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Graph interpreters.... do your worst!
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shawn42 Offline

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Machine: Philips DreamStation AutoBiPAP
Mask Type: Nasal mask
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Humidifier: detachable-- currently not using this
CPAP Pressure: 4-10 EP/IP, 2-4 PS, 3 BiFlex
CPAP Software: SleepyHead

Other Comments: Using CMS50IW Pulse Oximeter; Diagnosis AHI 60.2 with 74% O2 Desaturation Nadir

Sex: Male
Location: US

Post: #1
Question Graph interpreters.... do your worst!
Last night I had a late start since I had to pick up my wife from the airport past midnight. Got to sleep around 2:30, and awoke naturally around 5:15. This isn't exactly unusual for me-- I don't do it too often, but I've been known to pull 3-4 hours of sleep and go on just fine with everything for the day. I even feel refreshed when I wake up on those days. This is one of the weirdest parts of my apnea experience: I never feel abnormally tired during the day, even prior to treatment. In any case, I tried to let myself have a little extra this morning, so I dozed back off and was disturbed a few times by my dogs & alarms before finally giving up and just getting out of bed.

For reference, on a normal night, I can pull off 7 hours tops if I'm trying to be really good to myself. Past that, and I just end up laying in bed awake feeling like I should be up. The longer I lay there, the more tired I feel, but the less I'm able to sleep despite it.

So I've never tried to properly interpret one of these SleepyHead daily reports before. Can any sleep data gurus out there take a gander and give me some insight? This was my highest AHI (4.39) in a month despite being one of the shortest nights. I've been averaging 3 AHI on treatment. I was diagnosed at 60 AHI.

The hard part is that I have no tangible complaints that need resolving. I'm really just curious to know if this looks good, or if it looks like I can improve something. I'm relying on this data alone to help me understand if I'm actually controlling the issue because my body has been convincing me that I always feel just fine.


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(This post was last modified: 06-24-2016 06:54 PM by shawn42.)
06-24-2016 06:48 PM
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sonicboom Offline

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Machine: Airsense 10 AutoSet
Mask Type: Nasal pillows
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CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Washington

Post: #2
RE: Graph interpreters.... do your worst!
As you are no doubt aware, under 5 AHI is considered treated although many of us try for lower. How you feel is a huge barometer of the success of your therapy. The fact that you feel great means your treatment is working. Congrats and keep it up.

Coffee
06-24-2016 07:19 PM
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shawn42 Offline

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Posts: 36
Joined: Jun 2016

Machine: Philips DreamStation AutoBiPAP
Mask Type: Nasal mask
Mask Make & Model: Philips DreamWear
Humidifier: detachable-- currently not using this
CPAP Pressure: 4-10 EP/IP, 2-4 PS, 3 BiFlex
CPAP Software: SleepyHead

Other Comments: Using CMS50IW Pulse Oximeter; Diagnosis AHI 60.2 with 74% O2 Desaturation Nadir

Sex: Male
Location: US

Post: #3
RE: Graph interpreters.... do your worst!
I would agree more with the "how you feel" bit if I had felt terrible when my AHI was 60, but I didn't. In fact I woke up from that first sleep study feeling far more energized and awake than I did during my CPAP study which contrarily improved my numbers on paper dramatically. That was exactly the complaint that got me on APAP, eventually. But now even with APAP, I'm back to feeling basically like I always did before I got treated: fine & dandy. My inability to "feel" that I'm asphyxiating myself without treatment is pretty much the only thing about all this that has me worried despite my numbers.

With that in mind, is there nothing useful to glean from the graphs?
06-24-2016 07:33 PM
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JudgeMental Offline

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Location: Florida USA

Post: #4
RE: Graph interpreters.... do your worst!
Hi Shawn42.. First of all I don't understand what it is that you are concerned about. The short night is understandably not going to give you your best sleep quality. Maybe the excitement of having your spouse back home safely caused some of the hypopneas. Although you appear to have a fairly irregular sleep sked, your statement that your are not tired or lethargic sends me the message that your sleep apnea is well controlled. The AHI 4.39 is only that high because of the hypopnea number, which are not full blown apneas. And 4.39 as a high for a month is not earth shaking either. It is of my opinion that your pressures are quite low and that could possibly lead to some hypopneas that may be squelched by a slightly higher pressure. Is it possible that you have considered raising your pressure up a notch or two yourself or consulting with your MD.

Yesterday is history; Tomorrow is a mystery; Today is a gift; Thats why its called "The Present".
06-24-2016 08:34 PM
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shawn42 Offline

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Posts: 36
Joined: Jun 2016

Machine: Philips DreamStation AutoBiPAP
Mask Type: Nasal mask
Mask Make & Model: Philips DreamWear
Humidifier: detachable-- currently not using this
CPAP Pressure: 4-10 EP/IP, 2-4 PS, 3 BiFlex
CPAP Software: SleepyHead

Other Comments: Using CMS50IW Pulse Oximeter; Diagnosis AHI 60.2 with 74% O2 Desaturation Nadir

Sex: Male
Location: US

Post: #5
RE: Graph interpreters.... do your worst!
For clarity, my primary concern was really just to learn how to get something useful from all the data being presented to me in these daily reports (aside from AHI, which I already knew before I started using SleepyHead). I just figured I'd use last night's scenario to give it a shot since my results were slightly worse than usual.

There was no real pressing issue or concern other than trying to learn. I've just been trying to explain that when people tell me that feeling fine means I'm being treated, then it's really no different to me than before I began my treatment-- because I feel the same as I did then. The only reason I had the study done in the first place was because my wife said my snoring was too loud, and I have a history of apnea in the family.

Anyway, I recall my doc saying he wanted to raise my pressure after the first 30 days, and he said he'd do that remotely. In my Statistics tab, there's only 1 line under Changes to Prescription Settings. Do you think that means the change never occurred? I should give the office a call and see if they recorded what my latest settings should be. Then I can verify them.
06-24-2016 10:16 PM
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chill Online

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CPAP Software: SleepyHead

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Sex: Male
Location: Vancouver, Canada

Post: #6
RE: Graph interpreters.... do your worst!
You say that you awoke naturally around 5:15. Your graphs show two hypopneas and a flow limitation at 5:08 - 5:10 followed by a spike in pressure and mask leak. I think it is likely that this is what woke you up, though you were probably not aware of it.

Overall, things look good. Personally, I feel much better when my AHI is under 2.0, but as you don't feel abnormal that might not mean much. Or it might mean that abnormal is your new normal and you need get a lower AHI and longer sleep to notice the difference.
06-24-2016 10:29 PM
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OpalRose Offline

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CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

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Location: Northeast Ohio, USA

Post: #7
RE: Graph interpreters.... do your worst!
shawn42,
Your graphs look pretty normal, and you say you feel fine. Feeling good is half the battle.

You may need a slightly higher pressure to treat the hypopneas, flow limitation and snores. The Apap will raise pressure in response to Flow Limitation, and snores in an attemp to head off an oncoming event, but the correct minimum pressure makes a difference. Right now, I don't see much of an issue.

An AHI under 5 is considered treated, but I know from my own experience that when I go over an AHI of 2, I feel a little off. Sad Everyone is different though.

Do you have the beginners guide to SleepyHead? You can learn quite a lot when comparing to your own data.
http://www.apneaboard.com/wiki/index.php...SleepyHead

OpalRose
06-25-2016 05:56 AM
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green wings Offline

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Other Comments: using CPAP since Jan. 2016

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Post: #8
RE: Graph interpreters.... do your worst!
Hi, Shawn. I think it's great that you're using SleepyHead and looking at your data, in spite of not having any detectable symptoms of apnea.

Re your graph, I do see that you're having some obstructive events that would possibly respond better if your starting pressure was higher. (That's not a recommendation to change your settings based on just one night's data, though.)

If your doctor gave you a copy of your initial sleep study, you can look at it to see if your apnea is worse when you are sleeping on your back or during REM sleep (or both). I'm guessing that it probably is, since your pressure graph shows hills and valleys.

If your apnea is indeed both positional and REM-related, I think it's good to know that if you are going to be looking at your SleepyHead data regularly.

I didn't have any daytime sleepiness before I was diagnosed with sleep apnea (and still don't, no matter what sort of sleep I get).

I think that you'll just have to ignore it when someone tells you that your data is "good enough and what really matters is how you feel". Just know that the "how you feel" part doesn't apply to you. The data is "good enough" part probably still applies. If you want to pursue a super low AHI, though, I don't see any reason why you shouldn't.

If you decide to get into analyzing your sleep, you may want to buy additional monitoring equipment like something to estimate the amount of time you spend in each sleep stage, and maybe a pulse oximeter, too, if you had any oxygen desaturations during your sleep study.

If you monitor your sleep stages (sleep architecture), you may discover that you get enough REM and N3 (slow-wave) sleep but have less lighter (N1 and N2) sleep than most people. That would explain how you can sleep fewer hours and still wake up feeling refreshed.

Article for you about REM-related OSA, should you want to read it.



(06-24-2016 06:48 PM)shawn42 Wrote:  Last night I had a late start since I had to pick up my wife from the airport past midnight. Got to sleep around 2:30, and awoke naturally around 5:15. This isn't exactly unusual for me-- I don't do it too often, but I've been known to pull 3-4 hours of sleep and go on just fine with everything for the day. I even feel refreshed when I wake up on those days. This is one of the weirdest parts of my apnea experience: I never feel abnormally tired during the day, even prior to treatment. In any case, I tried to let myself have a little extra this morning, so I dozed back off and was disturbed a few times by my dogs & alarms before finally giving up and just getting out of bed.

For reference, on a normal night, I can pull off 7 hours tops if I'm trying to be really good to myself. Past that, and I just end up laying in bed awake feeling like I should be up. The longer I lay there, the more tired I feel, but the less I'm able to sleep despite it.

So I've never tried to properly interpret one of these SleepyHead daily reports before. Can any sleep data gurus out there take a gander and give me some insight? This was my highest AHI (4.39) in a month despite being one of the shortest nights. I've been averaging 3 AHI on treatment. I was diagnosed at 60 AHI.

The hard part is that I have no tangible complaints that need resolving. I'm really just curious to know if this looks good, or if it looks like I can improve something. I'm relying on this data alone to help me understand if I'm actually controlling the issue because my body has been convincing me that I always feel just fine.
06-25-2016 09:41 AM
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chill Online

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CPAP Software: SleepyHead

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Sex: Male
Location: Vancouver, Canada

Post: #9
RE: Graph interpreters.... do your worst!
Quote:... you may want to buy additional monitoring equipment like something to estimate the amount of time you spend in each sleep stage ... If you monitor your sleep stages (sleep architecture), you may discover that you get enough REM and N3 (slow-wave) sleep but have less lighter (N1 and N2) sleep than most people.

Is there anything that you could recommend to do that. I have seen the Resmed S+ which looked like it might be useful. None of the smart phone apps that I have seen seemed like they would produce useful information.
06-25-2016 10:27 AM
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OpalRose Offline

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Machine: PR System One REMstar Auto 560 with A Flex
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Post: #10
RE: Graph interpreters.... do your worst!
(06-25-2016 10:27 AM)chill Wrote:  
Quote:... you may want to buy additional monitoring equipment like something to estimate the amount of time you spend in each sleep stage ... If you monitor your sleep stages (sleep architecture), you may discover that you get enough REM and N3 (slow-wave) sleep but have less lighter (N1 and N2) sleep than most people.

Is there anything that you could recommend to do that. I have seen the Resmed S+ which looked like it might be useful. None of the smart phone apps that I have seen seemed like they would produce useful information.


I'm wondering about the same thing!
I'm not sure there is a way to accurately monitor REM. There are a lot of gadgets on the market that claim to monitor REM sleep, but it's anyone's guess how accurate they are.

I have read that with using the ResMed S+, it should be facing your chest as you sleep. What about those of us who toss and turn frequently?

I'm hoping one day there will be a Cpap that will show us our REM sleep along with other sleep stages.

Well, I think we're off topic a bit, so back to shawn......

You should do whatever you can to monitor your sleep, and just so your aware, there have been others that say they felt good before therapy, and don't feel different with therapy, so I can see how it would be hard to gauge your results.

So learn what you can from the SleepyHead guide (link above), and watch your AHI readings and the breakdown of such.

Ask questions anytime. Although we are not doctors, we can answer according to our experiences.
Sleep-well

OpalRose
06-25-2016 10:45 AM
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