New to CPAP - Need advice!

[Sleeprider]

You're not tolerating the EPR, go to a setting of 1. We might end up turning it off just with Flex.  This looks a lot like complex apnea, and is triggered at pretty low pressure support levels, and as you note, much of it is during periods you are awake, so we shouldn't jump to conclusions.  Anyway, you were getting results on CPAP that did not have any CA, and we will get back to that, even if EPR is not part of it.

EPR is not going to work for you  Your current results are good and the only technology that would 
resolve the flow limits, H and CA is ASV.  That seems unlikely at this point with evevts consistently under 5.

[avaholic]

Hello all!

I'm still faithfully using my machine night in and night out with pretty good results. 

The past two nights however I've noticed some pretty strange behavior from the machine. I usually try to go to bed between 9:30 or 10:30 each night but the machine is starting to record data around 8:15 or so. I now have a section of blank data at the beginning of the sessions both Monday and Tuesday night. I'm positive the machine was NOT on. I even checked last night at 8:30 to verify there was NO pressure/air being blown into the mask so why is the machine recording data at that time?

The only option that I see in the clinical menu for an auto-on feature is 'SmartStart' which is OFF. 

After the recent time change, I noticed the time did not automatically change on the machine so I went into the clinical menu and manually set the time back one hour. Would that have caused this issue?

Any ideas?

Thanks!

Monday
[attachment=9061]

Tuesday
[attachment=9062]

[Sleeprider]

That is pretty odd, but the session information and STR.edf file is identified. You can de-select that session and it won't be counted or shown, but I don't know why it is being recorded.

[avaholic]

Thanks Sleeprider.

It happened again last night as well. 2 phantom sessions appeared when I know for a fact the machine was NOT on. I hit the button at 9:55 pm last night. That 21:55 session is valid but it as only 8 minutes and its SWJ.

I guess the question is should I be concerned about this? 

Wednesday
[attachment=9076]

[jaswilliams]

Try unplugging the machine maybe a reboot will clear it

[avaholic]

Ha! I tried exactly that last night before I turned on the machine JASW and low and behold the unit is not recording phantom sessions now. LOL

I know i keep asking the same thing but i'll ask one more time... 

Are the multiple Hypopneas that are listed in my charts events that I need to be concerned about?

If I've understood previous responses correctly, these events are NOT something that can be eliminated by changing to a ResMed AirCurve 10 VAUTO. They can ONLY be corrected with an ASV machine. Since my AHI is below 5 most nights there is no way that I will qualify for an ASV titration or for a different machine for that matter.

Note that I feel much better than I have in a very long time.

Thursday
[attachment=9094]

[Crimson Nape]

avaholic,
What are the time spans of the Hypopneas?  Look under the Events tab on the left. The times are dis[played within parentheses by each one.

[avaholic]

10 seconds each I think?

Here are all the events expanded.

Thursday events
[attachment=9095]

[Sleeprider]

Your machine measures hypopnea as a reduction on flow rate, and 10 seconds is the minimum for an event.  There are several definitions, and I doubt you would meet the AASM criteria.  It would take a recording oximeter to know for sure, but people dont typically have changes in SpO2 for 10 second events.  https://sleep.biomedcentral.com/articles...018-0023-1 

The AASM continues to recommend scoring hypopneas in adults when there is a ≥ 3% oxygen desaturation from pre-event baseline and/or the event is associated with an arousal.  However, it is acceptable for accredited sleep centers to score hypopneas in adults when there is a ≥ 4% oxygen desaturation from pre-event baseline.

Resmed defines hypopnea as

Hypopnea is a partial blockage of the airway (shallow breathing). During a hypopnea, breathing is reduced by 50% for 10 seconds or longer.  https://www.resmed.com/us/en/healthcare-...aries.html 

Your CPAP flags events, but doesn't offer much insight on their impact.  In this- case, the event appears to meet the minimum criteria for flagging, and that is about all we can conclude.

[avaholic]

Ok. So I just did an in-home Oximetry test last weekend with one night CPAP ON and one night CPAP OFF. Here is what my doc just responded this afternoon:

"We were able to get a download of the correct study from your DME. I have great news, your oxygen levels are normal while you are using your CPAP machine. Therefore, persistent low oxygen levels are not an issue at this time.

Not surprising, when you do not use your CPAP machine, your oxygen levels do drop (part of the definition of OSA).

Therefore, keep using your machine as much as you can when you are sleeping. It is optimally controlling both your sleep apnea and nocturnal oxygen levels."

So I guess I just won't worry about them if its indeed low oxygen levels that would cause concern with these Hypopnea events.

Thanks!