hello new to forum

[harmony]

Hi all

i have had sleep apnea for 6 years but only just got a machine that i can look at my own data with sleepyhead

so hope someone can answer some questions

tried ringing my sleep technican but so far no replies

couple queries - sorry if sound silly - i noticed i get a mixture or obstructive apneas usually first hours of sleep, then clear airway events ( which i first though was a good thing - but after reading up - is central apneas ? ) then unclassified and hypopneas then back to obsturctive before i wake up - any thoughts on this - is this a normal pattern or does it not really matter ?

i was told i have obstructive sleep apnea - but could this mean i have mixed ? does it matter ?- i use auto machine so pressure adapts anyway

also i get large leaks in the middle of the night - i wear nasal mask - so believe this could be mouth leaks ?( never heard of this until recently despite having sleep apnea for 6 years - use a nasal mask as was told to so never thought about if may need a full face one until now as can see the data ) i do occasionally get the red frowny face - i have tried moving my machine so it is up on my bedside table instead of on floor and raised the head of my bed with books as i believe this helps - my large leak does seem to be lessening at bit

thanks for any advice and thanks for having me on forum

[justMongo]

First you need to tame the leaks. You probably are leaking by opening your mouth. Many people can use a nasal type mask with a chin strap to gently reinforce the habit of keeping the mouth closed.

Large leaks can make the machine mis-score the apnea type. Also, it is not uncommon to have a some pressure induced central apneas when beginning therapy.

You can post a sleepyhead screen shot as an attachment. Keep it under 300kB. Try to show, Pressure, flow, leak and events.
Please redact any personal information from a screenshot. (Like your true name.)

BTW -- which S9 do you have. Look for a name near the start button.

[cate1898]

Welcome to the forum harmony! The large leaks could also be when you roll over at night perhaps you are dislodging your mask's seal. Some nasal pillows are bad for that, or perhaps it's a sizing issue.

[harmony]

HI guys

thanks for the responses - so promptly - that really great
as said have had sleep apnea for 6 years but told that machine just does its thing ( auto) and i dont need to be concerned about anything other than using it - but now under a different sleep team and got this data and has got me thinking maybe its not so clear cut as i thought ?

my new machine is a res med auto set EPR - doesnt say anything else - i used a fx mirage nasal mask for her
i did think maybe i move too much as i have quite bad restless legs and often nearly fall out of bed and have also nearly wrapped hose round me in sleep - but dont know how i would stop that - already on meds for that and cant take any more to help
the large leaks seem to happen between 2 and 4 am if that helps

these are average statistics copied straight from overview page - struggling with a screen shot - need to read through the sleepyhead info guide to work out how to do it with the right size attachment - i dont know if this makes any sense to you as i am new to actually reading any data

AHI 2.96 1.16 1.13 1.13 1.13
Obstructive Index 2.71 0.71 0.65 0.65 0.65
Hypopnea Index 0.08 0.21 0.21 0.21 0.21
Clear Airway Index 0.17 0.20 0.22 0.22 0.22
Leak Statistics
Average Leak Rate 8.70 14.59 13.90 13.90 13.90
90% Leak Rate 26.40 44.40 43.20 43.20 43.20
% of time above Leak Rate threshold 13.88% 26.61% 25.71% 25.71% 25.71%
Pressure Statistics
Average Pressure 5.93 5.25 5.24 5.24 5.24
Min Pressure 4.00 4.00 4.00 4.00 4.00
Max Pressure 11.52 11.52 11.52 11.52 11.52
90% Pressure 8.54 7.48 7.30 7.30 7.30
Average EPAP 5.93 5.25 5.24 5.24 5.24
Min EPAP 4.00 4.00 4.00 4.00 4.00
Max EPAP 11.52 11.52 11.52 11.52 11.52

many thanks for the support

[trish6hundred]

Hi harmony,
WELCOME! to the forum.!
Hang in there for more answers to your questions and much success to you as you continue your CPAP therapy.

[becker44a]

. . .
my new machine is a res med auto set EPR - doesnt say anything else - i used a fx mirage nasal mask for her
. . .
AHI 2.96 1.16 1.13 1.13 1.13
Obstructive Index 2.71 0.71 0.65 0.65 0.65
Hypopnea Index 0.08 0.21 0.21 0.21 0.21
Clear Airway Index 0.17 0.20 0.22 0.22 0.22
Leak Statistics
Average Leak Rate 8.70 14.59 13.90 13.90 13.90
90% Leak Rate 26.40 44.40 43.20 43.20 43.20
% of time above Leak Rate threshold 13.88% 26.61% 25.71% 25.71% 25.71%
Pressure Statistics
Average Pressure 5.93 5.25 5.24 5.24 5.24
Min Pressure 4.00 4.00 4.00 4.00 4.00
Max Pressure 11.52 11.52 11.52 11.52 11.52
90% Pressure 8.54 7.48 7.30 7.30 7.30
Average EPAP 5.93 5.25 5.24 5.24 5.24
Min EPAP 4.00 4.00 4.00 4.00 4.00
Max EPAP 11.52 11.52 11.52 11.52 11.52

Hi Harmony,
Welcome to the forum!!

A few observations from your data.

1) Your AHI numbers are great. Apnea is considered treated if the AHI number is below 5. The only question here is whether the numbers your machine is reporting are accurate, as the presence of large leaks will impact the machine's ability to treat apnea events, and to accurately report them.

2) Resmed machines report "unintentional" leak. Your mask is designed to leak or vent at a certain rate, so that you are not re-breathing your own CO2. This is referred to as "intentional" leak, and the Resmed machines subtract that venting, and only report leakage that is beyond the designed vent rate.

3) Resmed indicates that their machines can compensate for unintentional leak up to about 24 liters per minute. Your statistics are showing a significant amount of time above the level that the machines can handle. This is an important issue, and needs to be corrected before you pay too much attention to the other parts of the numbers.

4) It will help us to help you if you can correctly identify your machine. There should be a plate on the back or underneath that gives the Model number, if nothing else. Here is a link to an area of the forum that provides pictures to help identify Resmed equipment:
http://www.apneaboard.com/cpap-machine-p...ine-resmed

5) It will help us help you if you can be more specific in your profile. For example, provide your actual pressure range, not just "Auto".

As mentioned before, your AHI values are good. If they look similar after the leaks are controlled, your apnea can be considered well treated.

Good luck on your CPAP journey.

[vsheline]

AHI 2.96 1.16 1.13 1.13 1.13
Obstructive Index 2.71 0.71 0.65 0.65 0.65
Hypopnea Index 0.08 0.21 0.21 0.21 0.21
Clear Airway Index 0.17 0.20 0.22 0.22 0.22
Leak Statistics
Average Leak Rate 8.70 14.59 13.90 13.90 13.90
90% Leak Rate 26.40 44.40 43.20 43.20 43.20
% of time above Leak Rate threshold 13.88% 26.61% 25.71% 25.71% 25.71%
Pressure Statistics
Average Pressure 5.93 5.25 5.24 5.24 5.24
Min Pressure 4.00 4.00 4.00 4.00 4.00
Max Pressure 11.52 11.52 11.52 11.52 11.52
90% Pressure 8.54 7.48 7.30 7.30 7.30
Average EPAP 5.93 5.25 5.24 5.24 5.24
Min EPAP 4.00 4.00 4.00 4.00 4.00
Max EPAP 11.52 11.52 11.52 11.52 11.52

Hi harmony,

Your number of central apneas (Clear Airway, 0.17 per hour last night, 0.20 per hour within the last week) is very low and completely negligible. Nearly everyone gets a few, and sudden changes in Leak can fool the machine into thinking a central apnea is occurring when actually we are still breathing fine.

If the unintentional Leak gets higher than 30, your S9 AutoSet will give up trying to distinguish central versus obstructive and will mark all apneas as Unclassified Apnea (UA).

After the initial week of treatment, I think most people find a Min Pressure of 4 has become uncomfortable and prefer the Min Pressure to be higher than 4, because a higher Min Pressure makes it easier to breathe in.

Your Min Pressure (4) is probably lower than you need. Your measured pressure sometimes gets as high as 11.5, so I suggest a Min Pressure of 6, if comfortable. But I suggest not raising the Min Pressure faster than 1 cmH2O per night, so it doesn't feel like a big jump all at once.

What EPR setting are you using? EPR lowers the pressure while we are exhaling, but never lower than 4. So if you have EPR set to 3, while at a pressure of 7 or higher EPR will drop the pressure 3 cmH2O when we are exhaling, but when the pressure is lower than 7 EPR will drop the pressure to 4 while we are exhaling.

Take care,
--- Vaughn

[harmony]

thank you all for your replies and advice it is very helpful

in a few days i am learning more about sleep apnea than ever !

i have got my leak rate down a bit by moving my machine higher and also the bed head - if the leaks continue i will try and nag my sleep technician again about it but for now it seems better but its great that with sleepyhead i can check the data myself

so glad i found this forum

[Dawei]

In my view, Vsheline supplied some excellent analysis of your data and suggestion for minimum pressure increase and so did becker regarding mask leak rates.

David