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Sleepyhead v0.9.3-0 -- problem with Win XP?
#31
RE: Sleepyhead v0.9.3-0 -- problem with Win XP?
Ron, Thanks again for your help - I now better understand the term "Master Member". Let me digest your comments and then continue.

I had thought that the nasal mask was a good choice for me and that I was not only able to keep my mouth closed, I also had the luxury of being able to yawn without disturbing things. Now I'm realizing that it is apparently not uncommon for "fluttering" to occur (open mouth?) which wakes me up with a confusing start.

Although I feel like I'm sleeping pretty soundly, and seldom remember the events of the night, I'm seeing my data all over the map from day to day. I'm going to go back to the full face mask tonight and see what difference that makes.

Plus I don't really know what I'm looking at here, at least in terms of the event flags.

I'm hoping to have a conversation with the Doc next week, but as I may have indicated earlier, this is pretty much of a "mill" with little personal attention. We'll see how it goes.

Phil



(07-10-2013, 12:45 PM)RonWessels Wrote: I'd be somewhat surprised if you were _that_ lost.

For example, the pressure graph is pretty straightforward. It gives the pressure that the machine is providing at any given time. If you have a constant-pressure CPAP setup, this is a really boring graph - a straight line at the specified pressure. [ That for a REMstar machine. For a ResMed machine, the pressure data and hence the graph also includes the EPR, so you can see the individual inhale and exhale pressures. ] If you have an auto-adjusting machine, you can see the various pressure settings it chose throughout the night. If you find that the pressure graph frequently flattens out at the upper and/or lower limit of your auto pressure range, you should talk to your doctor about increasing that pressure range; the machine thinks you need a higher/lower pressure, but the pressure limit settings are preventing it from providing it. If the pressure readings always stay between your upper and lower limit pressures, everything is working properly.

The Flow Rate graph is another graph that is frequently looked at. It gives a moment-by-moment indication of your breathing. As you inhale, the flow rate goes up. As you exhale, the flow rate goes down. When that graph stays flat for a period of time, you are either intentionally holding your breath or you are experiencing an apnea event.

The Leak Rate graph is something else deserving of mention. One of the lines is the total overall leak rate in the system, including the intentional leaks in your mask and any unintentional mask leaks or leaks through your open mouth. RemStar machines need to be told what type of mask is attached, so they know the expected intentional leak rate and calculate the unintentional leak rate by subtracting that from the total leak rate. REMstar machines appear to perform a statistical analysis to determine the intentional leak rate, and again determine the unintentional leak rate by subtracting that off the total leak rate.

Get familiar with those graphs, and we can discuss some of the other graphs later.

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#32
RE: Sleepyhead v0.9.3-0 -- problem with Win XP?
As a general rule, full face masks tend to be more problematic with leaks (because of the bigger seal requirement). Again, as a rule, people tend to prefer nasal masks, or better yet nasal pillows, and work to keep their mouth closed. There are many options to help in that regard. I find it often sufficient to have my tongue fully forward so it touches by upper teeth and is firmly against the roof of my mouth. If you are a side sleeper, you could also jam some of your pillow between your lower jaw and your neck to provide a little extra support. There are also chin straps available for sale that hold your jaw closed at night.

In terms of being able to yawn, yes it can be done, but you have to train yourself to do it. Think about blowing up a balloon; to do that, you have to seal the airway going to your nose, otherwise the pressure would escape there rather than going into the balloon. With a little bit of practice, you can control that at will and be able to yawn without the weird feeling of the airflow going from your nose out your mouth. Now, that will register on the CPAP device as a breathing interruption, so at the very least, it may show up as an apnea event in the data log, depending on its duration.

In terms of events, the ones to pay attention to are the Apnea events (both obstructed and clear airway) and the hypopnea events. Those are what contribute to your AHI reading. The snore readings are a possible indication that your pressure might be too low, but can otherwise be ignored. Unless you get _lots_ of periodic breathing events, you can safely ignore those as well. With an auto-CPAP device, a flow rate event is the device sensing, based on the shape of the flow rate curve, that an apnea event might be forthcoming. Totally and completely ignore anything that happens in periods that you know you are awake.

Keep researching, and you'll soon get up to speed with this stuff. Believe it or not, two months ago, I had no idea what a hypopnea event was and had never even heard of SleepyHead.
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#33
RE: Sleepyhead v0.9.3-0 -- problem with Win XP?
Ron,

Okay, let's focus on just the facial equipment and see if that doesn't help.

I too felt that there were more leaks with the full mask, and plus, I had a nose or eyeball to scratch. Also, after 4-5 days of nasal pillows, I found that I would get minor, but distracting, skin irritations which were unhelpful in getting a full night's sleep. In the end, the nasal mask seemed to be the best choice.

I really thought that I was in fact keeping my mouth closed all night, with my tongue forward, and it seemed that I was on my way. But that was in the beginning of the night, and apparently things changed later on during the night. The chin straps were ineffective because I would simply part my lips even with my teeth closed.

Now, even though I find it easy to lock my mouth when the night begins, and I lock a pillow between jaw and my neck, I apparently can't make it through the night without something changing. (I even "trained" myself to not pee 4-6 times a night, and I was quite pleased with that major accomplishment.)

I must however unfortunately confess that recently I've been kind of obsessed with cooling down and controlling the air temp and circulation in our house at night by using the new whole house fan and opening various upstairs/downstairs windows throughout the night, rather using than the much more expensive AC. But since we will often see 80⁰+ temps outside as late as 1 or 2 AM, you can probably imagine the ridiculous hopping around, in and out of bed, and mask removal requirements, that might occur in dealing with that stupid issue. (No comments necessary)

So starting tonight - strictly AC.

Also, it is not unusual that I (and my wife) would be awoken by my "fluttering" (something going on in my mouth - tongue, cheeks, who knows?), but whenever this occurs, or if my mask gets pulled off, or if it's time to check the house fan, or whatever I'm programed to "need" to do, I never know where I am, or what's going on, when I actually do wake up. It's like suddenly coming out of a very deep sleep. In fact I sometimes wake up wondering what's on my face, or why I have on a mask (with no hose - because I fell asleep before I re-attached it), or why I seem to have a plastic nose.

So anyway, aside from the possible comedic value and effect of these problems, I will drop all of these otherwise unnecessary distractions, and see if I can't simply sleep through the night and gather some good data in the process.

Boy, this really is not easy!

Phil




(07-10-2013, 05:12 PM)RonWessels Wrote: As a general rule, full face masks tend to be more problematic with leaks (because of the bigger seal requirement). Again, as a rule, people tend to prefer nasal masks, or better yet nasal pillows, and work to keep their mouth closed. There are many options to help in that regard. I find it often sufficient to have my tongue fully forward so it touches by upper teeth and is firmly against the roof of my mouth. If you are a side sleeper, you could also jam some of your pillow between your lower jaw and your neck to provide a little extra support. There are also chin straps available for sale that hold your jaw closed at night.

In terms of being able to yawn, yes it can be done, but you have to train yourself to do it. Think about blowing up a balloon; to do that, you have to seal the airway going to your nose, otherwise the pressure would escape there rather than going into the balloon. With a little bit of practice, you can control that at will and be able to yawn without the weird feeling of the airflow going from your nose out your mouth. Now, that will register on the CPAP device as a breathing interruption, so at the very least, it may show up as an apnea event in the data log, depending on its duration.

In terms of events, the ones to pay attention to are the Apnea events (both obstructed and clear airway) and the hypopnea events. Those are what contribute to your AHI reading. The snore readings are a possible indication that your pressure might be too low, but can otherwise be ignored. Unless you get _lots_ of periodic breathing events, you can safely ignore those as well. With an auto-CPAP device, a flow rate event is the device sensing, based on the shape of the flow rate curve, that an apnea event might be forthcoming. Totally and completely ignore anything that happens in periods that you know you are awake.

Keep researching, and you'll soon get up to speed with this stuff. Believe it or not, two months ago, I had no idea what a hypopnea event was and had never even heard of SleepyHead.

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#34
RE: Sleepyhead v0.9.3-0 -- problem with Win XP?
Last night I ran a test of sorts. I used the nose mask and I taped my mouth shut because I want to see what the data looks like without breathing through my mouth. I also gave up on trying to hop around trying to control the house temp with AC and whole house fan. Unfortunately I ran into a period (2330-0300) where I couldn't get back to sleep.

Interestingly enough I see "events" during the time that I was awake so that further confuses my understanding of what I'm looking at. This is really all pretty overwhelming, but maybe that's partially because there are number of other issues on my plate right now. Also, if I click on a graph, the data jumps into a different look and I can't get it back to where it started.

Starting this Tuesday, we'll be traveling for about 9-10 days, so while I'll be able to continue using the CPAP, I won't be able to download additional data.

It's clear that I need to spend some quiet time deciphering this Sleepyhead program, and perhaps I can do that while on the road.

Phil

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#35
RE: Sleepyhead v0.9.3-0 -- problem with Win XP?
Firstly, when you say that you taped your mouth closed, I hope you didn't seal your mouth with duct tape. That is extremely dangerous. What I hope you did was take a single strip of tape to seal your mouth closed, but first checked that with a bit of effort, you could overcome the tape and open your mouth if you needed to. That latter technique will provide support for keeping your mouth closed, will remind you almost at a subconscious level to keep your mouth closed, but will let you open your mouth immediately if you really need to.

Yes, the machine will record events while you are awake. It has no idea whether you are awake or not. I find myself that I tend to hold my breath when I am adjusting my pillows, and that registers on my machine as apnea events. This is why a data-capable machine is important: I have looked at the nightly summary on the machine's LCD to see a relatively large AHI, but when I examine the data in detail, almost all of the events are in a period when I know I was still awake. Just ignore those and look at what is happening while you are asleep.

Oh and yes, the zoom functionality on SleepyHead, er, "takes some getting used to". A left click will zoom in on the region you click at, and a right click will zoom out with some weird relationship with where you clicked. With sufficient right-clicks, you can get back to the whole-night view.
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#36
RE: Sleepyhead v0.9.3-0 -- problem with Win XP?
The use of tape was pretty straight forward and is was not something I'll be doing again. I was just trying to take one variable off of the table.

In the end all I really want to do is get my energy back and the fact that has not happened, even to a small degree, is really what is most frustrating.

To make matters even worse, I have a friend who awhile back slapped on a C-Pap, had minimal adjustment period, and now has the energy he had 10 years ago (and he has a full beard and is very overweight).

I guess I perhaps need to ask what is a reasonable time period in which to expect results or perhaps look for other possible problems. That's the question for the Sleep Doc when we talk next week.


(07-11-2013, 02:40 PM)RonWessels Wrote: Firstly, when you say that you taped your mouth closed, I hope you didn't seal your mouth with duct tape. That is extremely dangerous. What I hope you did was take a single strip of tape to seal your mouth closed, but first checked that with a bit of effort, you could overcome the tape and open your mouth if you needed to. That latter technique will provide support for keeping your mouth closed, will remind you almost at a subconscious level to keep your mouth closed, but will let you open your mouth immediately if you really need to.

Yes, the machine will record events while you are awake. It has no idea whether you are awake or not. I find myself that I tend to hold my breath when I am adjusting my pillows, and that registers on my machine as apnea events. This is why a data-capable machine is important: I have looked at the nightly summary on the machine's LCD to see a relatively large AHI, but when I examine the data in detail, almost all of the events are in a period when I know I was still awake. Just ignore those and look at what is happening while you are asleep.

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