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Hypopnea's
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readyforsleep Offline

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Posts: 233
Joined: Mar 2014

Machine: Resmed S9 AutoSet for her
Mask Type: Nasal pillows
Mask Make & Model: Swift FX for her
Humidifier: attached
CPAP Pressure: 14.6-17.4
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Lawrenceburg, Indiana

Post: #31
RE: Hypopnea's
Last night
-Raised the low pressure to 12
-Loosened the mask-slept like a baby
-used a different chin strap over the mask

2010 sleep study 63 AHI, 2014 3.0
06-27-2014 08:23 AM
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diamaunt Offline

Members-b

Posts: 436
Joined: May 2012

Machine: S9 VPAP Auto 36006
Mask Type: Full face mask
Mask Make & Model: mirage quattro/pilairo q
Humidifier: none
CPAP Pressure: 9-20ish
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: texas

Post: #32
RE: Hypopnea's
(06-27-2014 08:23 AM)readyforsleep Wrote:  Last night
-Raised the low pressure to 12
-Loosened the mask-slept like a baby
-used a different chin strap over the mask

other than the leaks, it doesn't look too bad, and even the leaks aren't horrible, just not great.

can you scrunch the events chart down and shrink the size of the others enough to get the snore chart in there too?

something like: [Image: MCttZog.png]

huh, I had a pretty good night last night, if only I'd had more of it Sad
(This post was last modified: 06-27-2014 09:35 AM by diamaunt.)
06-27-2014 09:33 AM
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robysue Offline
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Advisory Members

Posts: 1,235
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #33
RE: Hypopnea's
The AHI looks better. But that Leak line is very problematic. Eyeballing it, it looks like your leaks were well into large leak territory (above 24 L/min for your machine) for somewhere around 2.0-2.5 hours, and maybe even closer to 3 hours. Run time for the machine was roughly 7.5 hours. So the percentage of time in large leak seems to be up around 25-33% and maybe even a bit more. Did Mr. Red Frowny Face show up on the short version of the Sleep Quality report this morning? He usually shows his ugly face when the leaks are above 24 L/min for at least 30% of the night.

During the periods when large leaks are at their worst, the accuracy of the AHI data may also be compromised. In other words, the periods of time when the leak rate is above 30 or 40 L/min may not be as event free as the data indicates. When the leak rate gets that high the machine not only has trouble maintaining the pressure (so the airway is more prone to collapsing), but also the machine has trouble tracking the breathing, and hence it may miss events that happened.

This is a case where using SH 0.9.6 would be useful since SH 0.9.6 shows the RedLine at 24 L/min AND calculates the amount of time where the leak is AT or ABOVE 24 L/min.

If this turns out to be an isolated "bad night for leaks" that's one thing. But if your leak line starts looks like this one more often than not, you need to work on the leaks even if they aren't waking you up.

Questions about SleepyHead?
See my Guide to SleepyHead
(This post was last modified: 06-27-2014 09:57 AM by robysue.)
06-27-2014 09:55 AM
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readyforsleep Offline

Preferred Members-2

Posts: 233
Joined: Mar 2014

Machine: Resmed S9 AutoSet for her
Mask Type: Nasal pillows
Mask Make & Model: Swift FX for her
Humidifier: attached
CPAP Pressure: 14.6-17.4
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Lawrenceburg, Indiana

Post: #34
RE: Hypopnea's
Last night with snore data.[attachment=897]

why did my pressure go down with leaks?

2010 sleep study 63 AHI, 2014 3.0
06-27-2014 11:01 AM
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robysue Offline
Wiki Editor
Advisory Members

Posts: 1,235
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #35
RE: Hypopnea's
(06-27-2014 11:01 AM)readyforsleep Wrote:  Last night with snore data.

why did my pressure go down with leaks?

Many modern APAPs are designed to DECREASE the pressure once the leak rate gets too high for the machine to properly maintain pressure and to properly track the breathing pattern. The idea is that by reducing the pressure, the mask may be able to seal itself again (if the problem is mask leaks) OR the person's mouth might close with less pressure (if the problem is mouth leaks). In other words, by pumping less air into the "closed system", the hope is that the leak will fix itself.

I analyzed one of my rare official Large Leaks on my own PR BiPAP some time back on my blog. If you're interested, you can read my Anatomy of a Large Leak in Encore and SleepyHead

Questions about SleepyHead?
See my Guide to SleepyHead
(This post was last modified: 06-27-2014 02:49 PM by robysue.)
06-27-2014 11:14 AM
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retired_guy Offline

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Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #36
RE: Hypopnea's
Yo, Readysleepy, Dudette! You rock!

I'm going to leave the what do we do next stuff to Robysue, because she's got a better handle on this than I think about anybody else could have.

But from my perspective your latest results are way better than before.

What I'm looking at are the intervals between high leak rates. When the leak was modest your pressures came down nicely, your CA's went clear away, and your OA's were nearly extinct.

So I think you are on the right track. Good job!
06-27-2014 11:55 AM
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readyforsleep Offline

Preferred Members-2

Posts: 233
Joined: Mar 2014

Machine: Resmed S9 AutoSet for her
Mask Type: Nasal pillows
Mask Make & Model: Swift FX for her
Humidifier: attached
CPAP Pressure: 14.6-17.4
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Lawrenceburg, Indiana

Post: #37
RE: Hypopnea's
I'm thinking I need to leave the low pressure at 12, and fiddle with the mask fit.
My aim is to get somewhere between last night's leaks and zero. I feel like the
tight mask is somehow contributing to excessive events.

about my mask fit, should I have the bottom straps nestle against the bottom
of my ear or try it further down?

My other option is to get a bi-level to trial. Not real easy( as I am not home
right now) but doable.

ok, RobySue need an executive decision here. This is all beyond me!

2010 sleep study 63 AHI, 2014 3.0
06-27-2014 12:19 PM
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diamaunt Offline

Members-b

Posts: 436
Joined: May 2012

Machine: S9 VPAP Auto 36006
Mask Type: Full face mask
Mask Make & Model: mirage quattro/pilairo q
Humidifier: none
CPAP Pressure: 9-20ish
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: texas

Post: #38
RE: Hypopnea's
can you upload a graph, like that, of your recent 'bad' night? the one where you spent most of the night up at 20cm?
06-27-2014 12:24 PM
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readyforsleep Offline

Preferred Members-2

Posts: 233
Joined: Mar 2014

Machine: Resmed S9 AutoSet for her
Mask Type: Nasal pillows
Mask Make & Model: Swift FX for her
Humidifier: attached
CPAP Pressure: 14.6-17.4
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Lawrenceburg, Indiana

Post: #39
RE: Hypopnea's
Bad day with snore

fyi, in the last 30 days I had 5 days with an AHI over 5.

5.99, 12.18 (forgot tennis balls that night), 6.49, 9.72, and most recent 8.10. Various
low pressures and was experimenting with epr.

glad they pay you guys the big bucks

2010 sleep study 63 AHI, 2014 3.0
06-27-2014 02:35 PM
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robysue Offline
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Advisory Members

Posts: 1,235
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #40
RE: Hypopnea's
(06-27-2014 12:19 PM)readyforsleep Wrote:  I'm thinking I need to leave the low pressure at 12, and fiddle with the mask fit.
This sounds like a reasonable plan. Keep the pressure settings with the min pressure = 12 until you have the leaks under control. Until you have the leaks under control, it's hard to say what the AHI will look like long term at 12 cm.

Quote:My aim is to get somewhere between last night's leaks and zero. I feel like the
tight mask is somehow contributing to excessive events.
Aim for decent enough rather than perfect when it comes to the leak line. As silly as it sounds, start by looking from Mr. Red Frowny Face or Mr Green Smiley Face in the morning. As long as you are seeing Mr. Red Frowny Face, you know the leaks are not under control.

The short term goal on leaks is to get at least 90% of the leak graph to stay below the Redline of 24 L/min. It doesn't really matter (for now) if your median and 95% leak rates are more like 10 L/min or 0 L/min. If the 95% is below 24 L/min almost all the time, the leaks are "good enough" for now.

Quote:about my mask fit, should I have the bottom straps nestle against the bottom
of my ear or try it further down?
I can't help you here since I'm a nasal pillows user.

Quote:My other option is to get a bi-level to trial. Not real easy( as I am not home
right now) but doable.
Keep this on the back burner. Once you get home and once you've had a week or more of sleeping with the min set to 12cm AND decent enough (NOT perfect) leaks, you'll be in a better position to make an informed decision about whether or not to trial the bi-level.

Questions about SleepyHead?
See my Guide to SleepyHead
06-27-2014 02:57 PM
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