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What does this mean?
11-20-2013, 08:53 PM
I just downloaded SleepyHead and loaded data from my card. Now I just need to learn what all this means. Looks like a lot of very confusing data. Hoping that I will find an answer somewhere within this mound of information. I am going to decrease pressure back to 10 and then do a gradual increase back to 12 by 0.5 increments. I can't thank you guys and gals enough for taking time from your busy schedules to help me. You have made me feel so much a part of this community! :-)
Donna, the most important figure is your AHI, the lower the better but it needs to be below 5, leaks are important too they should be below 24. You can type Sleepyhead into YouTube and watch videos, sorry I'm on my phone at the moment and don't have the links. We are all in this together, no one else understands sleep apnea like others that have it.
(11-20-2013, 09:26 PM)Tez62 Wrote: Donna, the most important figure is your AHI, the lower the better but it needs to be below 5, leaks are important too they should be below 24.To Tez:
That leak advice is misleading. Donna is using a PR System One machine that reports total leak not just the excess leak for her mask. And for most masks at most pressures, the expected leak rate is greater than 24 L/min. Hence it is very, very rare for a PR System One user to see leak rates that stay under 24 L/min.
Moreover, unlike the Resmed machines, the PR machines do not have a well defined "large leak line". However, from what I've seen on other boards from PR System One users Encore reports, the System One machines when start triggering is somewhat dependent on the pressure setting used. At pressures in the 10-12 cm range (like what Donna is using), Large Leaks tend to get flagged once the total leak gets up somewhere around 85-95 L/min. But leaks can be below that official Large Leak threshold and still be well above the expected leak rate of the mask and these large, but not "Official Large Leaks", are frequently a source of sleep disturbance in PR System One users.
There are three kinds of leaks to keep in mind when you are looking at your data in Sleepy Head.
1) First, the intentional leak rate is the rate that is built into the design of the mask and it keeps you from rebreathing your own CO2. This is the air that you can feel coming out of the exhaust vent holes if you put your hand near them. This is a good form of leak. But the intentional leak rate varies from mask to mask AND it also depends on what pressure you are using. There should be a graph or a table in your Wisp user manual that gives the intentional or expected leak rate at a variety of pressures. I've been unable to find the user manual on line, but similar sized masks typically have expected leak rates for 10-12 cm of pressure at anywhere between 25 and 35 L/min.
2) Next, there are unintentional leaks. These are any leaks over and beyond the intentional leak rate built into to mask. Unintentional leaks are the BAD leaks. The Resmed machines only report unintentional leaks and Resmed draws a bright Red Line at 24 L/min as the dividing line between unintentional leaks that are large enough to create problems and unintentional leaks that are small enough for the machine to compensate for. Hence some Resmed users think any leaks over 24 L/min as "bad news."
4) The third kind of leaks are total leaks. The total leak rate is just the sum of the intentional and unintentional leak rates. In other words:
Total leak rate = Intentional (good) leak rate + unintentional (bad) leak rate
The System One machine you are using reports the total leak rate. Because the total leak rate includes the intentional leak rate for your mask, your total leak rate will NEVER be 0.0 L/min. If you have NO bad leaks, your total leak rate will be equal to your mask's intentional leak rate at your particular pressure reading (plus or minus about 5 L/min "margin of error"---there is some varience in the actual intentional leak rate for a mask versus the calculated leak rate for the mask.
In other words, a perfect leak line in Sleepy Head would be a relatively flat line near your mask's intentional leak rate at your pressure. In practice, you're not likely to see a perfect leak line. In practice, your leaks are going to bounce around a bit and Sleepy Head may make the bounces look larger than they really are. A decent starting guideline for judging your leak line (for now) is to add about 25 L/min to your mask's intentional leak rate at your pressure, and then use that number as a rough guide of when the leaks are approaching large leak territory. For example, if your mask's intentional leak rate at 10 cm of pressure is about 30 L/min, then try to keep your leaks under 30+ 25 = 55 L/min.
11-21-2013, 12:33 AM
(11-20-2013, 08:53 PM)Donna Wrote: I am going to decrease pressure back to 10 and then do a gradual increase back to 12 by 0.5 increments.There is good advice here "How to find the optimum pressure"
I like the idea of a log "Keep a written log of how you feel each morning, afternoon and evening. Note any pain, daytime sleepiness, changes in energy level or mental alertness. Make sure you listen to your body."
Here some SleepHead links
Users Guide http://sourceforge.net/apps/mediawiki/sl...sers_Guide
Here is the link Tez62 talking about http://www.apneaboard.com/forums/Thread-...sleepyhead
11-21-2013, 01:25 PM
Several people have asked if my Pulmonologist looked at my data prior to increasing my pressure. I took my SD card with me to my last appointment and was told that the data was being extracted for the Doctor. When he entered the room, he was looking at my chart, I assumed that he reviewed the report. We discussed the return of symptoms such as an increase in my blood pressure, morning headaches, snoring, etc. My doctor told me that I would likely know when my pressure needed to be increased and wrote me a prescription for an increase of pressure ranging from 8-16, to be increased at increments of 2 per my request.
I was unaware of the ability to change the pressure myself so I called my DME company for an appointment. I was told to fax my scripts and after insurance approval, I would be called with an appointment date. It took several weeks and a cursing match before I was able to get my DME company to give me an appointment to make the change. Twice since I have scheduled appointments and driven 30 miles for pressure changes, first from 8 to 10, then to 12. Luckily for me, I found this forum and now can make adjustments myself. It infuriated me to find out how simple a pressure change is and I wonder what they charged my insurance company for pushing two buttons and rotating a dial! Anyway, I seem to have gotten off track.
My Sleepyhead report today shows: AHI 3.30, Events 29, Duration 08:47:11, Clear Airway Apnea 2 events, Hypopnea 8 events, Obstructive Apnea 19 events, Pressure Pulse 76 events, Respiratory Effort Related Arousal 5 events, Vibratory Snore #2 40 events. I'm not sure what all this means. Can anyone offer insight? Thanks.
11-21-2013, 03:41 PM
I am a bit of a geek. I like a lot of information. If I were told to use hop meds I would get a blood pressure cuff and record my bp every day or even several times a day to establish my norm and to be sure I was not being affected by white coat syndrome ( hi BP because I was at the docs office). Then I would Google HBP and learn what I could just as you and I do here. Only after I was convinced would I even consider meds and then I would research the side effects before accepting one over another.
In other words I would want to know as much or more about each of my medical concerns as my GP. After all he is supposed to know ever thing about everyone's problems, we only need to know everything about our own problems. With luck we only need to learn about three or four maladies.
You did not mention leaks. That info is almost as important as AHI.
In general your numbers look great. What pressure were you at last night?
I am not accustomed to using a fixed pressure machine. Mine are always set to auto adjust within a range, say 8-14 in your case. My machine would be able to change pressure with every breath if necessary. That takes most of the guess work out of it. That is why we show a preference here for machines that can auto adjust.
11-21-2013, 05:21 PM
BWexler, I am a bit untrusting when it comes to my health too. I am a Registered Nurse so I have a tendency to question any and everything when it comes to managing MY care. My primary care physician has been very good at recognizing my part in healthcare decisions and abiding by my decisions. We have long, lengthy discussions about every little detail. He has become accustom to "proving" his point when there is any change to my care. Uncontrollable hypertension runs in my family, I actually was surprised I made it as long as I did without medication. I only agreed to take it when it became apparent that it would not subside on it's own and it became so high that I was very much in danger of a stroke. Even still, I am on a very low dose and I do monitor my blood pressure daily.
I forgot to mention leaks when I put my stats up. Sorry about that. It's certainly not fair to ask for advice without giving adequate information on which to form opinions. I just downloaded SleepyHead yesterday so I am unsure of what is or is not important in that mass of data. Here is what I found regarding leaks:
LeaksLeak Rate (L/min)
W-Avg: 2.76 0.00 1.00 12.00 15.00
Total LeaksTotal Leak Rate (L/min)
W-Avg: 28.49 16.00 27.00 39.00 42.00
My setting is at 10 cmH2O. I haven't figured all this out yet so I am not sure what any of that means or if it has any significance at all. But I do want you to know that I appreciate your input. All help is greatly appreciated!
11-21-2013, 08:44 PM
one thing I was told about blood pressure machines for home use (and those used in doctor's office) is that they tend to read BP higher than it is.
I don't know if this is accurate but one of my docs told me this.
Just told Santa what to get me this Xmas, a recording oximeter. I have sufficient supplies of after shave to last lifetime
It would tell me if my "every now and then" headaches due to O2 drop or need looking elsewhere. At times an apnea score just prior of waking up, the machine try to pre-empt an apnea event by increase pressure in response to flow limitation but if pressure at that time was hoovering around the lower pressure, the pressure increase might not be in time or enough to prevent the apnea and sometimes an obstructive apnea event can sneak without any signs of flow limitation.
Donna ... have you tried, Auto-Trial and CPAP-check modes?
In this mode, the machine acts as auto-PAP, with two pressure setting (minimum and maximum) and the machine adjust pressure as needed within the range
11-23-2013, 07:58 PM
No, Zonk, haven't tried Auto Trial. Can I do that with my machine? And what is CPAP check mode? I haven't heard about that yet. Looks like I need to do a little more research.