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LOW AHI vs actual REAL quality sleep
#1
I've had my machine now for about 50 days. I ALSO have 2 infra-red camera's that watch me all night from 2 angles. They snap a pic every 2 seconds IF I move.
The idea behind doing this was to see if there was a correlation between my obstructive events and a particular position I'm laying in.

An additional interesting thing has come out of this.

Doing the math every morning, I am able to get a number representing movements/Hr and this has shown some disturbing data. Even though my CPAP numbers are great going from 43 events/Hr without cpap to under 4 with, I HAVE had nights with 63 movements/Hr and as low as 16. MANY of these high numbers were due to my mask. I am still trying different ones but having difficulty finding one that doesn't either bypass air out the perimeter at high pressures OR blow air from my nose through to my eyes via the nasolacrimal ducts. I'm in the process of trying another mask setup tomorrow hopefully. Right NOW, I have the best results with a Simplus using a pressure no higher that 14. I tried that new Respironics AmaraView and although it initially FELT like is was going to work, it failed the worst. The design just doesn't work for ME. I'm thinking of going to one of those full face gasmask looking things. At least then, I won't have air blowing THROUGH my eyes! Yikes!
<snip>
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#2
i'm at the same point as you are, about 50 days and wondering if it works.

I personally find pressures about 9 and above disturb my sleep and are possibly counter-productive. I ran min/max pressures 5 & 6 last night and got low AHIs. I am not a mouth breather [thats awkward, I once bred "mouth breeder" tropical fish] so I think I will find a pillow good enough, I have a larger size to try tonight. Smile

We can buy try and hope.

ps. If I get it quiet enough I might be welcome back in the matrimonial bed. Big Grin
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#3
If you have not already done so go into the preferences area of SH software and configure it to allow both User Flag 1 and User Flag 2. This will show you events (I believe the default is set at 8 seconds) that do not "qualify" as apneas because they don't technically fit the definition (10 or more seconds in length). They are not counted in the AHI calculation but they do effect your sleep as they are arousal events. if you see many UF1\UF2 events then you have figured out the problem.
Coffee

Happy Pappin'
Never Give In, Never Give Up


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. 
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#4
How do we know that they <are> arousal events?
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#5
(08-19-2015, 03:22 PM)PaytonA Wrote: How do we know that they <are> arousal events?


I use simple logic. The machine is programmed to record apnea events which our doctors tell us are arousals. I look at all of my graphs to see what happens to each one during a recorded event that is an arousal to see what happens during one. For an example, perhaps respiration goes up and tidal volume goes up, etc...I look for the same patterns for a UF1 or 2 event. If I see the same graph behavior I conclude its an arousal of a sort. If this is erroneous please feel free to educate me.
Coffee

Happy Pappin'
Never Give In, Never Give Up


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. 
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#6
But an event of shorter duration may not be an arousal. I do not know this but am just speculating.
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#7
True enough. It may not be. With a UF default of 8 seconds it's close enough to the standard 10 and if one is not feeling rested in the AM with a very low AHI, UF 1s or 2s might help explain why. It's a place to look to try and find a reason why.

Following up on your point it would be interesting if one of our members who is seeing a sleep doctor soon could ask the question of whether an 8 second "event" is enough to constitute an "arousal".
Coffee

Happy Pappin'
Never Give In, Never Give Up


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. 
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#8
Sorry, but the term arousal and the term apnea event are so different they cannot be describing the same thing. There are many apneas that resolve without arousal per se. There are many arousals that are not scored as apnea or even hypopnea. Case in point, RERA or respiratory effort related arousals are detected by some machines, and those wave forms do not resemble the hypopnea or apnea events. There are arousals that are not connected with any apnea, such as periodic leg or arm movement, or from being startled by noises inside or outside. There are apnea that get resolved by central nervous system feedback, without arousal; there are apnea caused by mechanically overventilating which may not lead to arousals. My natural arousals throughout the night are not the product of apnea, hypopnea, or mini- or micro- UFish partial unscored apneas.

I applaud your use of the experimental SH parameters of UF1 and UF2 to try to correlate the feeling you get when the frequency of these parameters are higher versus lower. But, there may or may not be a direct correlation. Many suffering from sleep disorders do not even exhibit apnea.

soap box has been removed, and my rant is now over - Smile

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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#9
My AHI has always been below 1.

FWIW, I have tweaked UF1 and UF2 parameters and recomputed these indices for values of 5-8 seconds and 10% to 80% reduction in airflow. I found no correlation with how I felt in the morning. So these may be of dubious value to diagnose sleep issues and sleep related arousals.

Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
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#10
I find that when I am really examining the data for some purpose other than a routine check, that zooming in on the flow rate and scanning through the whole night is best. Rather than trusting an algorithm I can actually see all the nuances of my breathing. I don't have to wonder what the algorithm settings might have missed. In addition to seeing every apnea/hipopnea no matter the length, I can also assess areas of rough or distorted breathing.
When I was first setting up my APAP this allowed me to understand that I needed a little more pressure than the auto wanted to settle at. I had good AHI but was not getting rested. So I nudged the run pressure up with my min EPAP setting.
if you can't decide then you don't have enough data.
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