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Interpreting my results
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whodat Offline

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Posts: 3
Joined: Dec 2012

Machine: ResMed S9
Mask Type: Full face mask
Mask Make & Model: ResMed Quattro Fx
Humidifier: ResMed S9
CPAP Pressure: 8
CPAP Software: ResScan

Other Comments:

Sex: Male
Location:

Post: #1
Interpreting my results
Hi All,

I'm struggling interpreting my results. AHI ranges from 1-16. Been using the CPAP for 4 months or so.

Would love if someone can help me interpret what may be going on during these Obstructive Apneas shown on the chart. Or any general guidance on what is going on would be great too!

Thanks!


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12-09-2012 02:25 AM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #2
RE: Interpreting my results
Hi whodat and welcome to the board
you need to book an appointment with the sleep doc and show him these reports. is this typical night or just one-off
you might need to go to a different type of machine. did the sleep study shows any centrals
I,m not an expert, just sharing my thought, more likely to be off the mark
play with EPR some people seem to do better turned off and vice versa. sleep on your side would helps

S9 autoset can distinguish between obstructive and central apnea
increase pressure when obstructive apnea detected and does nothing when central apnea detected

it looks to me the machine want more pressure to attack those stubborn obstructive events also snore and flow limitation which is quite evident between 1.30-3.0 ... but as the machine set on cpap mode cannot go any higher or lower than set pressure
(This post was last modified: 12-09-2012 03:47 AM by zonk.)
12-09-2012 03:30 AM
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vsheline Online

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Posts: 1,915
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #3
RE: Interpreting my results
(12-09-2012 02:25 AM)whodat Wrote:  Hi All,

I'm struggling interpreting my results. AHI ranges from 1-16. Been using the CPAP for 4 months or so.

Would love if someone can help me interpret what may be going on during these Obstructive Apneas shown on the chart. Or any general guidance on what is going on would be great too!

Thanks!


Hi whodat,

Welcome to the forum!!

You have an S9 AutoSet unit which is being operated in CPAP mode, with a pressure set to 8 cmH2O and EPR set to 2.

It would be helpful to give some some more info:

Do you have a sleep doctor? Did your sleep doctor decide your machine should be set in CPAP mode, with a pressure of 8? Is the EPR set to Patient and have you adjusted it yourself, or did the doctor set the EPR to 2?

You have about twice as many Central Apnea events as Obstructive Apnea events, but one of the OA events was 45 seconds long, which is fairly long. Your pressure is too low now to stop all OA events. Were the number of CA events higher when the pressure was higher? Is that why the pressure is set to only 8?

Have higher pressures been tried? How much adjusting has your doctor (or have you) tried?

Do you have a copy of your Sleep Study report? (If not, you are entitled to a copy and should ask for one.) Did it also show mixed OA and CA? What was the highest pressure explored during the sleep study? Or, instead, did you have an in-home auto titration using the AutoSet?

Take care,
--- Vaughn


P.S. Oh, I just noticed Zonk has made some of the same observations.
I second his suggestion to avoid sleeping on your back, because it usually makes obstructive apneas worse.
Some people find good success in keeping themselves from sleeping on their back, by wearing a teeshirt with pockts sewn on the back of the teeshirt for tennis balls. I find the tennis balls need to be right in the middle, between my shoulder blades or higher, so the two tennis balls stay completely out of the way when I am on my side.

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. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 12-09-2012 10:04 PM by vsheline.)
12-09-2012 04:28 AM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #4
RE: Interpreting my results
see case study 3 ... page 62 and page 63 ... resscan interpretation guide
http://www.apneaboard.com/ResScan_Interpretation-Guide.pdf

Case Study 3: page 62
High AHI–suspected CSR .. Patient treated on S9 AutoSet with a high AHI

The numbers 1–4 (below) show the recommended order in which the data should be analyzed.

We can observe
1- Good therapy compliance: Usage of 6 hours 50 min per day.
2- A high CAI of 6.2, giving a total AI of 11.4.
3- Leaks are under control (95th percentile leak: 9.6 L/min).
4- Pressure at the 95th percentile is 13.8 cm H2O with a maximum pressure setting of 19.6 cm H2O.

Case Study 3: Suggested Solution ... page 63

Perform a sleep study to check for Cheyne–Stokes respiration (CSR).
Consider using an S9 VPAP Adapt
if CSR is confirmed.
Result: The sleep study confirmed the presence of CSR. The patient’s AHI normalized with the S9 VPAP Adapt

this may or may not apply to you ... something to discuss with your sleep doc
12-09-2012 05:26 AM
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JudgeMental Offline

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Posts: 324
Joined: Feb 2012

Machine: Respironics DreamStation Auto-CPAP
Mask Type: Full face mask
Mask Make & Model: Respironics Amara View
Humidifier: Respironics
CPAP Pressure: 11-14
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Florida USA

Post: #5
RE: Interpreting my results
Other posters have given very good suggestions. Tell us more of your history, such as, sleep clinic results, why do you have a AutoPap if you are not using it, is this a typical night.

The picture that you paint appears to me to be typical of one who could us a AutoPap in the suggested range of say 7-12 and see if it helps. Maybe a suggestion to your sleep doc about that might help. The one OA of 45 is concerning along with other in the 20s. The offshoots at the 6:30am - 07:30 are very typically of morning arousals. Not too concerning to me. We stir around alot as we awaken subconsciously.

Yesterday is history; Tomorrow is a mystery; Today is a gift; Thats why its called "The Present".
12-09-2012 11:20 AM
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whodat Offline

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Posts: 3
Joined: Dec 2012

Machine: ResMed S9
Mask Type: Full face mask
Mask Make & Model: ResMed Quattro Fx
Humidifier: ResMed S9
CPAP Pressure: 8
CPAP Software: ResScan

Other Comments:

Sex: Male
Location:

Post: #6
RE: Interpreting my results
WOW! You guys are amazing.

(12-09-2012 03:30 AM)zonk Wrote:  is this typical night or just one-off
you might need to go to a different type of machine. did the sleep study shows any centrals
I,m not an expert, just sharing my thought, more likely to be off the mark
play with EPR some people seem to do better turned off and vice versa. sleep on your side would helps

Thia is a typical night, although I do have some nights with very low numbers. I appreciate your input. I also read that use case, which helped me understand a bit more.

(12-09-2012 04:28 AM)vsheline Wrote:  It would be helpful to give some some more info:

Do you have a sleep doctor? Did your sleep doctor decide your machine should be set in CPAP mode, with a pressure of 8? Is the EPR set to Patient and have you adjusted it yourself, or did the doctor set the EPR to 2?

You have about twice as many Central Apnea events as Obstructive Apnea events, but one of the OA events was 45 seconds long, which is fairly long. Your pressure is too low now to stop all OA events. Were the number of CA events higher when the pressure was higher? Is that why the pressure is set to only 8?

Have higher pressures been tried? How much adjusting has your doctor (or have you) tried?

Do you have a copy of your Sleep Study report? (If not, you are entitled to a copy and should ask for one.) Did it also show mixed OA and CA? What was the highest pressure explored during the sleep study? Or, instead, did you have an in-home auto titration using the AutoSet?

Take care,
--- Vaughn
I do have a sleep doctor but haven't shared all of this with him yet... all settings were set by him (and never changed). So pressure at 8 is all I've tried.

I just checked my sleep study and found that my AHI was 4.8 with a mix of CA:OA of 3:1 (so three times as many CAs). It also has a line for Cheyne Stokes breathing: No (but I will bring this up with my Dr). During the study, the settings varied from 5-8cm, so yes, 8 was the highest.

I hope I answered your questions... my take-away from this is to get to the Dr to have him start tweaking that machine!

Again - THANK YOU!

(12-09-2012 11:20 AM)JudgeMental Wrote:  Other posters have given very good suggestions. Tell us more of your history, such as, sleep clinic results, why do you have a AutoPap if you are not using it, is this a typical night.

The picture that you paint appears to me to be typical of one who could us a AutoPap in the suggested range of say 7-12 and see if it helps. Maybe a suggestion to your sleep doc about that might help. The one OA of 45 is concerning along with other in the 20s. The offshoots at the 6:30am - 07:30 are very typically of morning arousals. Not too concerning to me. We stir around alot as we awaken subconsciously.
Sorry, I missed providing a response here. I'm not sure why they haven't set the AutoPap feature. And yes, this is a typical night. I will bring this up with my Doctor.
(This post was last modified: 12-09-2012 11:34 AM by whodat.)
12-09-2012 11:33 AM
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jgjones1972 Offline

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Posts: 516
Joined: Nov 2012

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: ResMed Quattro FX
Humidifier: ResMed H5i
CPAP Pressure: 18 - 20
CPAP Software: ResScan SleepyHead

Other Comments: CMS50I PulseOx

Sex: Male
Location: Ohio - USA

Post: #7
RE: Interpreting my results
I wonder if your doctor opted for CPAP and a fairly low setting due to the CAs. Some think higher pressures or auto make CAs worse. I wonder if your Doc knows the AutoSet has a feature to differentiate Clear Airway events from Obstructive and respond accordingly. This feature can only work in Auto mode.

You might want to read up on that and bring it up to your Doc.
(This post was last modified: 12-09-2012 01:01 PM by jgjones1972.)
12-09-2012 12:43 PM
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trish6hundred Offline

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Posts: 6,453
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #8
RE: Interpreting my results
Hi whodat and WELCOME! to the forum.!
You should tell your sleep Dr. all that is going on regarding your problems with your CPAP treatment.
Best of luck to you and keep us posted.

trish6hundred
12-09-2012 12:52 PM
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zonk Offline

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Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #9
RE: Interpreting my results
you can get an oximeter to check O2 level during the night. members here recommend Supplier #19 (supplier list)
if interested start your own thread so members who use them can point in the right direction

SleeyHead supports CMS50 oximeters. 2 reviews from review forum:
http://www.apneaboard.com/forums/Thread-Pulse-Oximeter-CMS-50H
http://www.apneaboard.com/forums/Thread-Pulse-Oximeter-CMS-50E

wiki oximeter http://www.apneaboard.com/wiki/index.php?search=oximeter&go=Go
Importing CMS 50D Plus oximeter data into SleepyHead
http://www.apneaboard.com/wiki/index.php...SleepyHead
12-09-2012 04:29 PM
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vsheline Online

Advisory Members

Posts: 1,915
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #10
RE: Interpreting my results
(12-09-2012 05:26 AM)zonk Wrote:  see case study 3 ... page 62 and page 63 ... resscan interpretation guide
http://www.apneaboard.com/ResScan_Interpretation-Guide.pdf
...
Case Study 3: Suggested Solution
AHI normalized with the S9 VPAP Adapt
...
this may or may not apply to you ... something to discuss with your sleep doc

Hi whodat,

During CA events, the ResMed S9 VPAP Adapt and the Respironics ASV (Adaptive Servo Ventilator) machines can do the work of breathing for the patient. The machines increase and decrease the pressure as much as needed, to keep the airway open and to maintain an adequate amount of tidal volume (airflow in and out of the lungs), until the patient starts breathing again on his or her own. In the long term, this might be the best type of machine for you.

In the short term, suggesting to your doc to set your machinee in Auto mode with a range of 7-12 (or maybe 8-12), and suggesting you can provide him with ResScan reports for his review after 2 weeks or 4 weeks in Auto mode, may lead to improvements in your AHI and sleep quality.

And sleeping on your side.

And turning EPR down (or off). As Zonk mentioned, some people have fewer CAs when they turn EPR down. If your machine already has EPR set to Patient in the Clinician's menu, this is permission for you to change the EPR setting as desired, using the normal Settings menu. If patient adjustment of EPR is not yet enabled, I suggest you ask your doctor to do so at the same time he sets the machine into Auto mode, at his earliest convenience.

However, since you are accustomed by now to an EPR of 2, I would suggest lowering EPR to 1 for at least a day or two before trying to sleep with EPR off.

If you invest in a Pulse Oximeter, I would suggest a wrist-mounted unit from Supplier #19, because wrist-mounted units apply less force on the finger and therefore are less uncomfortable to wear overnight.

Take care,
--- Vaughn

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. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 12-10-2012 04:52 AM by vsheline.)
12-10-2012 04:47 AM
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