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I think things are getting better.......
#1
So, after 8-9 days of hell, leaking masks, not being able to sleep, waking up every hour etc etc. I think I finally have things settled down. Leaks are pretty much non-existent now, and I'm sleeping better, not perfect yet, but better.

I'm on an APAP, my average pressure is around 15 or so. What I'm wondering about now though is my AHI. Over this last 1 1/2 weeks the lowest it's gotten is 15, highest was 28. If I remember correctly my sleep study was 44.

I do feel better overall, not falling asleep all day long, headaches are almost gone, better mood, so something must be working. But does anyone have any idea why my AHI's are still so high?

Not looking for medical advice per se, just other folks opinions and experiences.

Thanks!
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#2
Congratulations on your progress so far, reallytired! With mask leaks well controlled and your auto machine operating as it should, those still high apnea numbers make me wonder if many of your events might be due to Central Apnea. Others know more about SleepyHead, but across the top of the AHI chart, I see numbers listed for CA and OA events. What sort of CA numbers do you see?
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#3
Also, you should give it some time to see how your AHI numbers look over a longer period. You didn't mention how long it's been since leaks were first controlled, but it sounds like it's only been a night or two. I don't know why, but I've seen my own AHI continue to come down "all by itself" after first getting mask leaks under control.
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#4
Hmmm, good point, maybe.

I'm at work at the moment and don't have SleepyHead installed here. I'll have to take a look when I get home and see exactly what's making up the numbers.

I briefly mentioned it to my DME the other day and he said one possibility is that we may have to look into a BiPAP. Don't know enough about what that means yet though, I will be reading up on it!


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#5
When you get home to look at SleepyHead, look at any leaks and if you had any you should see subsequent apnea's (of any kind) during the same timespan(s) so your actual AHI's are being skewed by the leaks.

In SleepyHead you can find the longest timespan on the Leaks graph and then click-n-drag your cursor to highlight the area between two leaks and then release the mouse button, the graph shown for Leak should now show just a flat-line of 0.0, now scroll to the Flow Rate graph and it will show you (at the top just above the actual graph) the Events=, Duration= and AHI= for just the selected area.

This is a more accurate way to judge the efficacy of your CPAP sessions without a major leak skewing the data, whenever a leak occur's the majority of all the other data (except Leaks and Tidal Volume) being recorded during the same period are not accurate.

I really wish SleepyHead had an option to leave all the actual data but to then recalculate the session data (AHI's especially) without the extreme's where I could set a Leak threshold like over 25 L/min and then see what really happened if there wasn't a major leak to screw-up the results.

Fortunately, now the only leaks I get are whenever it's time to replace the mask cushion or the headgear when the velcro wears out and won't stay in place.

Ren
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#6
I don't think it's leak related, my unintentional leak line is virtually flat all night. A couple bumps here and there but nothing huge and also nothing that correlates to any events.

After reviewing the data I can see the majority of events are Obstructive A's (101 last night) vs 23 CA's and 44 H's.

When I zoom into the flow rate graph and look at what's labeled as Obstructive Apneas I just don't see it on some of them, in other words those areas look like any of the normal areas, no flat line where I stopped breathing. Maybe I'm just not used to reading them yet, either that or maybe they're not being captured accurately.
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#7
One thing to try is to raise that lower number. If you are regularly hitting 15, a minimum of 5 is a huge jump.

The machine can act fast, but if it is cruising along fine at 7 and you roll over onto your back and have an event, it now has to raise the pressure continually until it fixes the event.

You may want to raise that lower number to 10 or higher.

How long are your events lasting? In SleepyHead, click the "events" tab on the left. Then open the "obstructive" or "central". Those numbers in parenthesis are the seconds each event lasted.
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.




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#8
(11-30-2012, 01:33 PM)ImReallyTired Wrote: Not looking for medical advice per se, just other folks opinions and experiences.

Based on my experience and what I've seen others report, it's normal for your AHI to gradually drop during the first few days or weeks of CPAP therapy.

After that it can continue to slowly taper off,
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
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#9
Paula02 - Good point about raising the minimum pressure. I will be talking to my DME next week and will be sure to go over that. Also, looks like the events are ranging between 20-60 seconds.

Sleepster - This is the first time I've read that the AHI can improve over time as you get things dialed in etc. My numbers over the last couple days seem to bear that out, night before last was 15, last night was 13. Granted that's not much data to go on but it's nice to see it going in the right direction.

Lastly, one more question. In the SleepyHead Flow Rate graph, I see little dots here and there directly over the actual waveforms. I haven't been able to figure out what they are, does anyone know? Oh wait, one other question, in the same graph every now and then I see an area highlighted in green, any ideas on that one?

Thanks everyone. Great forum!
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#10
Do the dots in the flow rate have a line with them? That is the marking of the events. Each color indicates the kind of event.

No clue on the green highlight.
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.




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