humidifier: Resmed 5i
CPAP Pressure: 11.4-20
CPAP Software: SleepyHead

Other Comments: CMS-50D+

Sex: Male
Location: Virginia

Post: #1
Please help me read this daily chart
[attachment=460]
Hello,
Attached is my latest daily report from sleepyhead. I'm using a RESMED S9 (Auto set to 11.4-18 cmH2O) with Quattro Air. My goal is to consistently get an average nightly AHI under 3 and nightly peak under 5. (Aside: Is that a good goal to set?). I've been making good progress towards that goal.
However, every few nights, I have a period where three things happen at once. Leakage goes up, AHI goes up and the pressure goes up.
Last, night you can see that happening between 1 AM & 2 AM. At 2 AM, I was woken up with an urge to urinate and a pillow wet from sweat. Lately, I sleep through the night.
So, the question is: Did the following happen: A major leak occurred which caused the AHI to go up which caused the pressure to go up? Or, Did the pressure go up for another reason and the higher pressure cause the leak? Or another sequence.
If I can figure out to to stop this sequence I should have it licked.
Any assistance would be appreciated.
Paul
08-17-2013 02:43 PM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,062
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #2
RE: Please help me read this daily chart
Your leak rate isn't that bad, it's right at the line (which is kinda arbitrary) of 24.

At the same time of the leak, your snore increased.

It could be: you rolled onto your back and mask slipped slightly out of place, causing the leak. the sleep position caused the airway to close so the machine increased pressure both due to the closing and the leak.

Your AHI is still wonderfully low. Anything less than 5 is the ultimate goal although some of us like to tweak to get it as low as we can. For you, as a newbie, your goal is less than 5 and to get used to everything.

My suggestion is to not worry about which came first, the leak or the increase. Look at the overall picture, look for trends, and live your life. As long as the leaks stay that low, don't fret about them.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.
08-17-2013 03:29 PM
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PaBlum Offline

Members

Posts: 15
Joined: Aug 2013

Machine: Resmed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Quatro Air
Humidifier: Resmed 5i
CPAP Pressure: 11.4-20
CPAP Software: SleepyHead

Other Comments: CMS-50D+

Sex: Male
Location: Virginia

Post: #3
RE: Please help me read this daily chart
I'm not really a newbie. I've had OSA for about 8 years. This is my third machine and the first that I could get enough info to self titrate with. Note that I set the top of the range to 18 and I frequently hit that. My 95% pressure for this night was 18 and for the past week was 17.84. It is tempting for me to increase the max slightly except that some nights I get centrals. (Here it was 0.23 for the night, 0.23 the previous night and 0 the two nights before that). As I understand it, centrals are natures way of saying no higher.

The reason that I am bothered, forgetting the numbers, is the sweating. I've been told that the excessive sweating is because the body is not getting enough oxygen and is fighting. So this is important to me. This did not happen with my S8 and regular Quattro cinched down. So, I'm tempted to cinch more on the Air. The leaks can't possibly be that low if they are causing high Apnea spikes.

Paul
08-17-2013 03:50 PM
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vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #4
RE: Please help me read this daily chart
(08-17-2013 03:50 PM)PaBlum Wrote:  My 95% pressure for this night was 18 and for the past week was 17.84. It is tempting for me to increase the max slightly except that some nights I get centrals. (Here it was 0.23 for the night, 0.23 the previous night and 0 the two nights before that). As I understand it, centrals are natures way of saying no higher.

The reason that I am bothered, forgetting the numbers, is the sweating. I've been told that the excessive sweating is because the body is not getting enough oxygen and is fighting.

Hi Paul,

What PaulaO2 wrote.

I suggest either raising your max pressure to 20 or making sure you stay off your back while asleep. I wear a snug teeshirt with a tennis ball in a pocket sewn right between the shoulder blades.

Do your centrals occur more often at your average pressure, or more often when the pressure is higher? If they occur more often at your average pressure then, in at least your own case, higher pressure is not the dominant cause of the (very few) centrals which you are seeing.

Do not be overly-concerned about centrals. How long are yours lasting, compared to some of your longer obstructive apneas? I would think short central apneas should be less concerning than long obstructive apneas. With central apneas, as soon as you try to breathe again, you do. With obstructive apneas, your system may need to create a jolt of adrenalin which, long term, can create huge problems for the heart and other organs.

Take care,
--- Vaughn

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. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 08-17-2013 05:15 PM by vsheline.)
08-17-2013 05:10 PM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,062
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #5
RE: Please help me read this daily chart
Ah, sorry, I read it wrong.

And yes, with the CAI being .23? Absolutely nothing to worry about.

As for the sweating, I don't think it is sleep apnea related. It could be that you had to go pee. Some people get really hot in their sleep when they need to urinate. BUT, if this is new for you, it may be time to discuss it with your doc.

You could invest in a really cheap oximeter and look at the readings for a few nights to see if there's any connection and/or if it dips down too low. For some people, their blood O2 doesn't drop that low, even with severe sleep apnea. Others, it can drop a lot even with mild sleep apnea. Supplier #19 has some cheap models, in particular the CMS 50D-Plus. Very simple, very cheap. Check out the review section of the forum.
http://www.apneaboard.com/forums/Forum-Product-Reviews-Forum

some other reading:
http://www.apneaboard.com/wiki/index.php?title=SpO2_software
http://www.apneaboard.com/wiki/index.php...SleepyHead

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.
08-17-2013 07:44 PM
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PaBlum Offline

Members

Posts: 15
Joined: Aug 2013

Machine: Resmed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Quatro Air
Humidifier: Resmed 5i
CPAP Pressure: 11.4-20
CPAP Software: SleepyHead

Other Comments: CMS-50D+

Sex: Male
Location: Virginia

Post: #6
RE: Please help me read this daily chart
Thanks, both, for your expert advice. I'll be sure to read those links and try an increase to 20.
I have absolutely no idea how to tell when centrals occur and for how long. All I have is a CAI to go by.

Last night had a different profile. (Maybe I'm tilting at windmills by trying to cure a single profile?).
Most recent/Last 7 days (no changes in settings during this period)
AHI 4.99/3.54
avg press 14.68/14.61
95% press 17.78/17.88
avg leaks 1.98/2.61
95% leaks 6/15.6

AI=2.42
HI=0.91
CAI=1.66
UAI=0.0

My pike AHI was about 9 and occurred from about 11-11:40. It stayed down till 2 am and hovered around 6 till about 4 AM. I got up at 5:30.

Pressure peaked (at the 18 max) about 11:30 and 2:20, 3:00 3:20 and 4:40
There were a few leak spikes but those didn't necessarily correlate to the pressure and AHI.

That's all I know. Maybe when I rad those articles, I'll be smarter :-)

Paul in Virginia (the state, not the person)
08-18-2013 08:03 AM
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