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First Nights Data - Your thoughts?
06-27-2015, 11:02 AM
Its been two months since my first study but I finally got through the hurdles to get a true data machine. I know my disorder is pretty severe. I was prescribed 17cm...looks like the machine averaged 16.9, so at least that seems good. AHI <5 not by much but I'll take it. Leaks look really good except the two time I took the mask off in my sleep. Please let me know if my interpretations are correct and anything that might look unusual. Thanks.
06-27-2015, 11:13 AM
it would be helpful if you update your profile so we know what machine, mask, etc. you are using.
06-27-2015, 12:03 PM
Your Auto machine is set at 5-20. I believe the starting pressure of 5 is too low, since you don't spend much time below 14.
If I were you, I would set my minimum pressure to 13 and leave the max pressure at 20 since you are maxing out at close to 18. I think you could see better AHI numbers. Just watch it for a couple weeks before making more changes.
You should also turn off ramp.
Let us know if this makes a difference for you.
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I agree, your minimum pressure needs to be higher to eliminate some of the hypops being scored while the machine is lagging behind in getting the pressure up to handle them. I wouldn't advise changing it all at once since that may upset the apple cart. Since your AHI is <5, you're getting good therapy so boost the pressure gradually over a couple of months time. Check for effect after each change, whether it be for the better or worse. If it causes you to have trouble getting to sleep, staying asleep or scoring more CA's, then back it off and wait a couple of months. You'll be amazed how well you can tolerate full pressure once your body adjusts to the therapy over time. Small incremental changes are advised, when change is needed.
The bottom line right now is, your sleep disturbance from the therapy is to be considered right along with how effective the therapy is in getting the low AHI's. From your graph, I deduce that you are waking when the pressure rises or are bothered by the mask or some other aspect of the therapy. That would make it a bad idea to increase the pressure right now. Later, it'll be easier to tolerate higher pressure, trust me, it works that way. For now, stay the course. You can fiddle with it later after you get comfortable with the new way of sleeping.
BTW, It sounds like your sleep doctor hit the pressure requirement on the head. Bully for him/her!
06-27-2015, 12:30 PM
Jumpinminnow - How do you like the Amara View?
06-27-2015, 04:26 PM
I should have made this clear from the start - this is actually the end of week 4. The DME brought a DS220 when a 460 was prescribed. Since it needed to be changed anyway I had it upgraded to a 560. I was so excited to finally get it I forgot to do my profile. Its done now.
If I understand correctly a "problem area" is occurring during the ramp up. So don't use that feature and adjust the minimum to what I can best tolerate and still fall asleep. If I'm tired enough I've been able to do that with 17cm so I'll try 13 tonight and if it is too much I'll move the ramp up so it starts at 8 and maybe 30 minutes instead of 45 and only use it as a backup. Thank you for the help - I'm starting to feel like I understand this stuff.
I have the Amara View, the Amara Gel (that looks like an athletic cup) and the wisp. I'm using the View but its cinched very tight. It is less material in my face and I like that it doesn't come up as high on the nose. I'm hoping to use the leak data to loosen the view and then see how it compares to the wisp with a chin strap. Am I correct that the leak data was very good except when the mask was removed?
06-27-2015, 04:45 PM
by the way, I typed a nice post, and then did not save it. I would note that your chart seems to show that you fall asleep easily, under 10 minutes, you were awakened about 12:07 but were again back to sleep by 12:10.
So, ramp setting for 10 minutes vs. 30 or 45 would likely be enough.
I think your idea of 13 as a start, and a ramp from 8, sound fine. I think I would have set my min at 9 instead of 13, and my ramp to start at 6.
I was pleased to see that you do not have many CA events. That suggests that you would be fine at higher pressures with high AFlex settings.
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.
(06-27-2015, 04:26 PM)jumpinminnow Wrote: ... Am I correct that the leak data was very good except when the mask was removed?
Your "Total Leak" is usually around 42 liter/minute. No need to be too concerned about Total Leak, which is the total of intentional (through the task vent holes) plus unintentional Leak.
Your unintentional Leak is usually zero. Yes, that is very good.
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.
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