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New DreamStation - Wildly different AHI from session to session
#1
New DreamStation - Wildly different AHI from session to session
Hello. I'm new here. I was using a Philips Respironics System One for about 6 years. They just upgraded me to the DreamStation. I love all the new features and functionality. But I'm having some weird issues and I'm not really sure what is happening. 

I was told I have mild sleep apnea way back when I had my sleep study. I used my auto-pap for years and just assumed all was good. I just got this new machine and I have been using the Dream Mapper app to track my AHI and see how my sleep is. The first few nights I was under 5. But then I got some surprising results. Some sessions above ten. I just got a 36 tonight. I had a one hour nap above 40. But I also had a string of days that were really low. 

At first it was only happening for short naps. I'd have tons of apnea events during a 1 or 2 hour nap. Then I'd sleep at night and things seemed more reasonable. I also noticed that, on occassion, I was waking up with a lot more pressure than the System One ever gave me. I think I generally stay around 9 or 10. But I was getting above 11 a few times on the DreamStation. I had never felt pressures that intense before.

I got the OSCAR software and have been trying to interpret the data. I watched some videos. But I don't really know what I'm looking for. I'm wondering if I am getting tons of false positives because of a faulty new machine or if my sleep really is all over the place. I was thinking of sticking an SD card in my old machine and using it for a night to compare, but they are tracking my usage of the new machine and I'm worried they'll take it away if I don't use it. One night would probably be okay. I don't know. 

I have a link to my SD card data. The first few nights are incomplete because I didn't have the SD card actively recording. 

I don't know if anyone is able to look at it and see if they can interpret it better than me. 

drive dot google dot com/drive/folders/1JdL_l1Te-NKc2Ow_othu09_3ApiIpKAK?usp=sharing

I've also have a few screenshots if that is helpful as well. 

imgur dot com/a/AKXCX0d

One other thing to note: I also have narcolepsy and so my sleep schedule is erratic, to say the least. I often don't sleep more than 4 hours at night. And then I will sleep periodically during the day. So if my sessions seem to be at weird times, that's why.

Thank you for your help. 

PS: It's telling me I can't post links yet. So you'll have to change the dots to actual periods.


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#2
RE: New DreamStation - Wildly different AHI from session to session
G'day Froggie. Welcome to Apnea Board.

To allow us to give the best advice please post a couple of complete daily screenshots. Also post a close-up of the cluster, but in the context of a complete daily page.

See here how to format and upload the page: http://www.apneaboard.com/wiki/index.php...ganization

You can attach the images direct to your post - this is better than linking to 3rd party sites like imgur.
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#3
RE: New DreamStation - Wildly different AHI from session to session
Nights are unique and different. AHI and leaks vary a lot for me on different nights. I've been thinking that sleeping position affects a lot. Some nights are more restless than others. You can try to reduce leakage by choosing a more suitable mask. It would be interesting to see the Oscar daily chart of events. Are apneas obstructive or central mostly.
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#4
RE: New DreamStation - Wildly different AHI from session to session
(10-13-2019, 05:01 AM)DeepBreathing Wrote: G'day Froggie. Welcome to Apnea Board.

To allow us to give the best advice please post a couple of complete daily screenshots. Also post a close-up of the cluster, but in the context of a complete daily page.

See here how to format and upload the page:  http://www.apneaboard.com/wiki/index.php...ganization

You can attach the images direct to your post - this is better than linking to 3rd party sites like imgur.

Okay, I took some new screenshots. As I said, I don't have a normal "night" of sleep. Usually it is a few hours at a time. On a good night I might get 4 hours. So I'm going to refer to "sessions" rather than nights. 

I have attached a good and bad session. Plus some data from the DreamMapper app. I used photoshop to organize them a bit better. I tried to show an entire session and then I drilled down to an event so people can look a bit more closely. Hopefully that works. 

I'm open to the possibility that I am having bad apnea, but I don't know why my old machine wasn't ever blasting me with 12 pressure. It was an auto pap too. And if I am having this many events, I feel like the pressure might shoot up towards 20. Or maybe that's not how it works. I dunno. 

I'm just worried the DreamStation is faulty or detecting things incorrectly. If not, I guess I should go see the sleep doc.


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#5
RE: New DreamStation - Wildly different AHI from session to session
You may do better reducing the flex setting it may reduce the ca’s
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#6
RE: New DreamStation - Wildly different AHI from session to session
(10-13-2019, 01:30 PM)jaswilliams Wrote: You may do better reducing the flex setting it may reduce the ca’s

It's currently set on 1. I guess I could turn it off. 

Do you feel like the data is for sure legit? Or could my machine be interpreting my breathing poorly? I just can't explain why it is behaving so much differently from my old System One. And why there is such a disparity between my good sessions and bad. Is going from 3 to almost 40 atypical?
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#7
RE: New DreamStation - Wildly different AHI from session to session
You have Periodic breathing from 2243 through 2320. At this scale I can't definitively classify it though it looks like it could be CSR. Can you zoom in to provide a couple of 10 minute views to help us out.

Do you have this pattern often?

The disparity between good and bad is very common when centrals are present.

It would help us to understand your apnea if you could post redacted full copies of your sleep studies including your initial diagnostic study.

And yess turn off your flex and we can see if it helps, it should.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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#8
RE: New DreamStation - Wildly different AHI from session to session
I don't have my study handy. It was 6 years ago so I don't know how helpful that would be. I could request it but that could take a while. They told me I had very mild sleep apnea and just barely qualified for a machine back then. They got me a System One Remstar Auto PAP and I used that until last week. 

At the time, the sleep doctor was mostly concerned with my narcolepsy and treated my apnea almost as an aside. But I never responded to the treatments for narcolepsy so he just kind of shrugged and told me that's just how it is until some new research makes a breakthrough.  

He did monitor my apnea for a few months and said I was doing well. But I am disabled and it's very hard for me to get to the doctor and it didn't seem like they could do much more for me. The office was 40 minutes away and I couldn't really afford any more copays so I never went back for a further checkup. Since they felt my apnea wasn't very serious I didn't think that was a big deal. Perhaps that was a mistake. 

Honestly, the CPAP never helped my energy. I have Chronic Fatigue Syndrome and Narcolepsy and those conditions are so overwhelming that I could get the perfect night's sleep and still be extraordinarily tired. I just used the CPAP because they said I should. Then I got so used to it I couldn't sleep without it. I suppose it is possible my sleep deteriorated without me knowing because my other conditions obscured it. 

I guess what is perplexing me right now is that the DreamStation is behaving differently from the System One. I am waking up with higher pressures than I ever have before. I don't know if that is because the DreamStation is more advanced and has different criteria for setting pressure or if there is something else at play.  

I don't have a lot of sleep data to show yet. I've only been using the machine for a week and recording for four days. I've attached 3 ten minute chunks. Plus above I have a "good session" and "bad session" attachments, in case you missed those. I don't know if that is enough. But I'll keep recording from here on out. 

Also, I'm a newbie so I'm not quite up to date on the initialisms. What is CSR in this context? 

I think tonight I will try turning off Flex. And if I wake up midway through the night I might switch back to my System One and record data on that to see if I get different results.


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#9
RE: New DreamStation - Wildly different AHI from session to session
Thanks for the close ups, it is not CSR or Cheyne-Stokes respiration, that is a good thing.  Try tonight with Flex turned off.  It may take several nights to see the effects because centrals tend to be erratic, that is consistently inconsistent.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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#10
RE: New DreamStation - Wildly different AHI from session to session
I noticed your leak rate is high.  That is another 'first thing to fix' with that machine. 

If you can how about posting a good night and bad night screenshot of your previous System One  results for reference.  

I think seeing your solid, repeated historic results might clarify and help to quickly cut out the noise.  In short help us better help you find a solution faster.  

WillSleep

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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