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Help Needed Please
#1
    Hi guys and gals . I need help to work out if this is a good bad or worse reading of my memory card using sleepy heads software .
It gives a lot of data but i must admit i dont understand it .
I dont mind sharing this as it may help someone else withthe same problem as me .
Im not saying im the best but im in the top one
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#2
(05-10-2016, 08:30 AM)RapmasterUK Wrote: Hi guys and gals . I need help to work out if this is a good bad or worse reading of my memory card using sleepy heads software .
It gives a lot of data but i must admit i dont understand it .
I dont mind sharing this as it may help someone else withthe same problem as me .

Rapmaster, that is an awesome scary avatar pic, but not as scary as your data! You are using an AVAPS machine setup to very very high pressures. In fact it is setup in a way that it cannot do its job to help you breath, when you have central apnea. As a result, you are having incredible numbers of central and hypopnea events and significant obstructive apnea, in spite of high pressure.

Let's have a look at what's going on, and why it's wrong. Your machine is setup to an exhale pressure of nearly 17 cm H2O and inhale pressure of 20.0. This machine is supposed to help you trigger a breath by providing pressure support when you don't initiate a breath on your own, or fail to maintain respiratory volume, but because the pressure is so high, it doesn't have the capacity to change pressure, or the AVAPS pressure support may be disabled (machine should go to IPAP of 25 to support your breathing).

First, why are you on a AVAPS machine? Do you have COPD or other chronic obstructive lung disease or severe obesity hypoventilation? What were the results of your most recent sleep test? Who set this thing up like this.

We can help, but a bit of background is going to help us. I don't want to get too far ahead of ourselves, but we're going to suggest lowering the EPAP pressure significantly, review the mode settings, and setting an appropriate pressure support and backup timing to make this work. The best advise at this moment is, if you're working with a doctor, make an appointment now and see him ASAP.
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#3
(05-10-2016, 08:44 AM)Sleeprider Wrote:
(05-10-2016, 08:30 AM)RapmasterUK Wrote: Hi guys and gals . I need help to work out if this is a good bad or worse reading of my memory card using sleepy heads software .
It gives a lot of data but i must admit i dont understand it .
I dont mind sharing this as it may help someone else withthe same problem as me .

Rapmaster, that is an awesome scary avatar pic, but not as scary as your data! You are using an AVAPS machine setup to very very high pressures. In fact it is setup in a way that it cannot do its job to help you breath, when you have central apnea. As a result, you are having incredible numbers of central and hypopnea events.

Let's have a look at what's going on, and why it's wrong. Your machine is setup to an exhale pressure of nearly 17 cm H2O and inhale pressure of 20.0. This machine is supposed to help you trigger a breath by providing pressure support when you don't initiate a breath on your own, but because the pressure is so high, it doesn't have the capacity to change pressure.

First, why are you on a AVAPS machine? Do you have COPD or other chronic obstructive lung disease? What were the results of your most recent sleep test? Who set this thing up like this.

We can help, but a bit of background is going to help us. I don't want to get too far ahead of ourselves, but we're going to suggest lowering the EPAP pressure significantly, and setting an appropriate pressure support and backup timing to make this work.

Many thanks for the quick reply , i have cronic obstructive sleep apnea and was put on BiPAPA some time ago .. the machine settings have all been done by the clinc which i attend in Sheffield UK . The last time i saw the clinic staff was back in February this year and they was very happy with the latest test results . I seem to still be having episodes of apnea most nights but nowhere near what i was before ,,, i was having between 28 to 40 per hour apneas . Im sure its better now but im not sure which software my clinic uses but i sseem to have an AHI 23.50 which means nothing to me as i cant work it out what the data is telling me ,,,Im sorry i cant be anymore help ...

Im not saying im the best but im in the top one
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#4
Your clinic is no doubt using some version of Philips Respironics Encore software. You can download EncoreBasic from the forum, and it will give you the same information they see. http://www.apneaboard.com/forums/Thread-...hines-only I think it's interesting they find a residual AHI of over 22 acceptable.

In order to know your settings, I'll need you to go into the clinical settings mode and record the information. No changes for now. Turn the rotary dial to highlight SETUP on the display, then press the rotary button and ramp button at the same time. The machine will beep twice as it enters clinical setup mode. Now turn the dial to highlight setup, and push once. This will reveal the settings. Record the following (just turn the dial to scroll through settings. Do not push the knob which will enable changing the settings. The clinician menu will time-out after a minute so you can exit or not):
Mode (CPAP, S, S/T)
Flex
CPAP
IPAP (4-25)
EPAP (4-25)
BPM (0-30)
Ti (0.5-3.0)
Rise time controlled (yes/no or setting)
Ramp time
Ramp start pressure

The objectives in setting up your machine are to control obstructive apnea with adequate EPAP pressure, and to assure volume and respiratory rate with the BPM and IPAP settings. It is possible, you might respond better to a machine known as an "adaptive servo ventilator" (ASV), and this may be an option to discuss with your physician. Anyway, lets start with your settings.
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#5
To be fair whilst i really appreciate your help but im not happy to go into setting ona machine i dont understand the working of .

Some of the data you might be seeing is not mine ive only had this machine since April 2016 . I Would love to help provide you more details but i really dont want to go into the machines setting as i really dont know what im messing with .
The information i would like is just to know what state my sleep apnea is at present . The clininc and consultant must have set the prescription on the card to those setting for a reason , although im not aware of any problems now , my sleep has improved so much and i feel more refreshed when waking than i did before Christams 2015 . things then were at its worse so if my data is still showing massive apneas its nowwhere near to what id was .....
Im not saying im the best but im in the top one
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#6
Okay, that's fair. Just to let you know what you submitting in the first post. You have a total AHI (apenea + hypopnea index) of 23.5 events per hour recorded on May 2, 2016. Your central apnea index is 9.91, obstructive 2.52 and hypopnea 11.07 events per hour. That means your sleep is disrupted more than once every 2.5 minutes through the night What we don't know from the data is the duration of apnea events or total time in apnea. This could be important as the longer you don't breath, the more desaturated your bloodstream becomes.

I respect that you do not want to adjust any settings, but your problem is serious enough that a doctor should be supervising this treatment, not just the techs. To determine if the situation is serious, you should request an oximetry evaluation. This is simply a monitoring of your blood oxygen levels during the night. If you have significant periods of low oxygen saturation, the situation is more urgent than if you do not. I think you should be evaluated for a BiPAP ASV machine to replace your BiPAP AVAPS, particularly if the current results are what your clinic considers "successful".
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#7
(05-10-2016, 09:27 AM)RapmasterUK Wrote: To be fair whilst i really appreciate your help but im not happy to go into setting ona machine i dont understand the working of .
We're not asking you to change any of the settings.

But to help you, we need to know exactly how the machine is set up. Some of the things we can tell from the SleepyHead data you posted, but it would be nice if you could confirm them by checking the machine.

Quote:Some of the data you might be seeing is not mine ive only had this machine since April 2016 .
All the detailed data from May 2 would be yours.

Quote:I Would love to help provide you more details but i really dont want to go into the machines setting as i really dont know what im messing with .
Again, we're not asking you to mess with the settings. We just need you to check out what the settings are. Some of them can be checked from the patient set up menu, but others really can only be checked from the clinical set up menu.

If you can't bring yourself to look at the settings, do you have a copy of the script that was sent to the DME so that they could set the machine up properly? The script would likely have most of the settings specified and any setting that's not specified would likely be left at the default values.

The information i would like is just to know what state my sleep apnea is at present . The clininc and consultant must have set the prescription on the card to those setting for a reason ,[/quote]Do you have a copy of the script? If not, you should request one.

Think of it this way: Would you take a new medication if you didn't know what drug was prescribes and what the prescribed dosage was? Using your machine without knowing its settings is just like taking medication that you don't know the name or dosage for.

Quote:although im not aware of any problems now , my sleep has improved so much and i feel more refreshed when waking than i did before Christams 2015 .
If this night's data is typical, then I'd love to know just how bad things were before you started PAPing.



Questions about SleepyHead?
See my Guide to SleepyHead
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#8
I also want to add that the flow rate graph in the SH data doesn't look "normal". The highlighted part of the flow rate graph is for 3.5 hour period, and yet the flow rate is far too "smooth". In a 3.5 hour window, the flow rate should still be pretty much a solid black mass with a few spikes for the largest inhalations. The y-axis units also don't look right: The flow rate graph ought to be balanced around y=0.

Is this a SH bug of some sort? If so, should we trust the rest of the data?

Can any of those of you who use a PR System One AVAPS make sense of why the flow rate looks so weird?

And to RapmasterUK: It looks like you are using SH 1.0-1 beta. The newest version is SH 1.0-2 beta if I recall correctly. It is worth downloading the new version of SH and seeing if this data looks any different in it.
Questions about SleepyHead?
See my Guide to SleepyHead
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#9
Robysue, he is using the 1.0.0 beta release which was the first to support the 1060 AVAPS machine. There are only a few users on the forum with this machine that could make the comparison. Good questions and comments. I didn't want to pressure the Rapmaster into anything he is not comfortable with, so the only alternative I have is to refer him back to professional medical help.
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#10
(05-10-2016, 09:40 AM)robysue Wrote:
(05-10-2016, 09:27 AM)RapmasterUK Wrote: To be fair whilst i really appreciate your help but im not happy to go into setting ona machine i dont understand the working of .
We're not asking you to change any of the settings.

But to help you, we need to know exactly how the machine is set up. Some of the things we can tell from the SleepyHead data you posted, but it would be nice if you could confirm them by checking the machine.

Quote:Some of the data you might be seeing is not mine ive only had this machine since April 2016 .
All the detailed data from May 2 would be yours.

Quote:I Would love to help provide you more details but i really dont want to go into the machines setting as i really dont know what im messing with .
Again, we're not asking you to mess with the settings. We just need you to check out what the settings are. Some of them can be checked from the patient set up menu, but others really can only be checked from the clinical set up menu.

If you can't bring yourself to look at the settings, do you have a copy of the script that was sent to the DME so that they could set the machine up properly? The script would likely have most of the settings specified and any setting that's not specified would likely be left at the default values.

The information i would like is just to know what state my sleep apnea is at present . The clininc and consultant must have set the prescription on the card to those setting for a reason ,
Do you have a copy of the script? If not, you should request one.

Think of it this way: Would you take a new medication if you didn't know what drug was prescribes and what the prescribed dosage was? Using your machine without knowing its settings is just like taking medication that you don't know the name or dosage for.

Quote:although im not aware of any problems now , my sleep has improved so much and i feel more refreshed when waking than i did before Christams 2015 .
If this night's data is typical, then I'd love to know just how bad things were before you started PAPing.
[/quote]

To be totally honest ive never seen a prescription with the details on it.
If you PM me with instruction on how to get the data you require i will pop a blank SD card in and get fresh data from the machine . i just dont know what im doing withthe machine , i tend to leave alone what i dont understand , and as far as the DR and techs go only thing i can asume is my problem must have been really bad if they are happy with the latest test results .. but yeah PM me the instructions how to get the data off .
Thanks
Raps
Im not saying im the best but im in the top one
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