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Some mornings AMAZING, some awful
Other than the leak rate at the end of the night, that looks pretty good. The 1.5 cm pressure fluctuations are a part of the Phillips auto algorithm. I really think you are a candidate for fixed pressure, but using the auto mode. Setting minimum and maximum pressure the same, eliminates those pressure fluctuations which are not doing anything for you. Stay at 6.0 for the duration of the week, and if the hypopnea come back or get worse, increase to 6.5. Believe me, at these low pressures, the auto-changing pressures are not an advantage to you. We're looking to make the night quiet, without any pressure disruptions, and enough pressure to overcome upper airway resistance. You are very nearly dialed in and CPAP is working better than APAP for you...just one of those things.
10-17-2016, 01:16 PM
(10-17-2016, 12:15 PM)Sleeprider Wrote: Other than the leak rate at the end of the night, that looks pretty good. The 1.5 cm pressure fluctuations are a part of the Phillips auto algorithm. I really think you are a candidate for fixed pressure, but using the auto mode. Setting minimum and maximum pressure the same, eliminates those pressure fluctuations which are not doing anything for you. Stay at 6.0 for the duration of the week, and if the hypopnea come back or get worse, increase to 6.5. Believe me, at these low pressures, the auto-changing pressures are not an advantage to you. We're looking to make the night quiet, without any pressure disruptions, and enough pressure to overcome upper airway resistance. You are very nearly dialed in and CPAP is working better than APAP for you...just one of those things.
Any idea why I'd have a night with so few Hyponeas and then a night with so many? All within the same pressure range?
I'll try the fixed pressure but whats your thinking behind it? Do pressure fluctuations cause hypos? Thanks again
10-17-2016, 01:48 PM
Some variation is normal, especially soon after making a change. You were pretty excited about the first night after the change, but not so much for the second. Wait to pass judgement, because we can't know in one night. Your second night was not at all bad. We know you don't have obstructive apnea, even at low pressure. The incidence of hypopnea seems to increase with pressure. Hypopnea can be related to either obstructive or clear airway events. I'm leaning towards CA with you. I think based on this a more constant low pressure will likely be your solution. Once thing that's nice is that you're able to use EPR for an even lower EPAP pressure. So what you're really getting is bilevel therapy at 6/4.
10-17-2016, 02:02 PM
Thanks. Two quick things:
1) In looking at the data, how are you correlating (or at least connecting) higher pressure with more Hypos? (trying to get better at understanding the data)
2) Are you thinking I should change the EPR flex setting? Its currently set at '2' (out of a 1-3 range).
10-17-2016, 02:09 PM
(10-17-2016, 01:16 PM)SleepyMcGee Wrote: .................There's a lot of random variability in this business. Frequently there's no attributable cause. Or could be as simple as more physical shifting in bed one night vs. another. But since we have tools to look for clues, why not take full advantage of them.
Suggestion: post SH data images for one "great" and one "zombie" night. Stay with the details tab, but hide the calendar and the pie chart. Include the events channel and the respiration channel (which are absent in the prior image). You can vertically compress channels to fit in one or two more if you want. Add any dotted lines you feel might be helpful. The more data the better, as long as everything is clearly legible.
Post back if you need help manipulating the SH display.
We are such stuff
As dreams are made on, and our little life
Is rounded with a sleep.
10-17-2016, 02:24 PM
first attempt here...Cant seem to find the respiration chart for me 'good night' example...???
10-17-2016, 02:26 PM
I only have the one chart to look at, so not much to correlate since it shows virtually fixed pressure until your leaks started. There is a lot less certainty to this than my comments may seem to infer. what I see is no obstruction at any pressure. You don't need the max pressures at all. There is no obvious benefit to pressure increases, and days with higher pressure had more events based on your summary data.
I agree with Ron in the previous post. The charts would help, and this tutorial explains how best to organize them. https://sleep.tnet.com/resources/sleepyhead/shorganize
10-18-2016, 08:01 AM
Ok, here is two nights worth of data. One from Friday, a VERY good night and one from last night an 'almost zombie' night. For some reason the flow rate chart is missing from the good night...I'm not sure what happened. Tried resetting the graphs etc. Maybe I forgot the memory card that night or something...Unsure.
Hopefully this is good clean data to look at. Happy to provide anything else that you guys think would be helpful to see. Thanks a million!!
and here is the bad night data and the good night data together. Sorry, ran out of space had to put out on photobucket. EDIT: Ugh. Cant get the pics to display here. Links work through...SORRY.
10-18-2016, 08:44 AM
The night with 0.43 sure looks good. Pressure stayed at 6 through the night, and very few events. Even the "bad" night was reasonable. Again, predominately hypopnea as events. Your event rate is very low. At some point, I'd like to see you try Flex set to off.
If you could move the flow limit chart into the location of Resp Rate it would be better.
I like Photobucket for some things as well, but have moved to Imgur due to all the ad clutter. https://sleep.tnet.com/reference/tips/imgur
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