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Interpreting SleepyHead data
#1
NOTE: I'm a new CPAP user, about 1 month, no positive results seen yet ... terrible masks fitting issues, too

Last night showed some unusual data, see attached jpg. I assume the 1st 10 minutes were falling asleep ... but what followed in the 50 minutes before things stabilized?

Unrelated ... SleepyHead reports show I begin and end an hour earlier than "real"; is there a setting for that?


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#2
(05-06-2015, 02:20 PM)gbynum Wrote: Last night showed some unusual data, see attached jpg. I assume the 1st 10 minutes were falling asleep ... but what followed in the 50 minutes before things stabilized?

It looks like your mask was leaking "Big Time". You might have it over tightened or you didn't adjust it while you were in different sleeping positions. If you can't get it adjusted, I'd recommend that you explore other brands and models. With so many different facial geometries, is one reason that there are many different ones on the market. . . (not to mention profit)

(05-06-2015, 02:20 PM)gbynum Wrote: Unrelated ... SleepyHead reports show I begin and end an hour earlier than "real"; is there a setting for that?

It's the clock on your Resmed. It is probably set to EST rather than EDT. Go into the clinician menu to adjust it.
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#3
Why such a high pressure? 25/22 in S mode Bilevel.
Need to see the classification of the type of events reported.
At such high pressure, could be pressure induce central apnea; but that's a guess.

A sleep lab actually titrated your settings to 25/22?

As for the 1 hour difference. First thing on a ResMed machine is to check the clock in the machine.
It's settable through the clinician menu.
Or, SleepHead has a clock offset setting. I don't use SH, so, I cannot tell you how to adjust via SH.
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#4
(05-06-2015, 02:43 PM)sgearhart Wrote: It looks like your mask was leaking "Big Time". You might have it over tightened or you didn't adjust it while you were in different sleeping positions. If you can't get it adjusted, I'd recommend that you explore other brands and models. With so many different facial geometries, is one reason that there are many different ones on the market. . . (not to mention profit)

It's the clock on your Resmed. It is probably set to EST rather than EDT. Go into the clinician menu to adjust it.
Well, being newly on medicare with a supplemental that pays, SO FAR, the rest, I don't know how to complain ... since I see no positives after over 4 weeks, I'm tempted to hand it back to them. I've tried tighter, looser, different positions, all to no improvement. They tried a nasal mask and nasal pillows; cannot keep my lips shut even with the chinstrap misapplied holding them closed ... switched to the full face used in the sleep lab but it seals for only a few minutes before popping out somewhere. I'll have further discussion with the DME respiratory therapist.

As for the clinician menu ... medicare and insurance require "compliance" to pay, and messing with those settings isn't a good idea yet ... I understand what you are saying (I'd A$$UMED it came from the cell connection) and will keep it on the back burner for now. THANKS!
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#5
(05-06-2015, 02:46 PM)justMongo Wrote: Why such a high pressure? 25/22 in S mode Bilevel.
Need to see the classification of the type of events reported.
At such high pressure, could be pressure induce central apnea; but that's a guess.

A sleep lab actually titrated your settings to 25/22?
Why ... that's what the doctor prescribed; he told me that it wasn't enough to do what is needed, but it is all he could do. I don't think he was comfortable with the data from the 1st night, so I had a second before he prescribed the machine. It is very difficult to get a seal, and harder to keep a seal. My nose and mouth both have sores from pressure and abrasion.

Event classification; Hypopnea 36 events, large leak 6 events (these were all in the 1st 10 minutes as I manipulated the mask to get a reasonable seal), Obstructive 18 events.

(05-06-2015, 02:46 PM)justMongo Wrote: As for the 1 hour difference. First thing on a ResMed machine is to check the clock in the machine.
It's settable through the clinician menu.
Or, SleepHead has a clock offset setting. I don't use SH, so, I cannot tell you how to adjust via SH.
Since this is still rented by Medicare, I'm not going to mess with the machine settings, but next time I'm at the DME, I'll ask. All I have changed is mask type available in my settings menu.

I'll look at SleepyHead clock offset further; looked a little and didn't find it.

THANKS!

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#6
(05-06-2015, 08:16 PM)gbynum Wrote: As for the clinician menu ... medicare and insurance require "compliance" to pay, and messing with those settings isn't a good idea yet ... I understand what you are saying (I'd A$$UMED it came from the cell connection) and will keep it on the back burner for now. THANKS!

Dear gbynum,

When I got my machine back in 2009, I was also newly on Medicare. And had a dickens of a time getting used to the therapy Sad But I decided to try to stick it out for just the minimum for compliance, which is an average of 4 hours per night.

And that's the only compliance requirement, the number of hours and number of days. My first machine was set by the doc or the DME, and never changed for at least the 1st 2 years. It wasn't even checked on!

Gradually I got used to having the mask and eventually learned how badly I missed it when I didn't use it. Dry mouth, waking up with a sore throat, taking 2, 3, or even more naps during the day because I didn't sleep through the night. This particularly bothered me when I had to drive any distance, and I knew it's very easy for me to get sleepy behind the wheel.

Anyhow, just me, but I know it was not an easy adjustment for me. That all this was going on when there were a lot of major life changes at the same time may have been part of my struggle, but I'm convinced I would not be here to type this if I hadn't persisted with it.

Takes a while for it to seem natural -- getting a mask that works, a chinstrap that works, learning whether or how much humidity you need -- it all seems like a lot to take on.

I wish I had know about sleep apnea and the therapy for it many years sooner. Might have had my mother with us longer. My brother and I, both SA, now know that Mom had it too but was never diagnosed. It still makes me so sad to know that for the last 20 years or so of her life, she never got a good night's sleep.

Hope you'll keep trying. This forum is a great resource and I'm glad I just recently found it.

All the best,
AirSign






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#7
The settings are essentially 25cm in CPAP mode, and make no sense at all for the Aircurve VPAPS. I would expect to see a much lower exhale pressure, with IPAP higher to stop any OSA. The whole purpose of prescribing this machine is the bilevel therapy. What I'm seeing in your flow rate graph data appears to be some serious periodic breathing from 22:35 to 23:00. It would really help to see the events chart or event summary on the left.

Can you zoom in on that flow graphic, and include the events? We don't know ifyou're having CA, OA or H.

COMPLIANCE, does not mean you can't change settings. Compliance for Medicare means at least four hours of use on 70 percent or more of nights, and a determination that the therapy is benefiting you. The only thing they look at is days of use and hours per day.
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#8
   
(05-06-2015, 08:48 PM)Sleeprider Wrote: The settings are essentially 25cm in CPAP mode, and make no sense at all for the Aircurve VPAPS. I would expect to see a much lower exhale pressure, with IPAP higher to stop any OSA. The whole purpose of prescribing this machine is the bilevel therapy. What I'm seeing in your flow rate graph data appears to be some serious periodic breathing from 22:35 to 23:00. It would really help to see the events chart or event summary on the left.

Can you zoom in on that flow graphic, and include the events? We don't know if you're having CA, OA or H.

COMPLIANCE, does not mean you can't change settings. Compliance for Medicare means at least four hours of use on 70 percent or more of nights, and a determination that the therapy is benefiting you. The only thing they look at is days of use and hours per day.
Chart attached; I'm near the size limit, and will delete the larger one in a day or so.

There is no "events chart"
Leaving hour off for shorter listing, Clear Airway, Large leak, none in period

Hypopnea 36:28, 39:03, 40:43, 41:36, 47:44, 49:16, 50:21, 50:50, 51:15, 52:13, 53:38, 57:35, 58:16, 59:45

Obstructive 35:26, 42:17, 43:36, 44:18, 45:06, 46:07, 47:12, 55:44, 56:45, 59:41
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#9
you have a full face mask. I am going to speculate - wild guess... since your hypopnea is most prevalent.

My guess is that you start out breathing through your nose (less flow volume). After a few breaths, your brain signals you just aren't getting enough volume, so it makes you uncomfortable enough to switch to mouth breathing. You take 4 5 or 6 breaths through your mouth, and nod back off - naturally switching back to nose breathing. You're body is ok with taking these lower volume breaths for several breaths, maybe 5 or more, then it starts the cycle over again.

QAL
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.
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#10
(05-06-2015, 08:28 PM)gbynum Wrote: Since this is still rented by Medicare, I'm not going to mess with the machine settings, but next time I'm at the DME, I'll ask. All I have changed is mask type available in my settings menu.

I'll look at SleepyHead clock offset further; looked a little and didn't find it.

THANKS!
Medicare only cares about compliance. Not settings.

In anycase, you can adjust your time in SH with clock drift... Clock offset is done on the CPAP tab..
[Image: sgnY4TGl.png]

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