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New To Apnea Board [confirmation of my data analysis]
#1
New To Apnea Board [confirmation of my data analysis]
Recently DX'ed with Moderate OSA (AH events 23/h, O2 sat <82% at times). Now Using the AirSense 10 Auto and ResScan Software. I'm a side  sleeper and mouth breather and that's not going to change. I understand this can affect mask fit and flow. I'm having a lot of problems being awakened (RERA) 2-3X/night. The AirSense is set at pressures of 5 minimum and 18 maximum. I have a heated tube and I set my climate controls to manual because I didn't think the humidity setting was high enough in Auto (lots of dry mouth). I have spent the last three weeks going from a small to a medium Amara View full face mask for comfort and getting the head straps adjusted well to make the mask comfortable, placed correctly and not leaking. I get no perceptible air leaks at the lower pressures and even at the higher pressures (up to 10-12), as far as I can tell.

I use a TempurPedic neck pillow which tends to be hard and with side sleeping presses against the mask causing it to shift. I've started to experiment with a softer pillow. With AutoRamp selected, I fall asleep quickly at minimum pressure but I am usually awakened within 3-4h. In the image below (click to embiggin), we're coned down to 5 minutes where an RERA is recorded. Having watched these RERAs for about 3w, I can see that when an RERA is recorded, there is a lot of mask leakage that accompanies a rise in pressure usually above 14. This typifies the 2-3X per night awakenings. You can see there is also a significant flow limitation due to an obstruction to the airway that starts at 22:19:30 and leads up to the pressure rise and the awakening. So, if I'm interpreting available data correctly, I get this.

The problem is that now, with the CPAP my AHI is down to <3 most of the time but, I'm getting more interrupted sleep and I'm probably not getting to N3 stage let alone REM sleep. My day-time feel-god index is pretty high but because I'm usually awakened by the 3rd set of CPAP pressure/leaks at 5a or so, and get up shortly there after, I'm ready to sleep by 8:30p. Before starting CPAP I was in bed at 10:30p and up at 7a  I'd like someone to confirm that I am interpreting the data that is available to me (objective from ResScan and subjectively by experience) correctly and suggest some steps I can take to ware my CPAP and, at the same time, get a good night's sleep within the previously established time frame that was perfect for me before CPAP.   

   
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#2
RE: New To Apnea Board
I think you will be better downloading sleepyhead from the top of the page, it is more user friendly out of the box and displays data in a detailed way on one page, for the forum members to offer advice..
min 5 max 18 may not be your ideal pressure range. Having too low of an initial pressure can cause problems. I can see 3 obstructive and one ca. A leak starting at 5, peaking at 25 and levelling off to 15. A pressure rise in response to the OA, during that 5 minute segment. I can't say anything else about it, others may see more. the Resscan can also change display y-axis to see the charts better.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#3
RE: New To Apnea Board
To followup on ajack's advice the link's to sleepyhead are below.
Download SleepyHead
Organize your Sleepyhead Charts
Posting Charts
Beginner's Guide to SleepyHead
Mask Primer
5
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#4
RE: New To Apnea Board
Thanks ..... I've downloaded SleepyHead to my PC and downloaded my AutoSense data card to SleepyHead. I'll have to find some time to become more familiar with the displays but I've got the general idea as compared to ResScan and you are right, SleephyHead seems a bit more robust and easy to read/Interpret data. We can look at data from January 24th. I use the Windows 10 Snipping Tool APP to take "screen shots." What areas, data graphs, etc. do you want me to snip as screen shots? When you let me know, I'll provide some comments to enhance the objective data you'll be looking at with experiential (subjective) data. I'm really anxious to get some suggestions as to what I need to do to start developing a better sleep rhythm. This one with the new CPAP is not great even though my AHI isn't terrible.

PS: ajack, if that's your son/grandson in a flight suit, mask and helmet that's cool. I can see a name tag just out of sight that looks like a set of Naval Aviator wings on a USMC name tag. Is the owner of that nametag an F18 or AV8 type? I retired from USMC in 1990 and flew A6s and EA6s for 20y. My last assignment before retirement was CO, VMAQ2. I'm also a retired Physician Assistant with some but limited knowledge/experience with OSA and CPAP therapy.
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#5
RE: New To Apnea Board [confirmation of my SleepyHead data analysis]
Read Wala Wala post above for the organize.
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#6
RE: New To Apnea Board [confirmation of my SleepyHead data analysis]
jbuch, the Sleepyhead program automatically takes great screenshots in .png format using your F12 key, and stores the file in My Documents/Sleepyhead/Screenshots. Those can be uploaded as attachments on the forum or using Imgur. Organize the graphs as described in the first link in my signature. This is a very easy process and the forum makes it very easy to attach images. The second link in my signature describes that procedure.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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#7
RE: New To Apnea Board [confirmation of my SleepyHead data analysis]
OK, will do.
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#8
RE: New To Apnea Board [confirmation of my SleepyHead data analysis]
I do my screen shots and post them a little differently than the Wala Wala post suggests but it should work so, here it is (click to embiggin). As I related above, I am awakened at least 3X/night and perceptually it seems like it is associated with a pressure rise above 10. The data graphs confirm that. You can see my pressure setting at the L sidebar. In this record for 1/23/18 you'll see how there are RERA marks around 2300h accompanied by a pressure rise and significant leaks. At this point I'm awake, aggravated, take the mask off, shut down the autoSense and watch TV until I'm sleepy (the mask is back on). Around 1:30am to 2:00 am it happens again (no RERAs) and I am awake. Once again, it happens at 4:00 am (no RERAs). This is a pretty typical night out of the first 21n on CPAP. I've had only one night with just one awakening. Last night awakening happened about 40m after I fell asleep. I took off the mask exasperated, went back to sleep without it and had a nice night of uninterrupted sleep until around 6:15am.


Attached Files Thumbnail(s)
   
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#9
RE: New To Apnea Board [confirmation of my SleepyHead data analysis]
Try using a fixed pressure at 10cm and see how that works.
Download SleepyHead
Organize your Sleepyhead Charts
Posting Charts
Beginner's Guide to SleepyHead
Mask Primer
5
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#10
RE: New To Apnea Board [confirmation of my SleepyHead data analysis]
OK, got it ....... let me make sure I understand why I'm doing this and what the goal is, Walla Walla.

I've changed my AirSense from Auto (min 6, max 18) to CPAP (10). It does not appear that with CPAP mode selected that I have auto start and stop or auto ramp features (no bid deal). On start, I get 4cm (very comfortable). I selected Run Mask Fit to test the 10cm setting and it feels fine.

I am assuming that if an airway obstruction is sensed in the AirSense, it is going to ramp to 10cm to try to eliminate it so there is no apnea or hypopnea. How fast in the CPAP mode is the ramp from 4 to 10? I'm assuming that the goal is to give this setting a try and see if we get AHI below 5, right? If not, we might step it up at 1cm increments each night until we do, right?

Thanks.
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