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What to believe: the good nights or the bad?
#1
What to believe: the good nights or the bad?
I thought I had my condition under control; I found the right mask and the right pressure and my AHI's approached zero. 
Then along comes last night when my AHI hits 13, and I have no alibis like mask leaking: they're all  obstructive/hypopnea.
If I have to describe my status, can I ignore this session as an aberration?
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#2
RE: What to believe: the good nights or the bad?
If the OA and H events are clustered, that would be positional (chin tucking) and may or may not be a one-off. Chart?
Sleeprider
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#3
RE: What to believe: the good nights or the bad?
Show the data and there might be an answer.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: What to believe: the good nights or the bad?
OK. My first attachment: I assume that the selected traces are the most informative, is there any way to screen capture all?
The chin tuck explanation sounds very plausible, given the clustering. I should acknowledge that I had taken 5 mg zolpidem immediately prior to masking.
I have no memory of removing the mask after only 1 h. I have in the past, without sleep aids, suffered through split sessions to accumulate > 4h.
Without the zolpidem, I have never been able to sleep under the mask.


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#5
RE: What to believe: the good nights or the bad?
This chart consists of a sleep session only one-hour long. We have not seen other charts to compare this short session with. This chart suggests you are using a minimum pressure of 5.0 and maximum of 10.4. We normally want to see Events, Flow Rate, Pressure, Leaks, Flow limitation and Snore, so this chart is not helpful.

There are many low-flow periods that are not flagged as apnea or hypopnea, but they sure look close. I think your pressure is too low and your airway is unstable. Alternatively you are experiencing a blocked airway from chin tucking. With EPR at 2, you are starting at a pressure of 5/4 and this is extremely low for obstructive apnea. We can see your airway does not stabilize, but is better at the higher ranges of pressure.
Sleeprider
Apnea Board Moderator
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____________________________________________
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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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#6
RE: What to believe: the good nights or the bad?
Thanks for your instructions on the most relevant tracings to include. I am puzzled that you regard information from low pressure intervals inconclusive. Do these intervals not mimic the untreated state? The original sleep test, with its major indications of apnea, was conducted at ambient pressure.  

In the recommended format I include as attachments, last night's results, my first night under zolpidem (which led me to believe I had all under control,) and a preceding split session marred by leaks but with an obstructive apnea rate I had regarded as acceptable. The latter session was without zolpidem and without sleep under the mask.

Again, thankyou for your instructions.


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#7
RE: What to believe: the good nights or the bad?
I'm glad you're asking questions here. I don't have the experience to make recommendations to you.

However, participating here has transformed my treatment. I've done this a long time with no success. I've always been compliant.

Difference? I took the advice of the wonderful people that helped me. That included setting up my machine properly. It didn't give me instant results. But it gave me wonderful results over time.

People here are incredible and so knowledgable. I hope that you find the results you want.

After all if we have to wear all this crap it better work.
DaveL
Compliant for about 30 Canadian years

I'm just a cpap user like you. I don't give medical advice. I hope to learn from you, and share my experiences with you. 
Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

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#8
RE: What to believe: the good nights or the bad?
Even as a newcomer, I share your positive assessment of this forum.
Unlike most patient forums dealing with chronic conditions, this forum is remarkably devoid of complainers, skeptics and trolls.
Instead, the moderators believe in and have personally benefited from treatment.
Moreover, the analytical and technical resources are absolutely beyond compare.
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#9
RE: What to believe: the good nights or the bad?
I'll admit I find it puzzling that you had very low AHI then found events going very high at what I assume are the same pressures. Can you show a chart from before the high AHI? The last one was a very good chart and has all the needed information, but I'm just having trouble spotting what is going on as things vary quite a bit. The whole night looks like your sleep is disrupted and there is a lot of inspiratory spikes and variations in pressure.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#10
RE: What to believe: the good nights or the bad?
a 10 minute view scale screenshot from 12/11 might also be instructive. try something between 23:53 and 00:00.
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